Published in Living Well Magazine

February 2009

AMMAN-Mohammad Abdul-Nabi, 23, was found hung in his home by his 14-year-old brother. The young farmer was rushed to the hospital but was pronounced dead upon arrival. He decided to end his life because of a second failed marriage, explain his relatives. His story, like others similar to it, is shrouded in mystery and recorded only in snippets. And just like their short interrupted lives, information regarding suicide victims’ acts and their aftermath is scarce in Jordan. Like so many families who prefer to deny or forget the past, a person who knows a person tells a story of pain.

“When it comes to suicide cases in Jordan, we only get a glimpse, like a car whooshing by,” says Fayez Al-Fayez, Editor in Chief of Arabiya magazine and a popular social columnist. “We end up never knowing the reasons, we end up never knowing the whole story and no one wants to talk about it either.” Every year, one million people worldwide die by suicide, according to World Health Organization (WHO) statistics. Moreover, in the past 45 years suicide rates increased by 60 percent and is now among the three leading causes of death among those aged 15-44 years. These figures do not include attempted suicide, which are up to 20 times more frequent than suicide.

WHO statistics reveal that suicide in Jordan and in the region remain low, but in-depth research remains inadequate. “Statistically suicide is not considered an epidemic problem in Jordan,” explains Hani Jahshan, a Forensic Pathologist. There are 35 to 40 cases of suicide in Jordan every year, and the age range is between 20-25, according to the National Center for Forensic Medicine. However, attempted suicide cases are not recorded, says Jahshan. “Research is lacking in this field, especially in terms of attempted suicide.” Emergency services in hospitals are not keeping records of suicide attempts, adds Jahshan.

Sultan, 39, stole a knife from a shop in Amman and stabbed himself in the stomach. Witnesses say the man was “desperate”. He did not die. He was taken to hospital where reports suggest he is in ‘critical’ condition. Just a few hours before he stabbed himself, family members saved Sultan. They found him wearing a noose around his neck. Suicide is ultimately an individual and often a private act. Biological, genetic, psychological, social and cultural factors may impact the risk of suicide in an individual. Domestic violence, for example, can trigger a suicide attempt. “Psychological abuse can take on different forms including humiliation, threats of divorce, blackmailing and physical abuse,” explains Walid Sarhan, a psychiatrist. “The psychological consequences will include anxiety, frustration, low self-esteem and suicidal attempts.” Other risk factors can include serious mental illness, alcohol and drug abuse, childhood abuse, loss of a loved one and unemployment. “There is a lack of awareness about suicide,” admits Mohammad Khateeb, Police Security Department Spokesperson. “The truth is we still live in a tribal and conservative society that would rather not speak of suicide, which is forbidden in religion and brings shame to the family.”

Another short news piece on suicide was published in Ammonews, a popular electronic news website. A 20-year-old woman jumped from the top of the fifth circle tunnel, according to traffic police and witnesses. The woman whose ‘love affair’ failed recently, prompted her to attempt suicide, reports suggest. She was still alive when she was rushed to hospital and an investigation took place.

Individual cases of suicide in Jordan that were published in the media—overwhelmingly in electronic media–illustrate that shame, economic hardship, examination failure, unrequited love, family’s objection to a marriage and other family disputes were the greatest risk factors. One of the only in-depth documents that shed light on suicide in Jordan is a 2001 dissertation entitled, A Sociological View of Suicide in Jordan written by Ismeel Aqili, a former graduate student at the University of Jordan. Based on cases he examined from 1982-1999, his study reveals more males than females commit suicide but more females attempt suicide. University graduates between the ages of 18 to 37 were more likely to commit suicide in Jordan. Most of the individuals who committed suicide in this age range were unemployed.

Police were able to convince a 17-year-old from jumping off a telecommunication building in Zarqa, reported Ammon. The young man found out he failed the Tawjahi exam. Witnesses and friends said the young man was afraid he would be punished severely by his family for failing the exam. “At the end of the day, I worry about our youth because I don’t believe they want to commit suicide. It is often a cry for help” says Haifa Abu Ghazaleh, Senator and Secretary General of the National Council for Family Affairs. “If they fail the Tawjahi [high school exam] for example, they may fear the family’s reaction.”

