With CIPRB staff, research assistants, and the staff of village NGO
In 1996-97, a national survey on injury-related deaths among women in Bangladesh found that suicides have a major effect on mortality among women, specifically, among married women aged 10-291. Similarly, the nationally representative Bangladesh Health and Injury Survey (BHIS) Report on Children2 also showed that suicide was the leading cause of death for older adolescents of both sexes, with the highest rate of 50 deaths per 100,000 population among 17 year-old girls. As a culture with a patriarchal social structure and deep-rooted gender inequality, general violence against women is common in Bangladesh3, between forty4 and 60 percent5 of married women report having experienced physical, verbal, or sexual abuse by their husbands. Because of the communal nature of life in Bangladesh, violence in the form of verbal or physical abuse from a woman’s parents, extended family, or even the community at large is also present and may contribute to a women’s decision to commit suicide. However, not enough is known about the causes and risk factors for domestic violence, mental health problems, and suicide in Bangladesh, so I designed a qualitative research project for my practicum and thesis with the goal of determining more exact risk factors and causal mechanisms for domestic violence and suicide among young women in rural and semi-rural Bangladesh. The primary objective of this study is to add to expanding research on suicide among women in Bangladesh with the goal of informing the development of effective intervention projects or programs in the future.
I worked with the Centre for Injury Prevention and Research, Bangladesh (CIPRB), a brand-new NGO in Dhaka, Bangladesh, for eight weeks during the summer of 2005. CIPRB is a partner of The Alliance for Safe Children (TASC) and recently completed work with UNICEF Bangladesh on the BHIS. CIPRB was enthusiastic about the project and agreed to facilitate the fieldwork; UNICEF Bangladesh also provided support.
After arriving in Dhaka, I spent the first few weeks at CIPRB meeting with local experts, revising the questionnaires, training my research assistants, organizing the fieldwork schedule, and worrying about the controversial nature of my topic. CIPRB recruited two excellent English-speaking Bangladeshi master’s students (one male and one female) to conduct the interviews and focus groups, as well as transcribe and translate the texts. We used the database of injury-related deaths that CIPRB had developed from their national study to locate suicide deaths among women in Dhaka Division (the large district of the country surrounding the capital city). Generally, all suicide cases that we investigated were within a 100-km radius of Dhaka and we did not interview anyone in Dhaka city because of potential cultural, educational, etc. differences between rural and urban Bangladeshis. Additional cases were identified in the field by community health workers during focus group discussions at district health centers.
We conducted 15 semi-structured in-depth interviews with families of women who had committed suicide. The interviews focused on: the events leading up to the suicide; the woman’s status within the household; whether violence was present; education; fertility; relationships with family members; and sources of emotional support. In some cases, neighbors were also present and added to the interview, often contradicting the families.
In order to understand community-level attitudes and practices regarding domestic violence and suicide, three focus group discussions were conducted. Two focus groups were conducted at district health centers with Ministry of Health and Family Welfare community health workers and one focus group was conducted at the home of a local NGO leader with an imam, teachers, and locally-elected representatives. Focus group participants were asked questions about community norms and perceptions regarding marriage, family life, violence, and suicide. Both focus group participants and in-depth interview informants were asked about how the community responds to suicides and what could be done to prevent suicides in the future.
Results show that the main risk factor for suicide among young women in Bangladesh may be their general low status in society and lack of decision-making power over their own lives. The immediate cause of suicide described by families varied in each case, but all were linked to patriarchal gender norms and the resulting inequality. Though some sort of violence was present in most young women’s lives, it appears that suicide among women in Bangladesh stems not only directly from domestic violence, but from the traditional social structure which denies women power and choice over the paths of their lives.
I am incredibly grateful to the following people and organizations for enabling me to have this amazing experience of conducting research in Bangladesh:
The O.C. Hubert Charitable Fund
RSPH GH Department Professors/Advisors Rob Stephenson, PhD and Roger Rochat, MD
CIPRB (Dr. AKM Fazlur Rahman, Dr. Aminur Rahman, Dr. Saidur Rahman Mashreky, Dr. Selim Mahmoud Chowdhury, Sekander Ali) and UNICEF (Shumona Shafinaz)
Dipty Sultana and Nazib Khan, my research assistants/translators/explainers of Bangladeshi culture
The families and community health workers who trusted us enough to speak with us about this very sensitive issue
Links for more information:
Centre for Injury Prevention and Research, Bangladesh (CIPRB): http://www.ciprb.org/
UNICEF Bangladesh: http://www.unicef.org/bangladesh/index.html
WHO Multi-country Study on Women’s Health and Domestic Violence against Women http://www.who.int/gender/violence/who_multicountry_study/en/index.html
WHO Global Report on Violence and Health: http://www.who.int/violence_injury_prevention/violence/
1.Yusuf, Hussain R.; Halida H. Akhter; Mahbub-E-Elahi K. Chowdhury; M. Hafizur Rahman; Roger W. Rochat. 2000. “Injury-related deaths among women aged 10-50 years in Bangladesh, 1996-97.” The Lancet 355: 1220-1224.
2. Rahman, Aminur; AKM Fazlur Rahman; Shumona Shafinaz; Michael Linnan. 2005. Bangladesh Health and Injury Survey Report on Children. MOH&FW, ICMH, UNICEF, TASC.
3. Ahmed, M. Kapil; Jeroen van Ginneken; Abdur Razzaque; Nurul Alam. 2004. “Violent Deaths Among Women of Reproductive Age in Rural Bangladesh.” Social Science & Medicine 59: 311-319.
4. Bates, Lisa M.; Sidney Ruth Schuler; Farzana Islam; Md. Khairul Islam. 2004. “Socioeconomic Factors and Processes Associated with Domestic Violence in Rural Bangladesh.” International Family Planning Perspectives 30(4): 190-199.
5. World Health Organization. 2005. “WHO Multi-country Study on Women’s Health and Domestic Violence against Women, Bangladesh Country Findings.” WHO, Department of Gender, Women, and Health.