article

06.16.10

China's Female Suicide Mystery

Up to 60 percent of Chinese suicides could be caused by a toxic pesticide banned in many countries. Megan Shank on how rural women are paying the ultimate price.

In many rural Chinese homes, a jar of pesticide—often a variety banned in Western countries—sits in the family outhouse. Even after harvest, farmers are loathe to throw out the remainder. Despite Chinese President Hu Jintao’s promise to create a “harmonious society” by improving people’s livelihood and reducing the gap between wealthy cities and the impoverished countryside, surviving in China’s rural areas still requires thrift.

But the pesticide that ensures an abundant crop all too often reaps sorrow.

Chinese women pride themselves on their ability to “eat bitterness,” or put up with sadness and stress. But every woman has her breaking point.

Pesticide ingestion is involved in 60 percent of Chinese suicides, according to the World Health Organization, which published a 2009 report suggesting a link between exposure to organophosphate pesticides, the type commonly used in China, and suicidal thoughts.

Rural Chinese women—with their easy access to toxic pesticides, social isolation, and unique burden of feudal obligations and modern stresses—have been particularly susceptible.

A widely reported March 2002 study in the British medical journal The Lancet, by Michael Phillips, executive director of the WHO Suicide Prevention Center in Beijing, reported that from 1995 to 1999, suicide was the No. 1 cause of death for Chinese young adults aged 15 to 34. Rural suicide rates were three times higher than urban rates, and women had a 25 percent higher suicide rate than men—making China one of the few nations with that distinction.

Worldwide, female suicide attempts outnumber men’s three to one, but men have higher rates of suicide death. In China, though, women have experienced a higher rate of finished suicide attempts because they use a more effective method: pesticide. “In the West, you take a couple Valium, you get taken to the ER and washed out, and you go home,” Phillips told The Daily Beast. “In China, you take half a cup of pesticide and you’re dead two hours later.”

After the release of Phillips’ 2002 report, China’s atypical suicide gender gap garnered headlines around the world. The Western and Chinese media breathlessly spun the tale of Chinese college grads unable to find jobs and seeking solace in suicide—unsubstantiated press fodder, according to Phillips, since the real problem was the country’s poorest and most vulnerable women.

Chinese women pride themselves on their ability to “eat bitterness,” or put up with sadness and stress. But every woman has her breaking point. In the West, 90 percent of all suicidal behavior occurs in individuals with long-term mental illness. But 40 percent of Chinese suicide survivors thought about suicide for just five minutes before they acted; 60 percent considered it for less than two hours. And once the deed is done, many country doctors are ill-equipped to manage pesticide poisoning.

There’s evidence though, that China’s female suicide crisis is waning. A 2008 study by Phillips reported a 57 percent decline in Chinese suicides over the past two decades—largely due to decreased death among rural women. Experts attribute this change to a decrease in pesticide access. For years, the WHO has called on China to ban the most toxic pesticides. In 2008, the Ministry of Agriculture released new regulations on pesticides, including legislation to phase some out of use, though it is unclear how well this can be enforced. In the meantime, Phillips’ Beijing center has installed 10,000 lockboxes for pesticide storage in Shaanxi province in order to decrease access to the poisonous substance; a similar program in Sri Lanka has shown favorable preliminary results. And as more Chinese women abandon farm work for opportunities in the city, they are also further removed from pesticide’s deadly call.

Declining suicide rates among rural women are also likely the result of enhanced social networks and increased economic and social emancipation. Because suicide in China is the result of impulsive action rather than long-term depression, women’s health advocates emphasize that isolated women require social support, not just SSRIs. Traditionally, when a rural woman marries, she leaves her hometown, her family, and her friends to live with her husband’s family, which creates a gender imbalance and isolates the woman, says Xu Rong, head of the Suicide Prevention Project with the Beijing Cultural Development Center for Rural Women.

When a couple has problems, the husband’s family will usually take his side, even if he is abusing her, says Xie Lihua, founding editor of Rural Women magazine. Xie estimates more than 70 percent of rural suicidal behavior is the result of domestic strife. The notion that the home is an intensely private place prevents women from seeking outside help.

Women ingest pesticide in a moment of crisis because they have no emotional outlet or empathetic support, says Xu, whose organization set up support groups for rural women in northeastern China. In a moment of blinding rage over a cheating husband, a bad crop, or a critical mother-in-law, when a woman wants to end it all, having a place to talk over roiling emotions with other women and brainstorm positive problem-solving strategies can mean the difference between life and death.

China’s social and economic modernization have given rural women more access to education, technology, jobs, and divorce, but critics say national and local governments must be more pro-active in fighting suicide. China has failed to produce a national suicide prevention plan and local governments focus almost exclusively on GDP growth, says Zhang Chun, director of the Nanjing Psychological Crisis Center.

“When I was putting together the center in 2004, a local official warned me not to turn Nanjing into a tragic city because it would negatively impact the investment climate,” he recalls. Zhang estimates his center fields 2,700 crisis calls a year—80 percent are from women—yet he receives little government funding. “The government needs to pay more attention to people’s livelihood,” he says, “to allow people to live with dignity.”

Megan Shank is a freelance writer and Chinese-language translator whose work has appeared in Newsweek International, Ms., Archaeology, Global Journalist, and China Vitae. She is currently working on a book.