Kapok: Suicide in Macao

Émile Durkheim was the first academic to dedicate a whole book to suicide. In his seminal work, the French sociologist was able to distinguish between egoistic, altruistic, anomic and fatalistic forms of suicide, along a double axis of social integration and moral regulation. The book was published in 1897, and although it has been criticised, especially for its exclusive reliance on aggregated statistics, it still constitutes a reference and has helped design public policies to address what represents a crucial indicator of the soundness of an entire society. The plight of a few can lead to the destruction of the whole.

No wonder that the hanging suicide of a 16-year-old girl on May 2 triggered wide coverage in the Macao press and later made Secretary for Social Affairs Alexis Tam express his genuine grief, instructing the relevant administrations to fully investigate the case and provide counselling to those in need. His overall message to youth, despite the clumsiness of the wording “not to act silly”, was to exhort young people to “cherish life”. Having acted both swiftly and comprehensively, to Mr Tam’s credit Macao’s suicide rate has dropped significantly in the past few years, standing at 8.2 per 100,000 individuals in 2015 if only residents are included and at 9.6 if the whole population is taken into account. The world average was 10.7 the same year according to the WHO.

Back in 2008, I had the privilege of inviting to Macao Paul Yip Siu Fai, the director of the Hong Kong Centre for Suicide Research and Prevention who had just edited a book on Suicide in Asia. At the time, Prof. Yip had emphasised that Macao’s suicide rate for 2007 stood at 16 per 100,000 (a figure I was never able to reconstruct), higher than the world average of 15 and clearly higher than Hong Kong’s 13. He emphasised that one of the shortcomings was the lack of detailed statistics and in-depth research about the situation in our SAR. Nevertheless, something must have been done right regarding awareness, portraying suicide in the media, reducing access to lethal methods of self-harm, identifying potential cases, educating the young, addressing the problems of the survivors and putting in place suicide prevention programs.

Yet, providing statistics, the very first task towards adequate surveillance and monitoring, remains problematic.

Firstly, statistics about suicide in Macao are only released once a year on "World Suicide Prevention Day" on September 10 and somewhat overexposed on World Mental Health Day on October 10. Not only can it be deemed prejudicial — is suicide solely a mental illness? — it is also clearly not enough, with insufficient detail — age, sex, education, etc., are important elements – and not accessible to the wider public.

Then, turning to the statistics from the Health Bureau — available since 1996 — one notes many discrepancies: there are no statistics for suicide before 2001 and the method of counting drastically changed in 2007 and led to a (downward!) revision of the total numbers for 2004 and 2005. From 2007, the gender breakdown is no longer provided (men used to be the majority) and the rate per 100,000 disappeared from 2007 to 2013, resurfacing only in 2014. But even then, a rate of 7.8 for 2015 is given, whereas the Health Bureau made its communication on September 10, 2016 [corrected], based on 8.2: which one is right? What about the peaks of 2004 and 2011: any explanations?

According to Paul Pun, the head of Caritas, some 305 and 222 suicide-related phone calls were made to Caritas’ Life Line in 2015 and 2016, including respectively 4 and 8 when the act was about to happen. Women are the most at risk (respectively 179 and 136 cases). Now the Blue Whale Game is also menacing Macao and a collective suicide attempt was indeed prevented just last month…

Please Mr Tam, provide us with more and better statistics. 

Published in Macau Daily Times, May 26, 2017.

Kapok: The warning behind the praise

In the morning of May 9, while addressing a large audience supposedly representative of the Macao population, Chairman of the National People’s Congress Zhang Dejiang insisted on a task the government of the Macao SAR had to carry out: “Contradictions within the society never cease to exist; among poor people contradictions exist; among rich people contradictions exist; among majorities contradictions exist; among minorities contradictions exist; contradictions are to be found everywhere, regardless of time and place; what is crucial is how we correctly identify, get hold of and properly handle the issues, the difficulties and the contradictions.” In a sentence of only a few lines, “contradictions” — it has to be plural as there are many of them — appeared seven times!

For anybody slightly familiar with the history of Communism in China, the use of the word (maodun, 矛盾) rings a particular bell.

First, because it is markedly associated with Mao Zedong himself, who expanded on an original text from 1937 (“On Contradictions”) to develop his thinking in one of his most famous speeches entitled “On the correct handling of contradictions among the people,” delivered in February 1957. Given the comparisons that now exist between Mao and Xi Jinping, and that Zhang’s southern tour is perceived as a preparation for the one President Xi will embark on at the end of June, it is no overstretch to consider that Mr Zhang was actually uttering Mr Xi’s words.

Second, because in the 1957 harangue, Mao famously explained that “letting a hundred flowers blossom and a hundred schools of thought contend [was] the policy for promoting progress in the arts and sciences and a flourishing socialist culture.” It was a confirmation that criticisms were welcome, thus echoing the call for intellectual renaissance and freedom expressed by Guo Moruo, the intellectual from whom Mao had taken inspiration.

Third, because by drawing a line between what was termed “antagonistic contradictions” and “non-antagonistic contradictions”, Mao was indeed enriching the Leninist approach to class struggle, indicating that some contradictions — the ones that exist “within” — were acceptable, and even welcome as unavoidable, as long as they did not transform into contradictions “between” the people and what Mao called “the enemy”. As a first example of enemies, Mao mentioned “Japanese imperialists, their Chinese collaborators and the pro-Japanese elements”, which is rather ironic considering how some families in Macao started to build their fortune during World War II.

Of course, when it comes to the Hundred Flowers Campaign, one has to be extra careful: when Mao realised there were more than a few people expressing their discontent with the direction the Party was taking and that he was himself being targeted, contesters were rapidly hushed and soon persecuted. The tactic thus backfired, and the ones who suffered the most were those who had believed, reluctantly at first, the openness to be genuine. Yet, if Mao’s former physician Li Zhisui is to be trusted, it is only because the criticism became massive that the campaign turned tragically sour. Ultimately lingers the idea that some “contradictions” — political, economic and social — can become unacceptably unsettling if they are not handled properly.

Bearing in mind the context has changed, I cannot help thinking that the very fact only six “representatives” were able to openly express their opinions after Zhang Dejiang’s address serves as confirmation that behind the overall praise might lie a warning: if the contradictions were to become more antagonistic in nature, wouldn’t the Macao Chinese Chamber of Commerce (Kou Hoi In), the Federation of Trade Unions (Lei Cheng I), the Kaifong (Leong Heng Kao), the Women’s General Association (Wong Kit Cheng), the rising Fujian faction (Si Ka Lon) or Chui’s hench(wo)men (Eva Lou) be held responsible?

Let’s hope that these self-proclaimed “representatives” will not interpret the message as an invitation to tighten the screws: after all, the recent by-census indicates that about a quarter of Macao holds a tertiary degree… No more is ignorance bliss!

Published in Macau Daily Times, May 12, 2017