«Positioning for safety»: Attitudes and cultural responses toward suicide among the Baganda, Uganda

Abstract

Suicide is a public health problem all over the world. However, it has different meaning (s) in different societies. The general aim of this thesis was to gain an in-depth understanding of attitudes and cultural responses toward suicide among the Baganda of Uganda. Qualitative methods of social investigation were applied as the study topic was regarded exploratory. All data in this thesis were collected using Grounded Theory. Article one and four are based purely on Grounded Theory while article two and three were developed using a combination of Grounded Theory and Discourse Analysis. The cross cutting themes in the four papers are attitude formation and positioning. In all the four papers, there was a struggle by the individual or the community to occupy a safe position given the prevailing norms and beliefs in the study communities. These norms and beliefs largely influenced the attitude of the informants towards suicide.

Paper I is a methodical paper that focused on both ethical and practical challenges of conducting suicide research using qualitative methods in a low income country and we use Baganda, Uganda as a case study. In this paper, it is indicated that there was an external struggle by the informants to enter into a process of positioning as some of the data collection methods (Focus Group Discussions; FGD) were regarded as not sensitive (appropriate) to the culture and tradition of the Baganda. The Baganda do not discuss death openly in public. However, one of the data collection methods (FGD method) adopted in this study required such an engagement. This created culture tension among the informants. In addition, there were legal related fears since suicidal behavior is outlawed by the laws of the country (the Penal code, 1950). It therefore followed that both culture and some of the laws in the country created apprehension about participating in this project. Dealing with these two challenges depicts a protracted struggle of dealing with gate keepers at national (ethical boards) and community level (traditional leaders). This protracted process of securing ethical clearance from the ethical institutions and working closely with community leaders opened up doors to undertake this study.

Paper II reports on the internal dialogue between the individual and the community and how this influenced attitudes toward suicide among the Baganda. The key theme here is that there was always a struggle within the individual (who had his/her private views on suicide) and the communal view (public view) on suicide. In all the four discourses generated in this paper,informants were struggling to shelve off their private views (which were sympathetic to the suicide) and take on the community view that condemns suicide in all circumstances. In the urban study site, in a few instances informants were able to voice out their individual views and sustain them. This indicates a cultural orientation (urban culture) that respects individual rights.

Paper III deals with the religious views of the Baganda on suicide. The paper indicates that quite a number of the informants were struggling with the principle view of suicide as a phenomenon and the view on suicidal people. There was always an effort to contest the applicability of some of the religious doctrines and virtues on suicide in real life. The informants found some of the religious doctrines idealistic with limited application to some of the practical needs of the community members, especially those in situations that are associated with a lot of distress (for example due to poverty, long-term illness, loss of property, loss of a loved one among others).

Paper IV focuses on how Baganda deal with suicide cognitively and in practical terms. When a suicide occurs, Baganda struggle to enter into a positioning of safety by making an attempt to rewrite the history of the community. They do this through affect regulation by doing the following: no mourning of a suicide and burying a suicide immediately. They also struggle to rewrite the history of the community by securing future generation through practical steps such as: renaming children, performing traditional cleansing ceremonies, running away from the community (from the spirit), denying the suicide an heir among others.

The overall finding in this thesis is that suicide is largely unacceptable among the Baganda. Cultural norms, values and beliefs influenced the meaning of suicide in the study communities and these meaning systems in turn influenced the attitudes and cultural responses toward suicide. However, in a few locations (in the urban study site) due to globalization and westernization, a few of the study informants were able to hold accepting views on suicide. Though most informants depicted non-accepting attitudes towards suicide, alternative voices have started to emerge and this duality in the acceptability of suicide has implication for suicide prevention and management in the country. Suicide prevention programs in future should be designed in a manner that caters for this diversity.