Within the reach of our arms*

Good afternoon, everyone.

This is a literature class, which is to say that we are primarily concerned with literary texts, but I have always tried, to one degree or another, to situate our discussions squarely within the so-called real world—to underscore that, the “talismanic world” of the work of art, to borrow a phrase from the poet Marjorie Evasco, is not a self-contained space detached from, and therefore irrelevant to, our daily lived experience. Whether I have been successful is a matter of debate, of course, though my hope that I have been so, however marginally, springs eternal.

By now, I am sure that you have heard about the tragedy that took place last 15 March 2013, Friday: 16-year-old Kristel Pilar Mariz Tejada, a first-year student at the University of the Philippines (UP) Manila, apparently took her own life by ingesting silver nitrate, a toxic, corrosive substance. Unable to pay the tuition fees for her education, Kristel had had to take a forced leave of absence in observance of UP Manila regulations, and this has been identified as the event that likely triggered her suicide.

Perhaps the only authority on the motives behind such a deadly decision by Kristel is Kristel herself, but we can be certain that her passing, far from a painless one, should never have happened.

As we are not members of the UP Manila community, or indeed of the UP system, there would appear to be no reason at all for us to contemplate her suicide beyond the performance of the obligatory tongue-clucking and head-shaking that the daily pornographic coverage of hardships, misfortunes, and disasters has tended to reduce us to—a performance that we have probably already rehearsed a number of times over before moving on to other matters. “What,” you may ask, “does Kristel or her death, heart-breaking as it is, have to do with me?”

What, indeed?

One aspect of Kristel’s death that has so far not received much serious scrutiny is the possibility that she might have been afflicted with clinical depression. Depressed people are not always suicidal, but depression is definitely a significant risk factor for suicide, which should be understood as a fraught phenomenon that cannot be shrunk down to a single cause.

We have abused the term unto meaninglessness, but depression is not just about being melodramatic or “emo”—it is a serious issue that requires professional attention and care. We may be more used to asking for intervention only for physical illnesses, but we must remember that we are not our bodies alone: our minds need nurturance as well, and as embarrassing or as distasteful as it seems to us, there should be no shame in acknowledging that we need the support and the expertise of others when our mental health is compromised.

Depression is defined by the World Health Organization (WHO) as follows:

Depression is a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration.

Depression can be long-lasting or recurrent, substantially impairing an individual’s ability to function at work or school or cope with daily life. At its most severe, depression can lead to suicide. When mild, people can be treated without medicines but when depression is moderate or severe they may need medication and professional talking treatments.

Depression is a disorder that can be reliably diagnosed and treated by non-specialists as part of primary health care. Specialist care is needed for a small proportion of individuals with complicated depression or those who do not respond to first-line treatments.

If you suspect that you are suffering from depression, I urge you: please reach out for help as soon as possible. Should you feel uncomfortable talking to your family members or to your friends, there are other ways to get assistance.

On campus, you may wish to approach our counselors or our chaplain. Off campus, you may consider contacting the following organizations:

If you know anyone whom you feel may be depressed, then I ask that you bring up the foregoing options gently and carefully—force will do no one any favors.

Allow me to emphasize some parts of the WHO definition: depression is a common condition that can be treated even by non-specialists. In 2004, the Philippines was found to have 4.5 million cases of depression, nearly 6% of the total national population at the time, and the highest rate in all of Southeast Asia, no matter how much we may like to think of ourselves as a happy people. Unfortunately, according to the Department of Health (DOH), for every 90 Filipinos who suffer from depression, only one-third seek help. The remainder, either ashamed to ask for aid or unaware that there is something wrong with them, simply suffer through the symptoms. DOH assistant secretary Paulyn Jean B. Rosell-Ubial has observed that health care professionals, not to mention the general public, need greater literacy in matters of mental health, and that the stigma surrounding mental illness needs to be reduced.

There exists no evidence that the situation has vastly improved over the past nine years; our country was ranked among the least happy in the world late last year, for example.

The numbers are likewise grim with regard to suicide—in fact, Rosell-Ubial considers depression leading to suicidal behavior to be a major public health problem. Just consider what took place during the first quarter of this very year: last January 3, a 28-year-old woman attempted to kill herself by jumping onto the tracks of the Metro Rail Transit at Shaw Boulevard Station. A few days later, a man hanged himself from a nylon cord inside his rented shanty in Tondo, Manila. In early February, a 21-year-old female student fatally stabbed herself with a kitchen knife in her bedroom in Quezon City. A few weeks later, a car executive leapt to his death from the tenth floor of condominium building in Makati.

