Wednesday June 26 2013

Dealing with the surge in people jumping to their death

Mulago hospital has of recent become one of the

Mulago hospital has of recent become one of the places where people jump off the building in suicide attempts. PHOTO BY Stephen Otage 

By Abdulaziizi K. Tumusiime

The day was Sunday. The time was 12pm. Sulaiman Kasujja, a lorry driver on Ggaba Road, decided to end his life. He jumped off the sixth floor of Mulago hospital and died instantly. Back at his home, Sarah Nanfuka, his wife, thought that Kasujja was at work, because that is what he had told her. She realised otherwise when the police called and informed her that Kasujja had committed suicide at the hospital.

This year, Kasujja, was the first entry in the hospital records of people who have committed suicide from its buildings. Hardly 10 days after the first case, two more cases have been added to the list. Moses Mukwaya who was a malaria patient and Kenneth Muhumuza who was battling a heart disease also jumped to their death. Kampala is a city of many skyscrapers. Buildings that boast of more floors than the sheer six, that Mulago has. After appreciating this, the question that begs to be answered is; why do people prefer Mulago?

Enock Kusasira, the hospital’s public relations officer, says the nature of the services Mulago offers explains why people commit suicide there.

“This is a national referral hospital. We deal with the critically sick. Patients who are suffering from terminal illnesses like Cancer, HIV and Tuberculosis. Some patients come when their situation has degenerated from bad to worse. If it is a HIV positive patient, they may not have been taking ARVs. Or, they may not have been counselled on how to deal with the news that they are positive. When accepting reality becomes hard for such a patient, they find ending their lives the best solution. Unfortunately, they do it here,” says Kusasira.

He adds, “There are other people who come here with the sole purpose of completing their suicide mission. These people are not recorded anywhere as our patients. An example is Kasujja. Such individuals are psychologically traumatised. It could be because of indebtedness (it is alleged that the lorry driver was), poverty or unemployment. ”
I ask Kusasira why people like Kasujja do not opt to go to other building such as Kampala Sheraton or Crested Towers which have more floors than the hospital’s. He replies; “My assumption is that it makes a case to die at a hospital than anywhere else. And maybe, the deceased do not want to disturb their relatives with the posthumous handling since the hospital has the facilities to do so.”

Why choose Mulago?
But a one Husna Nakalema thinks there are bigger issues. On her facebook wall, she posted a comment: “We are beginning to see the secondary consequences of the mess at Mulago. So, when patients do not find drugs or are not attended to, they prefer dying at the hospital to reach out to the public that they have nowhere else to go since. Anyway, how about the administration putting burglar-proofs?”

When I share Nakalema’s suggestion with Kusasira, he informs me that it is not possible to put burglar proofs in the hospital’s windows or balconies. “I would like to challenge anyone out there to show me a hospital in Kampala that has burglar proofs on its windows or on their balconies. The hospital was constructed according to international standards. And burglar proofs are not mentioned anywhere in the standards. Doing that would not only frustrate the circulation of air, but it will also make it hard to evacuate equipment or patients in case of an emergency,” states Kusasira.

Nevertheless, he says the hospital has set up a committee, headed by senior psychiatrist Dr Margaret Mugherera, to study the situation and assess how the crisis can be averted. He further says the number of internal guards in the hospital has been increased. He states that these will be responsible for patrolling the hospital, and special attention will be put to critical areas which have been marked as black spots.
Kusasira adds, “We are also working hand in hand with faith-based organisations so that they can help us as far as counseling these patients are concerned.

“On the same note, we are calling upon the attendants to these patients to also be vigilant. They should keep a keen eye on them. What is paramount is for people to know that suicide is premeditated. One has made up their mind; therefore they are also on the look out for anyone who may stand in their way.

“We can only deal with this situation through a concerted effort,” states the public relations officer.Miriam Lawino, an architect working with the Ministry of Education, disagrees with Kusasira’s assertion that the reason why the hospital does not have burglar proofs is to cater for cases of emergency.

“That is wrong. If the hospital conforms to international standards of construction like he says, then it should have emergency exits to cater for emergencies. Is he trying to suggest that when there is an emergency, patients have to jump? If the reason is free circulation of air, that is right. Mulago is a hospital. It handles patients with all sorts of diseases such as air-borne diseases. Therefore, if free air circulation is frustrated then the risks of infection are increased,” says Lawino.

In the last two years, five people have committed suicide at Mulago. Whereas Mulago is dominating the news lately, a few years back, Workers House was in its shoes. Last year, one Juliet Nalugya, a 26-year-old graduate of Makerere University, jumped from the 14th floor and passed away. It is alleged that she was frustrated by the failure to find a job. In 2009, Musa Siraj, who was a supervisor at City Oil, also jumped from the 14th floor of the building.

Psychologist explains
Standing at the 14th floor of Workers House and staring at the ground is not an effort for the timid. That simply staring at the ground floor is scaring; one wonders where someone else gets the courage to look and then jump.

Paul Nyende, a psychologist at Makerere University, says it is the extent of the frustration and anger that tends to determine the method of suicide that one uses. “The more frustrated or the angrier one is, the more they are inclined to go for a violent approach. One who opts to jump off a building is usually one who is brimming with frustration and anger,” says Nyende.

Since July 2012, the management of Workers House was taken up by Knight Frank, a property consultancy company. An official working with the company who spoke to me on condition of anonymity, says that since taking over management, the company increased the number of guards in the building.

He added that the company plans to raise the level of the balconies. “Even access to the balconies is restricted. No member of the public can casually access them, it’s only tenants of the building that can. Unfortunately, we cannot put burglarproofs on the windows. It affects the air circulation in the building. Besides, the space in the windows is very small.

By the time one fixes oneself in it, to fall to their death, such a person is so determined in their mission that nothing can be done to stop them,” says the official.
The psychologist’s angle towards the solution is a unique one. He suggests that more effort should be put towards addressing the reasons why people commit suicide, than concetrating on the methods that people use to kill themselves.

“I am not suggesting that measures to stem people from jumping from buildings should not be undertaken. Though, I think most effort should be put towards helping people deal with stress in their lives. People should be helped in dealing with unemployment, poverty and drug abuse. I can guarantee that if this approach is used, suicide wes. People should be helped in dealing with unemployment, poverty and drug abuse. I can guarantee that if this approach is used, suicide will be “a tale of the past,” concludes Nyende.ill be “a tale of the past,” concludes Nyende.