Dance of Death in former Himalayan Kingdom

By Special Correspondent

About a crore people die due to suicide every year all over the world Which is the 4th leading cause of death. Seventy-seven per cent of global suicides occur in low- and middle-income coun- tries and India ranked 38 in the world. It is an irony that picture post card and most prosperous Himalayan state Sikkim reports highest suicide rate (42.5) which is nearly double than nearest ones like Chhattisgarh and Kerala. This is also way ahead of the national average of (10.6) and the glob- al average of 11.4. It is also quite sur- prising that with just people, Sikkim has about seven lakh population, Sikkim is India’s least populated state the smallest after Goa. It is one of the top richest states, by per capita income and its literacy rate is among the hig est. To contain the menace of suicide, World Suicide Prevention Day is observed every year this month (on 10th September) commemorating the awareness of suicide prevention. Suicide is a serious public health prob- lem; however, it is preventable with timely, evidence-based and often low- cost interventions. For national responses to be effective, a comprehen- sive multisectoral suicide prevention strategy    is    needed. Despite all-round progress, Sikkim’s suicide rate was 37.5 per one lakh peo- ple in 2015. But in contrast, Sikkim’s unemployment rate is also India’s sec- ond highest (after Tripura), more than three times the national average of 5%.

On top of this the state reports wide- spread drug abuse, a major cause of suicide. There are hundreds of injec- tion users registered by the National AIDS Control Organisation, but most drug users in Sikkim take the sub- stance orally. The government treats drug-addiction purely as a law-and- order problem, violating its own reha- bilitation laws in the process, there is, currently, no stemming the tide. But even this data is less than the actual fig- ures in the remote state. What is more disturbing is that at least seven of 10 teenagers in Sikkim abuse pharmaceu- tical drugs according to one report. Most alarmingly, the findings of this study offer insight into the crisis in Sikkim, where between 2006 and 2015, suicide was found to be most common in the 21-30 age group.

The high expec- tations and vulnerabilities of those born after the state’s merger with India in 1975 have resulted in them turning to drugs and suicide, said Kunal Kishore, a United Nations Office on Drugs and Crime (UNODC) official. “Sikkim opened up recently to the out- side world, but it has focused on speedy economic development at the cost of its people,”    he    said. “The state has neglected social aspects in the process.” Family problems, unemployment, alcohol abuse, mental illness, and extra-marital affairs are found to be common causes of self- destruction in the former Himalayan Kingdom. Sadly, Sikkim’s progressive outlook on social and civic reforms does not extend to dealing with drug abuse. It treats the problem purely as a law-and-order    issue. The Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985, crimi- nalises drug use, but a 2014 amend- ment provides for pharmacological options for treatment of drug depend- ence.

A distinction is now also made between users, peddlers and smugglers and punishment depends on the type and quantity of drug seized. The NDPS Act allows for states to have their own drug policy. Sikkim was amongst the first states to draft a drug policy but its act, the Sikkim Anti-Drugs Act (SADA), 2006, makes no distinction between drug users and peddlers. It criminalis- es drug use, imprisons addicts for small crimes but offers little help in rehabilitation or recovery. The state’s public health system too is indifferent to the health issues faced by drug users. The state has a 24 X 7 help line for per- sons under distress. Started in 2015, the helpline receiving calls from drug users is rare.

Callers usually have marital or rela- tionship problems, chronic illness, or are troubled by unemployment. In most instances drug overdose deaths are not accidental but cases of suicide. Receiving calls from drug users is rare because of stigma and lack of aware- ness. According to one United Nations Office on Drugs and Crime study about 9.8% women in Sikkim (of 150 participants) were injecting drug users. It includes the pathetic case study of a 32-year-old drug user who was made to forcibly have sexual intercourse with strangers for money by her husband. Fear of dis- crimination and stigma kept her from seeking   help   from    the    police. She was depressed and suicidal, and said there were many others like her. Most female drug users are either divorced or in troubled marriages, according to the study.

There are rehabilitation centres in Sikkim for women. But many who get dropped off at the centres by husbands or families are never taken back by them and fall back to drugs. Incidentally, a fifth of the world’s sui- cides were also related to unemploy- ment, and suicides increased nine-fold after the global economic crisis in 2008, according to this 2015 study. The same was found during the COVID 19 pandemic and long lockdown that followed. The link between unemploy- ment and suicides in Sikkim appears strong. More than 27% of those who committed suicide in Sikkim in 2014 (67 of 244 suicides) were unemployed, according to 2014 National Crime Records Bureau data.