Twelve years ago, a woman in her forties walked into an agrovet shop in Nyahururu and bought two bottles containing 250 millilitres of Sencor herbicide each.
Receipt in hand, she walked into a chemist’s shop and purchased 40 Piriton tablets and then travelled 56km to her upcountry home. To protect her identity, we will call her Loice.
At 3pm, Loice got to her house, opened the front and back doors, downed the drugs and lit a fire to dispose of the bottles. Then she went to bed, pulled her blankets over her head and lay down to await her end.
Her twin children, then aged six, were still at school, and she knew that by the time their school bus dropped them off at home, she would be long gone. Hours later, she could still blink her eyes, and she wondered what was going on.
“I tried to get up to at least find out why I felt nothing but ended up vomiting everything raw. A neighbour’s dog that licked the vomit died a few days later,” Loice says.
“Miraculously, I did not get ill at all. In fact, I joined my colleagues the following day in setting mock exams. My attempt at ending my life had failed.”
“At the point of purchase, I knew two bottles of Sencor totalling 500ml ought to kill me the way it kills weeds. I bought Piriton thinking it would make me black out and lessen the pain of death. I also opened the doors so that whoever came in wouldn’t have to break them down,” she adds.
Suffering from a broken heart, she says that when she shared her story with her friends, one of them, a man, advised her in jest to purchase the same drugs again but dilute them in water to make them more effective.
Others, she says, were supportive. A friend who had once attempted to take her own life helped her the most in her journey to healing.
This attempt, she explains, was the first and only one. She has since healed, thanks to time.
Dr Gideon Kiprono, a medical officer at Olenguruone Sub-County Hospital, says he has treated people who have ingested pesticides. Many of them do well and are discharged, he says, and few die.
In Loice’s case, he says, there is no locally available data on Sencor poisoning, but judging from the amount of poison she ingested, chances are she would not have made it without intervention, because there are no antidotes for the ingested drugs.
“If taking one Piriton tablet is enough to make one drowsy, how about 40 tablets? She must have thrown up most of it, but again, the way the body deals with drugs varies from person to person,” Dr Kiprono explains.
“There are also drug-to-drug interactions. We cannot tell exactly what happened. This is an isolated case and no studies whatsoever have been done when the two are combined.”
On mental health, Dr Kiprono agrees that it is an issue of concern, and that around July this year, he reported four cases of attempted suicide in one week.
According to official statistics, the number of suicides increased to 1388 last year from 1176 in 2019.
In August, George Kinoti, the director of criminal investigations raised the alarm, saying that Kenya had recorded a high number of suicides never seen before, and called for urgent interventions.
A month later, Rashid Aman, chief administrative secretary in the Ministry of Health, revealed that four lives were lost daily at the peak of Covid-19 in 2020, while globally, one in every 100 deaths was linked to suicide.
He said that suicide is the fourth leading cause of death among 15-29-year-olds, with 703,000 people dying annually by suicide and more than half of them below age 50.
To tackle the problem, a bill to amend Cap 63 of the penal code that criminalises suicide and to ensure that victims get the necessary help in line with the Mental Health Act is before the Senate. Attempted suicide is a mental health issue that should not be subject to a criminal process, the bill proposes.
And now, different professionals are torn on whether the bill, if passed into law, will help reduce cases of attempted suicide.
Dr Kiprono, for example, is sceptical that it will work
“Not all cases of attempted suicide are because of poor mental health. For those who opened up to me, mostly it was because of conflict with either parents, siblings or spouses. You will realise that their intention is not to die per se but to scare people,” he says, adding that some of the patients made multiple attempts.
However, Beryl Otieno, a social worker who has worked with USAid since 2018, says the bill would help, as the concerned person will be empowered to overcome the challenges they face.
Based in Rarieda sub-county, she deals with orphans and vulnerable children, and she says that since 2018, she has dealt with 11 cases of teenagers attempting suicide.
“Most of them, especially orphans, try to take their own lives because they lack food, school fees and someone to care for them at home,” Ms Otieno explains.
“When they go to school, some challenges they face at home follow them, and they feel like they cannot go on, so they attempt to end their lives.”
She says that criminalising suicide is a feeble attempt to reduce cases, adding that even in prison, a person intent on killing themselves will still find a way of executing the plan.
“When a person kills themselves, it means they are unable to address the challenges they are facing, and are in urgent need of support, advice and counsel. How is putting them behind bars helping?” she asks.
