Rising suicide rate rings alarm bells in Tunisia
TUNIS - Six years since a young Tunisian stallholder set himself on fire, triggering revolutions across the Arab world, his country's suicide rate is surging over economic and social woes, experts say.
Mohamed Bouazizi, who self-immolated on December 17, 2010 in protest at unemployment and police harassment and died a month later, was among hundreds of Tunisians who have killed themselves in recent years.
The rising suicide rate "had already been noticed... over a decade ago", Fatma Charfi, a child psychiatrist and head of the Committee for the Prevention of Suicide, said.
Last year, authorities recorded 365 suicides in a population of 11 million -- around 3.27 per 100,000 people.
While that rate is low compared to other countries, the data is likely skewed by social and religious taboos, meaning the real figure may be much higher.
The toll is particularly high among the young -- around half the victims were aged between 20 and 39.
Charfi said the continuous rise in recorded suicides was "a very serious matter".
The committee she heads was set up in 2015 in response to warnings from experts that suicides were on the rise.
It has been charged by the health ministry with collecting better data and creating a national strategy to tackle the problem.
Tunisia does not yet have a national suicide register.
Under the regime of former dictator Zine El Abidine Ben Ali, who was toppled in 2011 following mass protests sparked by Bouazizi's suicide, the data was incomplete, experts said.
"There was this complex: 'We don't have suicides, we don't have violence'," Abdessattar Sahbani of the Tunisian Forum for Economic and Political Rights (FTDES) said.
But Charfi said comparisons of forensic data from 1990, 2000 and 2010 showed a clear rise.
After Bouazizi's death, self-immolation became the second-most common method of suicide in Tunisia (15 percent of cases) after hanging (60 percent).
Between January and June 2011, several dozen Tunisians set themselves on fire in suicide attempts -- a phenomenon that continues today.
"It was expected that in 2015, we would start to experience a decline (in self-immolations), but it has remained stable since 2011," Charfi said.
Suicides usually have multiple causes, often including depression and other mental illnesses.
But Tunisia's economic woes and high unemployment also appear to be key factors.
"It's definitely linked... the result of an absence of hope," said Sahbani.
Tunisia's economy has struggled to recover since the revolution. Authorities have failed to resolve the poverty, unemployment and corruption that were rife under the Ben Ali regime.
The all-important tourism sector was devastated by a series of jihadist attacks in 2015 that left dozens of foreign tourists dead and slashed visitor numbers.
Some 15 percent of the workforce was unemployed in the second quarter of 2016, according to the National Statistics Institute.
A 2014 World Bank report said joblessness was as high as 30 percent in Tunisia's impoverished interior, which has been the heart of a simmering jihadist insurgency since 2011.
Forensic scientist Mehdi Ben Khelil of the Charles-Nicolle Hospital in Tunis is co-author of a study on the revolution's impact on suicide.
He said he found an increase in suicides between 2011 and 2012, then a small reduction before a second peak in 2014.
He linked the second rise to the country's difficult political transition and the impact of the economic crisis on individuals.
"There are more people without jobs (and) with financial problems," he said.
Historically taboo, suicide has received growing coverage in the Tunisian media. But that itself has its dangers, say experts.
"We are talking about suicide in Tunisia but mostly in an inappropriate way," Ourida Boussada, a lecturer at IPSI, the country's oldest journalism school, said at a recent seminar.
Boussada said too much coverage was sensationalist and revealed intimate details about the victim's life.
IPSI is working with the journalists' union and HAICA, the body responsible for broadcasting, to improve reporting on the issue.
"We must tackle suicide... as a public health problem, not isolating it to a single cause," she said, "so that vulnerable people will not be tempted to take the same course of action."