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Suicide is the leading cause of death among women of reproductive age (15-49), accounting for almost 16 percent of deaths in that age group. In the past 10 years there has been a significant change in the health and wellbeing of Nepalese women. According to a similar study in 1998, suicide then ranked as the third single cause of death.
When discussing deaths among women of reproductive age, maternal mortality usually gets the most attention. The majority of Nepalese women still give birth at home without support from trained healthcare workers, and social and economic conditions make proper prenatal and postnatal care a luxury.
Nepal ranks very high when it comes to maternal mortality. Thus it is surprising that in a 10-year period, suicide has overtaken maternal mortality as the leading cause of death for young women.
There is no one main cause for this shift. A complex mix of social, economic and political factors contributes to it. First of all, because of a national and international campaign to reduce maternal mortality, there is an increased awareness about the issue in the country.
Recently a local newspaper ran an article about how villagers in remote areas have banded together to care for expectant women and new mothers, sometimes without any help from government or agencies. Although investment in prenatal and antenatal care is still very low in Nepal, nevertheless there is a sense of urgency and necessity when it comes to saving mothers.
Suicide is a different matter, however.
In Nepal suicide is a deeply shameful matter. People consider it selfish and dishonorable. When a woman, whether single or married, commits suicide, it is even more shameful. A single woman's suicide prompts neighbors and community members to haunt the family with questions regarding her character. For a married woman, especially if she has children, suicide can forever brand her as a selfish person who didn't even think about her kids. The children suffer too, even when they reach adulthood.
The reason a woman is driven to kill herself is not considered important. But a person doesn't just get up and commit suicide; very often she is facing psychological, family or financial problems.
There is a deep stigma attached to mental illness. A limited awareness that being mentally ill does
not mean a person is mad or sinful has resulted in barely existent and severely underfunded psychological health facilities in Nepal.
I remember that once during my high school years I was very depressed and feeling hopeless because of my academic situation. I asked my mother if I could go see a counselor and she lectured me for hours on family honor – and my mother is a U.S.-educated professional with more than three decades of experience in development and activism. You can imagine how hard it must be for the average Nepalese woman with limited financial means to seek help.
Cultural norms also make it hard for a woman to discuss her family or financial problems. So the trap is set. The average Nepalese woman has a very tough life, filled with economic and social hardships and restricted by gender bias, limited opportunities and a lack of control over her life. To make it worse, she cannot ask for help or discuss her problems freely and openly. This makes life a pressure cooker. Sadly, some choose suicide over struggle.
It would be an understatement to say that in light of this study, Nepal needs to prioritize mental health for all and encourage counseling and services so that women and men have a way to deal with life's frustrations rather than giving up on life entirely. The country has been able to bring down its maternal mortality rate in spite of all the challenges; suicide must be handled with the same urgency.
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(Bhumika Ghimire is a freelance reporter. Her articles have been published at OhMyNews, NepalNews, Toward Freedom, Telegraph Nepal, Himal South Asian and ACM Ubiquity. She is also a regular contributor to News Front Weekly, in Kathmandu, and Nepal Abroad, in Washington D.C. She can be reached at bhumika_g@yahoo.com. ©Copyright Bhumika Ghimire.)