Kipkorir Shadrack, a lawyer with Nation Media Group, explains that most countries have decriminalised suicide on the grounds of mental health as a right, and that sending attempters to prison undermines their dignity.
“The law exists to serve a purpose. The law against suicide as it was enacted was basically on two grounds that God is the giver of life and that it was not in the best interest of government to lose a life due to suicide, as it meant a reduction in taxes,” he says.
“Those two reasons no longer hold water, for we are a secular country where people have a right not to believe in God and not to approve of any administration that is in power.”
He explains that the rationale for the law on punishing attempted suicide in Kenya was borrowed from the United Kingdom in 1930 under the colonial regime.
It was criminal as it was viewed as a crime against God, the giver of life who could naturally also take life away. Thirty years later, in 1961, England decriminalised suicide, while Kenya continued to have it in its statue books.
This, Mr Kipkorir says, is a case of colonial yokes still hanging on our necks. He details that from a criminal-law perspective, the penalty was grounded on deterrence, but that there is no evidence that it indeed acts as a deterrent.
“Humans are wired towards self-preservation, so it is largely abnormal for a person to kill himself. Science has it that those who attempt suicide are suffering from mental distress,” he says.
“Consequently, their place should be mental treatment and not the prison walls. The crime of attempted suicide, in my view, is wanting constitutionally for its insensitivity to the right to mental health and dignity. The Penal Code (Amendment) Bill 2021 is therefore timely.”
Other countries that have decriminalised suicide include South Africa, Zambia, Botswana and Canada.
“More potently, there is an array of scientific evidence that talks about mental health as being the leading cause of suicide globally. In response to this, I believe, our Constitution provided for the right to attainable standards of health accessible to all,” Mr Kipkorir argues.
“So it is the duty of the State to attend to those who attempt to take their lives by providing medical care and not through the criminal justice system.”
Cleopa Njiru, a senior psychologist at Chiromo Hospital, says that the bill will set people free to seek medical attention for their mental distresses, and hence reduce cases of attempted suicide.
“One of the symptoms of someone who can possibly attempt suicide is if the person has attempted to before. They attempt because they are unwell, and the reason people who have attempted suicide do not seek attention from their support system and psychologists is that they fear being jailed,” Mr Njiru says.
He explains that decriminalising suicide will eliminate the stigma attached to people struggling with mental illness, and that more people will be aware of how to help them.
“When this is passed into a law, and a person within your circle attempts suicide, then people will readily take people with suicidal thoughts and victims of failed attempts to hospital to seek counselling services,” he adds.
Even the disciplined forces, he says, have adopted an ethical guideline similar to the bill, in that a person known to be capable of committing suicide is referred to a mental professional instead of being arraigned.
He attributes this to the awareness of mental health issues that officers are predisposed to because of the nature of their job.
“Awareness helps people understand that they need to refer someone with suicidal symptoms to a professional. Someone just mentioning that they will commit suicide is good enough to see a psychiatrist to see how serious they are about it,” he says.
“Some mention that in passing, some want attention but if they repeat this twice or thrice, and say it like they mean it, then they need to be assessed by an expert. This is because many people don’t get to that point of mentioning.”
He adds: “When we treat patients with mental illness, we cannot report them to the police, even if they say they have attempted suicide. However, sometimes a patient may decline to come out openly to say they have suicidal thoughts, and when we sense, through our expertise, that they or their loved ones are at risk, we involve a next of kin to offer them extra support.”
Mr Njiru explains that factors such as finances, relationship problems and medical conditions predispose people to depression, which has been cited as the leading contributor to suicidal thoughts.
Treatment begins with diagnosis, followed by medication. In some cases, a combination of medication and therapy is advised, and family and friends are asked to provide support.
More than 700,000 people die by suicide every year, translating to one person every 40 seconds, the World Health Organization says. For each suicide, there are more than 20 attempts.
“While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) is well established, many suicides happen impulsively in moments of crisis,” the WHO says.
“Further risk factors include experience of loss, loneliness, discrimination, a relationship break-up, financial problems, chronic pain and illness, violence, abuse, and conflict or other humanitarian emergencies. The strongest risk factor for suicide is a previous suicide attempt.”
The WHO’s Live Life approach recommends four key interventions to prevent potential suicide attempts. These include limiting access to the means of suicide, interacting with the media for responsible reporting of suicide and fostering socio-emotional life skills in adolescents.
The agency also recommends identifying people affected by suicidal behaviours, assessing, managing and following up on them.