Bongani Mayosi’s suicide: the latest marker of an intractable public health crisis

Bongani Mayosi

The suicide death of Professor Bongani Mayosi on July 27 – cardiologist, researcher and dean of the health sciences faculty at the University of Cape Town – was not simply a tragedy in the academia. It was the latest marker of an intractable South African public health crisis that has been unfolding in slow motion for a generation.

During the short time we both served as UCT Council members, I found his contributions on innovative ways of managing a transforming institution of higher learning insightful. I will always remember the smile on his face whenever I sought his ‘cardiologist approval’ for my wine-drinking habit, as I often explained the hardship caused to a rural man like myself by scarcity of sorghum beer in Cape Town.

He was a role-model academic and a loving parent who inspired many. I remember last December as I watched him during the health sciences faculty graduation ceremony at UCT switch roles from the official being the dean who read citations and called out names of graduating students to being a family man walking across the stage to congratulate Camagu Mayosi, who was also graduating in medicine. It was one of those unforgettable inspiring moments to see proud father-mother-daughter embracing on stage, sharing in the success of Camagu.  

The idea of suicide offends and disturbs so much we will do almost anything to defuse it of its power. In the South Africa it was illegal from 1886 until 1968. This legacy lives on as a ghost in the phrase “committed suicide”.

It is rarely possible to know exactly why someone takes his own life, and suicide generally has multiple causes. But the death of Mayosi has rattled the academic community. His death at age 51 occurred at a time when treatment for chronic depression and anxiety — often the precursors to suicide — has never been more available and more widespread.

Yet the South Africa’s Medical Research Council recent Burden of Disease study reported a steady and stubborn rise in the national suicide rate, up 25 percent since6,133 reported in 2012. The study used post-mortem data to calculate a more accurate estimate compared to Statistics South Africa’s recent Mortality and Causes of Death report estimated that just over 1000 deaths were due to self-harm, based on death certificates from the department of home affairs.

Deaths due to self-harm are nothing new. Sadly, this Mayosi’s death once more confirms what we know all along; that how we view and understand suicide is largely shaped by who we think is important. The narrative of suicide as the lost potential of a life yet to be lived is strong because it comforts us even as it fills us with sadness. With the horrible loss of young people, especially high school learners and university students, we are confident in our assertion that things could have been better if they had stayed around. With adults, including teachers and professors, we are less convinced. Young suicides are politically blameless in a way that adult ones are not.

At present, SA community (including UCT community) is uncomfortable with making the individual tragedies of suicide into a case for collective change. Considering suicide as a problem of the young allows us to tell ourselves a simplified story where despair is a passing personal crisis rather than an endemic condition. We want suicide to be related to naivety and immaturity and to excessive emotional acting out. We want those who die to be worthy and innocent victims, not imperfect, multifaceted beings negotiating complex personal, career, social, economic and political factors in a transforming and decolonising liberal white university.

Popular rhetoric is always looking for clean and simple stories in South African society. We want so much to focus on prevention in mental health that we can sometimes ignore the people who already have problems. Middle-aged people are wrestling with the same social and economic changes as young people, often in situations where there will be no grand change for the better in the future.

Every suicide, of a young or an older person, deserves sadness and reflection. Every year my collection of phone numbers that will never again be answered and Facebook pages that will never again be updated seems to grow as I lose friends to suicide. To address those things that are causing despair, dislocation and loss of hope among those most at risk of suicide requires policy change and more than a vague commitment to the happiness of all. To counter the despair, people need to know that there are tangible ways of turning things around.

In the South Africa’s academic environment it can be too easy to run out of options and choices; to find yourself in financial hardship or to feel unappreciated and betrayed by colleagues in your academic fraternity, or to feel like a burden for relying on ever-decreasing welfare benefits or the kindness of others. Maintaining relationships with others takes time and effort that precarious work, illness or changes in circumstances can erode. This is especially true to those who are widely seen as role-models and successful in their careers. We pressure people to turn their lives around while austerity has removed help that people might be relying on to actually achieve that turnaround. Changing harsh colonial-era policies that cause hopelessness seems too big a task for leaders.

So instead, we tie the tragedy of suicide to lost potential and in the process end up as a society caring about some suicides far more than others. South Africa can, as a result, feel like a country where there are no second chances – and middle age is where this really hits home. Placing all the emphasis on young people and suicide allows us to think in terms of the race yet to be run. To address those in middle age who are at risk of dying by suicide would require us to do something about the ways people like Bongani Mayosi feel they have already run their race, and lost.

Nkosikhulule Xhawulengweni Nyembezi is a researcher, policy analyst and a human rights activist based at UCT Law School