Pakistan remains the singular country in the world where the incidence of suicide is persistently on the rise across all its provinces. Despite collective hopes that the ratio of suicide would decrease with the implementation of strict alternatives in Pakistan, reports indicate that, unfortunately, instead of mitigating these reports, the issue is soaring to new heights.
Additionally, it has become an indelible task among Pakistani people to attempt suicide. Suicide is not a recent issue in the country; rather, it is one of the oldest problems, with several people consistently finding themselves in the darkness of life. Despite suicide being one of the biggest sins in Islam, due to a lack of awareness and regulations, people in Pakistan often resort to desperate measures, such as binding themselves with a rope and attaching it to a fan.
The World Health Organisation estimates that 19,000 suicide cases occur every year in Pakistan, with evidence suggesting that the actual number could be significantly higher due to under-reporting. Previous research from South Asia demonstrates that 20-30 percent of deaths result from pesticide self-poisoning, a common problem among women and young people below the age of 30.
There is evidence indicating that most suicides in low and middle-income countries are of low intent. Young people often engage in self-harm after facing parental scolding, achieving lower marks, or being bullied by their peers. Instances of self-harm among women are often due to domestic violence issues. Restricting easy access to lethal means of suicide can prevent these low-intention cases.
Availability of lethal means
Research indicates that if a person has easy access to lethal means, such as toxic pesticides, the chances of attempting suicide and dying are much higher. However, if access to lethal means is restricted, there is a chance that survival can improve. Surviving an act of self-harm allows people to access services and support from within their community, reducing the likelihood of reattempting suicide. Hence, restricting access to lethal means is recognised as a cost-effective prevention strategy by the WHO. Therefore, the WHO, along with the United Nations Food and Agriculture Organisation (FAO), highly recommends banning highly hazardous pesticides.
Impact of pesticides as a means of suicide
Pesticide poisoning is the second most prevalent method of suicide in Pakistan and a major global health crisis, responsible for an estimated 150,000 deaths every year. The majority of these deaths occur in low and middle-income countries, where farmers often use easily accessible lethal pesticides. These pesticides are toxic, with some designated as highly hazardous. Pakistan, being mainly an agrarian nation with over 40% of the workforce employed in the agriculture sector, faces challenges as most farmers and agriculture workers use highly hazardous pesticides, often unaware of the dangerous risks.
Due to the absence of regulation and enforcement, these fatal pesticides are being sold in local shops in the country, kept in homes and fields, easily accessible to community members. Pesticide self-poisoning, being an impulsive act, is heightened by the easy availability of highly hazardous pesticides.
Examples from across Asia
Successful examples from other countries in South Asia, such as Sri Lanka, Bangladesh, and South Korea, show that carefully implemented bans on certain pesticides resulted in significant drops in annual suicide rates. Correctly banning these hazardous pesticides can decrease the ratio of suicide without leaving adverse impacts on agriculture, food production, and farmers' livelihoods.
Pakistan took a positive step in 2019 by imposing a ban on all WHO class s1 (hazardous) and class 1b (highly hazardous) pesticides, subject to the availability of alternatives. However, the effectiveness of these efforts would be bolstered with centralised data collection on suicides. Presently, there is insufficient information on the causes of death from pesticide poisoning and the specific pesticides responsible. Centralised data collection is crucial to understanding the scope of the issue and implementing targeted interventions.
It is hoped that if all acute pesticides are removed or prohibited in local shops or agriculture, the global pesticide rate will fall rapidly from 150,000 deaths in a year to less than 20,000. Therefore, the government should take proactive actions to prevent such hazardous pesticides in local shops and agriculture in the country.