According to Guyana’s Chief Medical Health Officer (CMO), Dr Shamdeo Persaud, the Ministry of Health will set up Poison Control Centers throughout the country to provide immediate, free and expert treatment, advice and assistance over the telephone in case of exposure to poisonous or hazardous substances. The CMO explained that the operations of such centers across the country can help curb the issue, or at least, reduce the amount of successful suicides by providing immediate life-saving information for suicide attempts.
However, The Caribbean Voice hopes that Dr. Persaud is aware that information by itself, is useless, unless it is acted upon. So we look forward to the unfolding of other measures aimed at ensuring that information disseminated by the Poison Control Centers is utilized to the fullest, that utilization is monitored, and that follow up is mandated. In this context we would like to point out again, that Shri Lanka’s Hazard Reduction Model relating to agro-chemicals, has proven to be highly successful in reducing suicide in that nation. In fact, the total number of suicides in Sri Lanka fell by 50% from 1996-2005 compared to 1986-1995 – a reduction of approximately 19,800 suicides, after this model was introduced. There is no such proven track record for Poison Control Centers.
The Shri Lankan model encompasses:
- Introducing a minimum agro-chemicals list restricting the use of pesticides to a smaller number of pesticides least dangerous to humans.
- Placing import restrictions to ensure that more dangerous chemicals do not enter the country.
- Restricting the availability of agro-chemicals by ensuring they are stored safely in locked boxes in rural households, along with all equipment with which these pesticides are used.
- Ensuring that empty containers are safely and effectively disposed of.
- Restricting sale of agro-chemicals only to licensed premises and to licensed farmers.
- Implementing administrative controls to ensure that sales outlets safely store all agro-chemicals.
- Implementing an ongoing safe use policy to educate people about safe handling, use, storage and disposal. Concurrently, for small-scale farming, non-chemical methods, including organic farming, should be encouraged.
- Improving medical management of pesticide poisoning: an important facet of control because better management will reduce the number of deaths. Requirements are the better availability of antidotes (both in central referral hospitals and ideally in peripheral health units) and ventilation facilities, better training, and better evidence for interventions.
- Constantly monitoring all measures to ensure ongoing conformity, including random home visits to check for locked box storage and field visits to ensure that only licensed premises and licensed farmers have access to chemicals and that safe handling, use, storage and disposal are in effect.
Given that in Guyana, the vast majority of suicides result from ingestion of agro-chemicals, it would seem logical for the Ministry of Health, in collaboration with the Ministry of Agriculture (and related other agencies), to implement (with necessary modifications) a suicide reduction model that has been tremendously successful, rather than a measure that is nebulous at best. Besides this innovation should cost less than poison control centers. The most difficult part would be regular enforcement but, given what is at stake, surely the resources should be employed accompanied by political will to ensure success.