Women and Suicide in Rural China: Suicide in China Accounts for about a Quarter of All Suicides Worldwide. in Contrast to Western Populations, in China More Women Than Men Kill Themselves. It Is a Gloomy Picture, but There Are Signs That the Situation May Be Improving
Weiyuan, Cui, Bulletin of the World Health Organization
In the days leading up to her suicide attempt, Zhang Xihuan was becoming more and more depressed. An attractive woman in her mid-40s, Zhang scrapes a living by farming a tiny plot of land in the village of South Sanguanmiao, in Shandong province, supplementing her income by picking up coal that falls off trucks from the nearby mines. Having hepatitis B, she had found herself isolated in her small community. A recent boundary dispute with neighbours, after she built a house for her 25-year-old son, was adding to her anxieties. "We had to borrow because we ran short of money," says Zhang. "Before that we spent about as much money to treat my liver problems and the debt added up."
Financial worries. Health worries. Social stress. Things came to a head on 11 May 2009. Zhang ate dinner at around 4 pm, went out for a walk and returned home just after 7 pm. What she did next, she did without any kind of plan or thought for the consequences. She was acting purely on impulse.
Suicide in China accounts for 26% of all suicides worldwide: It is the fifth leading cause of death in the country overall along with injuries, poisoning and falls, and it is the leading cause of death for young women in China. People are two to five times more likely to kill themselves in rural areas than in cities. In contrast to western populations, the suicide rate in China is higher among women than men and this was highlighted in a World Health Organization (WHO) report Women and health: today's evidence, tomorrow's agenda released last month. It is a gloomy picture, but impulse suicides --that is to say, spur-of-the-moment decisions in which mood meets means --among women in the area may be on the decline, according to a 2008 study carried out in Shandong province by Dr Su Zhonghua, vice-president of the Daizhuang Hospital, Jining Medical School in the province.
"My statistics are collected from emergency rooms of five county-level hospitals. This does not count as an epidemiological study, so it is hard to say precisely whether the number of suicide cases has increased or decreased," Su says. "But in our interviews with medical staff of these hospitals, all almost unanimously believe the number has decreased over the previous three years."
Not all suicides are impulse-driven. In China, as elsewhere, people with mental illness are more likely to attempt suicide than the rest of the population. The stigma attached to schizophrenia a severe mental disorder characterized by profound disruptions in perception and thinking, including delusions and hearing voices--can lead to isolation, as in the case of Dong Baoxin, a 30-year-old woman, whose mother (who also had schizophrenia) committed suicide the day after Dong got divorced. "She thought she had lost face," Dong says. "The next day, on 7 July, she hanged herself. When we saw her body in the morning, it was too late." Dong's husband divorced her because he was tired of paying her medical bills. After the divorce, he gained custody of their daughter and Dong went into hospital. "I miss my daughter. She is only five years old. Every day I wonder how she is." Dong's husband says it would be shameful if people knew about the child's "abnormal" mother.
In a study that included follow-up interviews, Su and his colleagues looked at 240 cases of attempted suicide in counties including Wenshang, Yanzhou and Jiaxiang in Shandong province. Su attributes the decline in part to improving social and economic conditions for women thanks to Chinas economic boom. "More and more [women] become migrant workers or make money on their own," says Su, noting that even women in economically dependent homemaking roles are becoming less confined as a result of changing social structures. He cites the departure of migrant workers from the area as an example. "The traditional tension within a rural family is alleviated as people of different generations no longer live together as long as they used to," he explains, adding that values too are changing. …