(Deliberate self harm in Sri Lanka: an overlooked tragedy in the developing world)
Deliberate harm is common in the developing world, write Dr Michael Eddleston et al from universities in Oxford and Colombo, in this week's BMJ. They suggest that research to find ways to reduce deliberate self harm is just as urgently required as attempts to eradicate physical illnesses.
Sri Lanka has a high incidence of suicide with at least 40 suicides per 100,000 people each year, compared to 8 in the UK. Eddleston et al's research showed that most suicides (two thirds) are under the age of 30. For most of the youngsters deliberate harm seemed to be a means of dealing with a difficult situation and they did not really intend to kill themselves. The reasons for this high mortality in Sri Lanka is the high toxicity of the substances or poisons commonly used and the difficulties of treating them.
Self poisoning with agricultural pesticides or natural poisons, such as oleander seeds, is an important cause of death in many rural areas. The authors believe that medical management of acute self poisoning is currently poor and that the introduction of better management protocols would reduce mortality.
Contact:
Dr Michael Eddleston, Research Fellow, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford