Alerted by a neighbor’s emergency call, Rita Catashunga raced back to her home in Nauta, in northeastern Peru, early one morning in January 2015 to find police gathered around the body of her 15-year-old daughter. The girl had committed suicide.
Her death joined a list of other reported suicides of teens in Nauta, a port town on the Marañón River, and Iquitos, Peru’s largest Amazonian city, some 60 miles away.
Most Nauta residents are Kukama, and their lives are closely tied to the river. They fish from wooden canoes, tend plots of cassava and rice, and communicate with spirits that live in the depths of the river—activities that help them maintain unity and balance.
In recent years, however, life in Nauta has changed rapidly. That is one factor behind the youth suicides, according to anthropologist Oscar Espinosa of the Pontifical Catholic University of Peru in Lima, who has been studying suicides in Peru’s Loreto region, where Nauta and Iquitos are located, since 2005.
“Nauta used to be a quiet place,” he says. “Most of the people who lived there were from there. Now there are many people who have come from other parts of the Amazon, and they bring their customs, as well as drugs and trash. There is a collision between the urban and the indigenous worlds.”
Pollution, especially from oil fields upstream from Nauta, also causes stress, according to Omar Peixoto, a psychologist at the government-run health center in Nauta. Contaminants poison the fish, as well as rivers and lake on which people depend for water for cooking, bathing and drinking.
Those problems create insecurity and uncertainty among indigenous youth, experts say.
“In the past, indigenous young people knew they would work in the fields or fish, like their parents or grandparents,” Espinosa says. “They had a defined role. Now there are no clear answers, and that increases the sense of not knowing how to deal with this new situation.”
Cases go unreported
Various suicides have been reported in Nauta since 2001, when three adolescents took their own lives. The cases peaked 2008, with more than 30 suicides.
Néstor Aguilar, a psychiatrist at the Loreto Regional Hospital in Iquitos, who has studied the suicides in Nauta since 2008, attributes the problem to a “dissociative disorder” characterized by possession, especially among teenage girls.
According to the American Psychiatric Association, possession involves taking on another identity, through the influence of a spirit or another person. Aguilar believes it has both mental health and cultural roots and can be triggered by stresses such as marginalization, poverty, violence, abandonment or sexual abuse.
“What’s notable about this disorder is that it looks almost like an epidemic,” Aguilar says. “One teenager shows the symptoms, and within a matter of minutes, others have the same symptoms.
In early September, there were three other teen suicides—a 13-year-old girl and two 15-year-old boys—in the Punchana neighborhood in Iquitos.
“It’s a frequent problem,” says the Rev. Miguel Angel Cadenas, pastor of the Catholic parish of La Inmaculada in Punchana.
Although teen suicides are a persistent problem, Peru’s Health Ministry lacks updated statistics. The most recent data, for 2009 to 2013, show just seven suicides in Loreto, probably because many go unreported, according to Marco Bardales of the Health Ministry’s General Office of Statistics.
There also is no epidemiological study of mental health among indigenous people such as the Kukama, Chayahuita or Achuar, even though a 2007 census by the National Statistics Institute found that about 11.9 percent of the population of Loreto is indigenous.
Cultural perspective lacking
In 2004, the mental health institute found that the cities of Iquitos, Pucallpa and Tarapoto had the highest frequency of psychiatric disorders, especially depression and anxiety, in Peru’s Amazon region.
A mental health study in 2009 in Iquitos, a city of more than half a million people, and Pucallpa, which is about half that size, found that the most common clinical disorders were social phobia and moderate to severe depression among young people. About 15.1 percent said they had wanted to die at some time, and 0.6 percent had attempted suicide at least once.
Researchers and mental health workers lack both the theory and the practical tools for dealing with the problem, says Javier Saavedra, executive director of the Office of Support for Research and Specialized Teaching at the mental health institute.
“We also need more anthropological and sociological studies to examine this in indigenous communities,” he says.
Standard methods of gauging mental health may not hold true for indigenous communities, according to a 2012 UNICEF study of indigenous youth suicide among the Awajún people in Peru, the Guaraní in Brazil and the Embera in Colombia.
Understanding the culture may be more important than knowing psychiatry or psychology, Espinosa says.
“For example, when a Awajún teen commits suicide, the cause may not necessarily be depression,” he says. “In the Awajún world, equating suicide with depression doesn’t work. But health workers say that suicide is due to depression.”
Besides changing the way the issue is studied, treatment methods must also change, experts say.
“If a person with a Kukama surname gets sick, everyone with that name suffers, so everyone with that name must become involved in curing the sick person,” Cadenas says. “The treatment is integral, not individual.”
When teen suicides occur, families face stigmatization.
As the body of Rita Catashunga’s daughter was being transported to the morgue in Iquitos, a teacher from a school in Nauta accused the woman of having physically abused her daughter. He offered no evidence, however, and neighbors defended Catashunga.
“I often see my daughter in dreams,” she says. “And in my dreams we talk, with the river forming a bond between us.”
This story was made possible by support from Comunicaciones Aliadas and Infostelle Peru.