18 Oct 2019

 

End Of Nightmare: Suicide Cases Reduce In Malakal PoC

"The PoC community discovered that enclosure in the camp was the main cause of suicide in addition to locally brewed alcohol and drug abuses."

By Jale Richard

MALAKAL/JUBA, 10 JUNE, 2019 [Gurtong]-For many living in Malakal Protection of Civilians site, 2017 and early 2018 were years of nightmares.

The PoC run by the United Nations Mission in South Sudan (UNMISS), is currently home to 29,190. It was created at the beginning of 2014 to temporarily protect thousands of civilians who had fled into the UN base from violence in the Upper Nile region at the peak of the South Sudan civil war.

Met with confinement and with the effects of the war still fresh in their minds, many could not cope with the situation in the UN camp.

They had lost everything left behind in their villages. They rely on food aid provided by the UN once a month. The overall allocation is just enough to keep a person alive and some sell a portion of what they have to buy other essential goods. Before the next ratio arrives, they already have nothing left to feed on.

The rainy season presents the most difficult time of the year. The clay soil turns thick enough to prevent people from moving. Many ease their movement with gumboots-without which they cannot virtually move in the mud.

Due to fear of being killed, many were limited in the fence of the UN protected camp. With limited job opportunities in the PoC, many were rendered jobless. They live on the hope that peace would return for them to get out from the camp to start new lives.

The difficult living conditions have had a profound effect on the mental health of those in Malakal PoC.

“2017 was the year of nightmares,” recalls Ms. Rachael Mayik Ayang, the Chairperson of the PoC Women Committee. “People could not spend a month without hearing cases of suicide. It was very serious. Many people were not rescued”.

According to the medical charity Medicines Sans Frontiers (MSF), providing medical care to the PoC population, there were 31 attempted and seven successful suicides in 2017.

At the end of the year, there was a spike of 10 attempted suicides in one month.

From January to October 2018, MSF’s Malakal mental health team supported roughly 30 new patients per month – one new case a day. Of those, half struggle with serious mental health conditions including attempted suicide. Depression and psychosomatic conditions constitute the main symptoms identified in Malakal.

Ms. Rachael said many of those who attempted or committed suicide were the youth who felt they had no hope for the future.

“It was very serious. You cannot go outside the fence because you could easily lose your life. Even women going to the forest that time, they used to go with escort from UNMISS soldiers to protect them because women were being raped and many negative things were happening,” she explained.
Causes of suicide

The women leader said young women abandoned by their husbands and young men who were not able to get jobs, “felt they had graduated but chances of getting employment were limited for them especially in the camp’s set up.”

The Secretary-General for Peace and Security Council in Malakal PoC, Orach Matjo noted that the nights of the conflict were bad to remember.

The common cause, according to Orach, is “When a person is locked up in a place where he cannot move and he has got problems to solve yet he cannot solve them.” He added, “Somebody sees himself that he has nothing to do and he is vulnerable, the only option is to commit suicide.”

The situation is however changing. The PoC population is aware of the dangers depression and mental disorder.

“I think personally the suicide cases have reduced. They got less. In 2018 there were no many cases like in 2017,” she said.

The women leader revealed that recently, two attempted suicide cases were reported but they were rescued.

Easing security situation:
After signing of the Revitalized Agreement on Resolution of Conflict in the Republic of South Sudan (R-ARCSS) last September, the security situation outside the PoC has improved.

“The situation is now better. People can move out of the PC, some people can go to Renk, Sudan, and carry on their businesses especially after the signing of the peace Agreement,” Ms. Rachael noted.

According to the women leader, if basic services were provided in the areas outside of the PoC, some people may voluntarily return to their homes.

“The issue now is the services themselves. Some of the homes are dismantled. We may need support in shelter, clean drinking water which they have got here (PoC) free, if they are provided, these are things that may encourage people to return to their homes,” explained Rachael.

Mr. Orach noted that suicide cases declined “due to the activities taking place in the PoC.
“For example people coming together to discuss issues they want to solve. It made things to become somehow good,” said Orach.

He noted that peace-building activities in the PoC were necessary for all the youth to enable them forget their situation.

One of the local organizations involved in helping the PoC community is Upper Nile Youth Development Association (UNYDA).

UNYDA organizes Sports for Peace Tournament in Malakal PoC every year with support from the Norwegian People’s Aid (NPA) to help youth unlearn violence and create an environment of interaction amongst the youth-most of who were idle.

“People come together and play together. This I think has helped in changing the mindset of the youth from what they had been experiencing,” said Ms. Rachael.

At the peak of the suicide cases, UNYDA mobilized the community leaders to discuss causes of suicide in order to respond to them.

The PoC community discovered that enclosure in the camp was the main cause of suicide in addition to locally brewed alcohol and drug abuses.

She said the views of the community were played on the local radio station and the agencies started working on the recommendations to resolve the causes.

“The activities being done by UNYDA are really good because they are uniting people and making people to forget all what had taken place and suicide cases are now disappearing because of these activities,” said Mr. Orach.

The World Health Organization (WHO) in 2017 said there is a significant proportion of the population affected by mental health conditions and less than 1% of those affected with common and severe mental disorders received the services they needed. Besides, South Sudan has a critical shortage of mental health workforce and has been unable to adequately meet the mental health needs.

Within the Ministry of Health establishment, there are only two psychiatrists, 20 community mental health workers, one psychiatric nurse and 30 psychologists serving a population of over 12 million people. This is equivalent to a ratio of 1 psychiatrist per 6 million, which is critically below the WHO recommended standard of at least 1 per 100, 000.

The Minister of Health, Dr. Riak Gai Kok, in January admitted mental health is a major concern as it intensifies reconstruction after five years of civil strife.

As part of the solutions, the country has now turned to India for its support to tackle mental health challenges. The first 120-bed ultra-modern psychiatric hospital is aimed at tackling a high mental health burden.

Dr. Kok said Indian offering to build the mental health facility came at the right time when South Sudan urgently needed assistance to strengthen the mental health sector.

“I believe this is a very big opportunity to help this country to transform its health sector. We have a serious challenge of addressing mental cases,” he said while meeting with the high-level delegation from India.

 

 Hope for peace
Mr. Orach is hopeful that with the signed Revitalized Agreement on Resolution of Conflict in the Republic of South Sudan (RARCSS), people could return to their homes to restart lives. He noted however, it depended on whether the peace agreement will be implemented as agreed on paper.

“People should be frank to each other in the implementation of the peace Agreement. If they are frank, the whole world would witness that South Sudanese are united and determined to make peace in their land and to develop their country because we cannot make any development if we are in disarray. We hope God will help those who are implementing the peace agreement to come to the reality,” Orach emphasized.

 

 

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