People at risk of suicide can be treated. Oftentimes, it is due to the inability to cope as a result of an event or series of events that the person finds overwhelmingly traumatic or distressing. Psychotherapy and continued contact with a health provider can decrease the risk of suicide. Programs that address risk and protective measures are effective. Moreover, suicide has a profound effect on family, friends, and those associated with the victim. “I reported on a story of a mentally ill woman whose husband eventually divorced her,” explains Al-Fayez. One day her parents and daughter found her on the roof of their house, says Al-Fayez. She poured gasoline on herself very calmly and she lit herself on fire. She didn’t die. The victim was rushed to the hospital and died two days later. “What I saw is the effect it had on the family, the devastation,” he adds. “The siblings and her daughter were devastated.” While those who are under the age of 18 and attempt suicide have access to rehabilitation programs from the Family Protection Department, those who are over 18 have no institutional support, according to Khateeb.

In Jordanian society, there is a great deal of social and religious stigma surrounding mental illness. Islam views suicide as a sin. The prohibition of suicide has also been recorded: “He who commits suicide by throttling shall keep on throttling himself in the Hell-fire, and he who commits suicide by stabbing himself, he shall keep stabbing himself in the Hell-fire.” In the sixth century, suicide became a Christian religious sin and secular crime. In 533, those who committed suicide while accused of a crime were denied a Christian burial.

Talking about feelings surrounding suicide promotes understanding and can greatly reduce the immediate distress of a suicidal person. “Is suicide a really big problem in Jordan? Are the numbers alarming? The answer is no,” says Khateeb, “However, I understand the concern among individuals and members of society at large regarding individuals who attempt suicide, where can they turn to for help?”

People who feel suicidal may fear expressing themselves, and may be reluctant to reach out for help. “The stigma of psychiatric illnesses is still very prevalent,” explains Sarhan. “A women, for example, who dares to consult with a psychiatrist could face the threat of divorce and deprivation from her children, although it is not legal, but women believe that.”

People often deal with stressful or traumatic events and experiences reasonably well, but sometimes an accumulation of such events, over an extended period, can push normal coping strategies to the limit.  Jahshan, like many others working with victims of violence and abuse, says that Jordan continues to lack skilled professionals in this field. “Those who provide counseling to victims of violence and abuse should consider cases of attempted suicide and provide them services as well,” says Abu Ghazaleh. “At the end of the day everyone has a role to play including all sectors of civil society.”

Jordan could go a long way by reducing the suicide rate by discussing ways to decrease suicidal tendencies. Providing protection programs is important. Shedding light on the issue can even prevent suicide cases. “Protection programs begin in our schools. There needs to be awareness campaigns, group therapy and individual counseling in schools,” says Abu Ghazaleh. “I believe there should be a more clear strategy on how to tackle this issue from different angles and address it in schools,” explains Abu Ghazaleh.

When forensic experts, doctors and members of various organizations wanted to begin combating family violence in Jordan, they turned to the media. In 2004, two forensic doctors presented statistics showing a dramatic increase in the number of abused children. “If this issue is not covered enough by the media, the children will not know there are people who are here to help them, and places they can turn to for help,” said Rabab al Qubaj, a specialist in the Jordan River Foundation. During that time, journalists present at the workshop asked members of organizations and others to play a role in giving them easier access to information. The journalists also pointed out hidden fears, about raising such taboo and sensitive issues, fearing repercussions.

Today, electronic media news websites such as Ammon (www.ammonnews.net) and Saraya (www.sarayanews.com) have taken a lead in shedding light on suicide in Jordan. Although suicide news segments in both news agencies are not covered in-depth, they do report individual cases. Ammon publishes statistics on the number of suicide cases per year in Jordan. They examine the reasons for each case, although there is little follow-up on the cases. Print and broadcast media in Jordan lags behind in both reporting and shedding light on suicide in Jordan. “Electronic media in Jordan is lifting the lid on many issues like suicide, and domestic violence,” explains Rana Sabbagh, a journalist and media expert.

In February 2004, the first ever conference on child abuse in the Middle East took place in Amman. Representatives from across the world, local government and NGO’s took part. Dozens of media outlets from the Arab world were present. During the conference Jahshan attributed the increase in the number of reported child abuse cases in Jordan to the increased coverage of the issue in the local press.

This successful and ongoing campaign to combat child abuse in Jordan can also be implemented to debunk misconceptions and reduce suicide rates in Jordan. “The more we deny as a society that there are cases of suicide in Jordan, the more we’ll have to look within and say, how could we not help these individuals from killing themselves?” says Al-Fayez. “That is shameful.”

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