Pesticide poisoning is the 2nd most common method of suicide in Malaysia. A national paraquat ban was announced in 2002 but rescinded to restricted use in oil palm plantations in 2006 due to challenges in viable alternatives for farming industry stakeholders. Subsequently, paraquat poisoning reported to the Malaysia National Poison Centre increased 5.5 times in 2006-2015 (Leong et al, 2018). A second national ban has been implemented in Malaysia since 1 January 2020. Thus, it is crucial to establish a surveillance system that will form the basis of a reliable database of pesticide poisoning cases which can be utilised to evaluate the effectiveness of a national paraquat ban as a suicide prevention strategy in Malaysia.
This pilot project will build on 2 ethics-approved projects based on retrospective hospital-records of self-harm: (1) Bintulu Hospital’s self-harm registry (2016) & (2) Ipoh Hospital’s retrospective study of pesticide poisoning (2013-2017), as well as existing state forensic death registries in the catchment areas of both hospitals. In this pilot project, funding approval will be sought from the Centre of Pesticide Suicide Prevention, University of Edinburgh to support the data collection in Ipoh and Bintulu hospitals. Ethics approval will be obtained to extend the data collection of hospital-based records to include the time frame before (Bintulu Hospital: 2017-2019; Ipoh Hospital: 2018-2019) and after (2020) the commencement of the national paraquat ban. Existing capacity-building efforts to improve the quality of data capture in hospital-based records of self-harm and pesticide poisoning will also be included as part of this pilot project’s hospital-based activities, i.e. continuous medical education of front-line clinicians in the departments of emergency medicine, internal medicine and psychiatry for comprehensive assessment, documentation, and management of pesticide poisoning. The pilot project will also include community-based advocacy and awareness building educational activities in collaboration with the local agricultural departments to facilitate local community dialogue and uptake of paraquat ban implementation. This pilot project will pave way to a second project focusing on facilitating inter-sectoral collaboration between health and agricultural agencies in terms of regulatory and policy implementation dialogue for pesticide suicide prevention; including capacity-building for accessible, sustainable and safe alternatives to highly-hazardous pesticides. Depending on the approval of the APEC (Asia Pacific Economic Cooperation) grant application (funding body: APEC), an APEC Conference on “Collaborative Model of Suicide Prevention of Pesticide Poisoning & Sustainable Agricultural Innovations: Mental Health for Economic Wealth” will be held as a platform to facilitate inter-sectoral collaboration (health and agriculture stakeholders) for policy recommendations of effective implementation of pesticide bans and accessibility of safe alternatives to highly-hazardous pesticides in APEC economies