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Despair can drive people to the most unspeakable acts. This was sadly apparent the weekend of Apr. 20-21 in Hong Kong, when the city witnessed one of its worst spates of suicide in recent memory. On Sunday, a 39-year-old woman killed herself, her 5-year-old son, and 7-year-old daughter. The three apparently suffocated to death after the mother burned charcoal, which emits carbon monoxide, inside their home in the working-class Tseung Kwan O district in the city's New Territories.
Tragically, that was also the method used the day before by a 42-year-old woman to kill herself and her 9-year-old son. Separately, a 34-year-old man also killed himself by burning charcoal in his apartment. The death toll from the weekend also included a 70-year-old man who jumped off a four-story building, a 22-year-old woman who jumped from the 14th floor, a 55-year-old woman who hanged herself, and a 21-year-old Canadian who died after jumping off the roof of a high-rise hotel on Hong Kong Island.
These are just the people who succeeded in killing themselves. Others tried. According to the South China Morning Post, the city's major English-language newspaper, a 22-year-old woman attempted to kill herself by burning charcoal in her apartment but failed after a friend discovered her.
AN OFFICIAL PROBLEM. The newspaper reports that the number of calls to Hong Kong's Suicide Prevention Services jumped 30% last year to a record 17,364. One reason cited is the flagging economy. And with the economic conditions having worsened since then -- the unemployment rate is a record 7% -- the statistics are likely to rise in 2002.
The number of cases in which parents kill their children and then themselves is now high enough that Hong Kong's police chief is speaking out about the problem. The death of the two children with their mother on Apr. 21 was the fifth suicide/murder this year involving parents and offspring, and Police Commissioner Tsang Yam-pui has joined a government committee looking into situation.
The elderly are most at risk. In late 1999, the Chinese University of Hong Kong published the results of a study showing that the suicide rate among the elderly in Hong Kong was two to three times higher than in the U.S., Britain, or Australia.
"ALARMING INCREASE." Those high suicide figures for the elderly aren't limited to Hong Kong. Radio Australia recently reported on a study that compared suicide rates of 40 countries. The results: The rate for the elderly -- people over 75 -- was highest in China. Radio Australia reported that "the study found that for every 100,000 people, about 140 people over the age of 75 commit suicide in rural China." In Australia, the number is just 32, and in South Korea, it's 34. Radio Australia also reported "an alarming increase in Hong Kong, Singapore, and the Philippines."
POOR RESULTS. Given such numbers, you might think that the demand for medicine to treat depression would be on the rise in Asia. That's what executives at Pfizer Pharmaceuticals Group thought in the mid-1990s, when the U.S. drugmaker launched a widespread campaign to increase sales of Zoloft in China.
Along with other antidepressants, such as Prozac and Paxil, Zoloft had become very popular in the U.S. So when Pfizer wanted to penetrate the Chinese market, with its billion-plus population and increasing affluence, it funded studies and launched an extensive advertising campaign to promote awareness of depression as an illness, treatable with medication.
IN DENIAL. The results were "very poor," says Pol Vandenbroucke, Pfizer's Hong Kong-based director of medical affairs in Asia. The number of prescriptions for antidepressant drugs was "very low," he says. The reason, he believes, is not that Chinese and other Asians are reluctant to resort to medicine. And it's not that Asians don't suffer from depression, as the dismal suicide statistics show. Says Vandenbroucke: "Incidences of depression in Asia are very similar [to those in the West]," he says.
The problem, Vandenbroucke says, is that too many people in Asia don't like to admit that depression is an illness. "There is a bias against recognizing depression," he sighs. "There's a very big cultural difference between the West and Asia, where depression is not very well recognized as an illness but seen as a weakness." The attitude, he says, far too often is to "suck it up, deal with it."
Of course, many people in the West also refuse to see depression as an illness. Some critics bemoan Americans' reliance on antidepressants, claiming that too many healthy people take Prozac, Paxil, Zoloft, and other drugs. Undoubtedly, some Americans shouldn't be taking these drugs, or don't need to be, or aren't helped by them.
HERBAL CURES. Antidepressants are no magic cure, since people in the U.S. still resort to suicide. And the drugs are controversial for various reasons, including studies showing that, in some cases, herbal cures such as St. John's wort or even placebo sugar pills work just as well.
It's all too clear, though, that many people in China, Hong Kong, and other parts of Asia need help and aren't getting it. Until the prevailing view of depression changes, Hong Kong and other cities in China could suffer many more tragic weekends.
Einhorn covers technology from Hong Kong for BusinessWeek. Follow his weekly Online Asia column, only on BusinessWeek Online Edited by Patricia O'Connell
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Copyright 2002, Bloomberg L.P.
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