Suicide shows we’re a nation in crisis
THE suicide death of Professor Bongani Mayosi, cardiologist, researcher and dean of the health sciences faculty at the University of Cape Town (UCT), on July 27 was not simply a tragedy for academia – it was the latest marker of an intractable South African public health crisis that has been unfolding in slow motion for a generation.
During the short time we both served as UCT council members, I found his contributions on innovative ways of managing a transforming institution of higher learning insightful. I will always remember the smile on his face whenever I sought his approval as a cardiologist for my wine-drinking habit, as I often explained the hardship caused to a rural man like myself by scarcity of sorghum beer in Cape Town.
He was an academic role model and a loving parent who inspired many. I remember him during the health sciences faculty graduation ceremony at UCT in December switch roles from the official dean who read citations and called out names of graduating students to a family man walking across the stage to congratulate Camagu Mayosi, who was also graduating in medicine. It was one of those unforgettable inspiring moments to see a proud father, mother and daughter embrace on stage, sharing in the success of Camagu.
The idea of suicide offends and disturbs so much that we will do almost anything to defuse it of its power. In South Africa it was illegal from 1886 until 1968. This legacy lives on as a ghost in the phrase “committed suicide”.
It is rarely possible to know exactly why someone takes his own life, and suicide is the result of multiple causes.
But Mayosi’s death has rattled the academic community. At the age of 51 it came at a time when treatment for chronic depression and anxiety, often the precursors to suicide, has never been more available and widespread.
Yet the South African Medical Research Council’s recent Burden of Disease study reported a steady and stubborn rise in the national suicide rate, up 25% since 6 133 were reported in 2012. The study used post-mortem data to calculate a more accurate estimate compared to Statistics SA’s recent Mortality and Causes of Death report estimated that just over 1 000 deaths were due to self-harm, based on death certificates from the Department of Home Affairs.
Deaths due to self-harm are nothing new. Sadly, Mayosi’s death once more confirmed what we have known all along: that how we view and understand suicide is largely shaped by who we think is important.
The narrative of suicide as the lost potential of a life yet to be lived is strong because it comforts us even as it fills us with sadness. With the horrible loss of young people, especially high school learners and university students, we are confident in our assertion that things could have been better if they had stayed around. With adults, including teachers and professors, we are less convinced. Young suicides are politically blameless in a way that adult ones are not.
At present, the community (including the UCT community) is uncomfortable with making individual suicides into a case for collective change. Considering suicide as a problem of the young allows us to tell ourselves a simplified story where despair is a passing personal crisis rather than an endemic condition. We want suicide to be related to naivety and immaturity and to excessive emotional acting out. We want those who die to be worthy and innocent victims, not imperfect, multifaceted beings negotiating complex personal, career, social, economic and political factors in a transforming and decolonising liberal white university.
Popular rhetoric is always looking for clean and simple stories in South African society. We want so much to focus on prevention in mental health that we can sometimes ignore the people who already have problems. Middle-aged people are wrestling with the same social and economic changes as young people, often in situations where there will be no grand change for the better in the future.
Every suicide, of a young or an older person, deserves sadness and reflection. Every year my collection of phone numbers that will never again be answered and Facebook pages that will never again be updated seems to grow as I lose friends to suicide. To address the causes of despair, dislocation and loss of hope among those most at risk requires policy change and more than a vague commitment to the happiness of all. To counter the despair, people need to know that there are tangible ways of turning things around.
In South Africa’s academic environment it can be too easy to run out of options and choices; to find yourself in financial hardship or to feel unappreciated and betrayed by colleagues in your academic fraternity, or to feel like a burden for relying on ever-decreasing welfare benefits or the kindness of others. Maintaining relationships with others takes time and effort that precarious work, illness or changes in circumstances can erode. This is especially true to those who are widely seen as role models and successful in their careers. We pressure people to turn their lives around while the help that people might be relying on to achieve this has been removed. Changing harsh colonial-era policies that cause hopelessness seems too big a task for leaders.
Instead, we tie the tragedy of suicide to lost potential and in the process end up as a society caring about some suicides more than others. South Africa can, as a result, feel like a country where there are no second chances, and middle age is where this really hits home. Placing all the emphasis on young people and suicide allows us to think in terms of the race yet to be run.
To address the suicide risk for the middle-aged would require us to do something about people such as Mayosi, who may feel they have already run their race, and lost.
Nyembezi is a researcher, policy analyst and a human rights activist at UCT Law School, board chairperson of the Election Monitoring Network, and co-chairperson of the Elections 2019 national co-ordinating forum