Poverty, political battles, and mental health problems are not unique to Guyana. Suicide, however, is. Guyana is consistently ranked in the top 1 or 2 territories worldwide in suicide rate, trailing behind only Greenland.

The statistics were just numbers to me until my first few weeks at Georgetown Public Hospital, where suicide attempt is a routine chief complaint and deaths from poisoning and hanging are common in our emergency department. These are just the patients that survive to get to the emergency department. In the US, I had seen plenty of suicidal patients, usually with a minimal gesture like taking 5 tabs of Tylenol in order to buy an admission to a psychiatric ward. In Guyana, suicidal patients mean it, and they are usually successful the first time.

How did such a beautiful warm tropical paradise get ranked up with the coldest, darkest and most remote territory in the world for suicide rate?

Nobody truly understands all the reasons behind Guyana’s astronomical suicide rate, but theories abound. There have been few studies examining the factors behind Guyana’s suicide epidemic. My friends and coworkers tell me that the reasons are cultural – young people who feel like a failure after getting dumped by a boyfriend or girlfriend or losing a job all have friends who have committed suicide, and it becomes the “attractive” option. Others point to the availability of the means –plenty of agricultural poisons, plenty of ropes, plenty of waterfalls and buildings to jump from.

I argue that we really have a cultural failure in Guyana. More than any other South American country, the Guyanese are inundated with the culture of the US. We speak the same language, we have the same broad diversity of religions and ethnicities, we listen to much of the same music. The Guyanese love to shop on Amazon.com . Yet, the culture that the US exports is one where self-worth and satisfaction are explicitly tied to material wealth. My friends in Nicaragua, a much poorer country than Guyana, live much more difficult lives but are insulated from the US by language, lack of internet, and the buffer zones of friends, family, church and community. It’s so easy to see how a young Guyanese person who has no money and no protective factors can fall through the cracks.

Our cultural failure is compounded by a crisis of mental, social and spiritual health care. I can’t solve the problems of lack of sense of self-worth in the emergency department. It’s a process that requires pastors, counselors, and most importantly a community of people who care, day in and day out. Faith leaders recognize this need. Pope Francis recently said, “I see the church as a field hospital after battle. It is useless to ask a seriously injured person if he has high cholesterol and about the level of his blood sugars! You have to heal his wounds. Then we can talk about everything else.” In the United States, Episcopal Bishop Michael Curry lamented the divisions between faith communities and the relief world: “The work of abolishing poverty... stopping the desecration of the environment... is not ‘secular work!’”

I’m not sure what the solution to the suicide epidemic is, but I suspect that Guyana is the canary in the coal mine. Americanization is only accelerating, and the materialism it brings will only continue to crowd out existing philosophies and faiths and communities that have sustained poor countries for centuries. How will we respond? The only way I can think of is to commit ourselves to working with our neighbors day in and day out, listening and loving and learning.