These incidents—which we know about only because they caught media attention; others may have not—reflect the disturbing upward trend in the number of deaths by suicide in the Philippines: according to data culled from the National Statistics Office (NSO), the suicide rate for men from 1984 to 2005 rose from 0.46 to seven out of every 200,000, while the rate for women over the same period rose from 0.24 to two out of every 200,000. Dr. Dinah Nadera, a psychiatrist and an associate professor of the University of the Philippines Open University who has been working on a suicide prevention strategy, has said that suicide rates have been climbing particularly among young people. Philippine Daily Inquirer cites Nadera as saying that the increase in suicides is particularly pronounced among young people aged between 5 and 14 years, and between 15 and 24 years, while InterAksyon.com quotes her as stating that the greatest proportion of suicides are committed by people who are between 20 and 29 years old. In other words, you and your peers are, statistically speaking, among the most vulnerable.

On a related note, the WHO reports that around one million people worldwide kill themselves every year, which means that one person commits suicide every 40 seconds.

It is all too easy to make fun of the idea of mental illness—to say that people who are afflicted with such disorders are simply maarte, pathetic, or weak. The mentally impaired or ill person is often a figure that draws ridicule rather than understanding or compassion. For instance, shortly after the woman whom I mentioned earlier jumped onto the MRT tracks, disrupting mass transit services along the southbound line for over an hour, some online commentators railed at the woman’s lack of consideration, as her suicide attempt had inconvenienced a number of passengers, while others suggested that she could have resorted to more effective, that is, more lethal, means. Look as well at popular representations of mental illness on television, in film, and even in our political institutions.

To my mind, this appallingly facile dismissiveness is rooted in part in the notion that mental health is a purely private realm that each person is expected to administer and manage by himself or herself. But we fool ourselves with such thinking. Why do we keep track of diseases like hypertension, diabetes, cancer, or HIV/AIDS? Because we realize that these illnesses are indicative of larger social problems, which is to say, public problems, among them poverty, malnutrition, lack of education, inferior health care infrastructures, and the generally inequitable distribution of resources. By the same token, the inability to imagine alternative futures that are more compelling than death, which I think is at the heart of suicidal ideation, should not be understood as symptomatic of merely individual, idiosyncratic misery, but of wider structural issues that need to be addressed. The personal, as the feminist saying goes, is political. There is, then, a need to re-evaluate and re-vision not only our attitude towards mental health, but also our attitude towards the society that we are part of.

The fact that you are here today, able to afford several times more per academic unit than Kristel ever could—she had been charged, and could not cover, PHP300 for each one—is as obvious a sign as any that you are beneficiaries of immense privilege. To have been born and raised in privilege were not things that could have been chosen and should not be things to feel guilty about. The crucial question has to do not with privilege as such but how one is using it.

Ensconced behind these immaculately white walls, with nearly every amenity imaginable at your disposal, and safe even from direct sunlight—one could conceivably spend his or her entire day here without having to be hit by a single ray—it is easy to lose sight of the bigger world that we inhabit. One reason that you are required to take subjects such as this—subjects outside your field of specialization, and subjects frequently thought to be bothersome and extraneous, and occasionally, “pa-major”—is to mitigate such a situation by showing you that there are many ways, critical and creative, to define yourselves and to make your lives matter beyond the narrow constraints of the careers that you wish to carve out for yourselves once you graduate. The raison d’être of this school, after all, is not to become a leading employee factory, reliably and efficiently churning out skilled workers term after term, year after year. Incidentally, I am willing to bet that, ten years from now, at least a third of you will be engaged in something that has no relation whatsoever to your present course—just think of how you, as a child, used to answer the question, “What do you want to be when you grow up?” and you will understand why I am so confident about my wager: your degree is not your destiny.

I would like to believe that all of us are interested in making the world a better place—that such an aspiration can, sadly, strike us now as a cliché does not drain away its potency or its urgency. We do need to make a better world, and I don’t mean better only for ourselves. As comfortable and as prosperous as each of us can become, we will not truly have accomplished anything if we fail to think of and uplift others, for we are all intimately, intricately, and inextricably connected. We ignore, tolerate, or abet systemic injustices at our own peril, for the day will surely come when these same injustices are visited upon us.

Our university declares that it develops achievers for God and country, and these words should not be taken as empty ones used for decorating classroom walls, official documents, and promotional materials—these words constitute a challenge for us all to take on the responsibilities of social transformation, to swear to ourselves that, in the words of the novelist Thomas Harris, “The world will not be this way within the reach of my arm.”

There is something deeply and fundamentally wrong with a nation when more and more of its people, especially its young people, are killing themselves, and such is the desperate state of our nation. The world, as we know it today, cannot—must not—be allowed to remain the way it is within the reach of our arms.

* This was written as part of an introductory discussion on poetry and its capacity to bear witness to human suffering. (Slightly edited on 20 March 2013, 12:42 AM GMT +8.)