AZURE waters. Coconut palms. Many people equate the Pacific islands with paradise. But two years ago, suicide was the greatest single cause of death in the Marshall Islands. And, while the suicide rate here has since fallen by more than 50 percent, it still is a major problem.
Experts here say they hope the Marshall Islanders' progress may hold lessons for other Pacific island nations trying to cope with what some consider an epidemic.
Health officials say suicide rates are related to the islands' shift from subsistence to cash economies and a breakdown of traditional family structures.
Suicide rates are highest (or at least best documented) in the Marshall Islands, the Federated States of Micronesia, and Western Samoa. But in the 1980s other islands, such as Fiji and Tonga, have also seen rising suicide rates.
Most victims are male, aged 15 to 24. Most die by hanging or poison.
Marshall Islands' authorities were shocked in 1987 when 21 men and one women committed suicide. For a population of 35,000, the figure was staggering.
``In these countries, you've got a suicide rate 10 to 20 times higher than for the same age group in the United States or Australia,'' says Don Rubinstein, director of the Micronesia Area Research Center at the University of Guam.
Most suicides are compulsive. A young man argues with his wife or girlfriend, gets drunk, and kills himself.
``It sounds crazy; but without the extended family, they have very poor coping mechanisms,'' says Neal Palafox, director of preventive health services. Traditionally, when a young man had an argument, an uncle or grandmother living with the family would step in and offer counsel or mediate.
But the cash economy is changing family roles and long-established methods of solving social conflicts. In the matrilineal subsistence economy, the land belonged to the mother. It was the source of income and gave her and her relatives authority in the family. When a woman married, the husband moved to her land.
Now that most cash jobs are in urban areas, part of the family follows the father. ``He's the one earning the bread in the family, and the mother's authority is diminished. Now he's the one with the authority,'' says Marie Maddison, minister of health services. But she adds, ``The fathers aren't ready to take on that role.''
Last year, a nationwide campaign was mounted. Workshops, seminars, and skits were held in schools and the workplace. The turning point came with a high-profile endorsement of the program in a nationwide radio broadcast of a briefing in Parliament.
This year, so far, the suicide rate is about the same as in 1988. The publicity campaign has been cut back to a weekly radio broadcast and occasional workshops.
``These are stop-gap measures but very important stop-gap measures,'' says Mr. Palafox. ``It will take years to teach people about coping, to teach people to come to counselors, to teach people that the culture is disrupting itself and other things need to be institutionalized to take care of what the disruption has caused. But in the short term, we have part of the answer in that Marshallese are now watching out for Marshallese.''