Suicide by self-immolation in Durban, South Africa: a five-year retrospective review

Self-immolation is an uncommon method of suicide, and its occurrence in South Africa is thus far unknown. This study aimed to determine the prevalence of self-immolation deaths and to establish a profile of these cases and the circumstances under which this condition occurs. A 5-year (1996-2000) retrospective review at a mortuary in Durban, South Africa, was conducted. Data were obtained from the Department of Forensic Medicine, the Medical Research Council's National Injury Mortality Surveillance System, and police and hospital records. During the study period, there were 12339 nonnatural deaths, of which 696 (5.6%) were suicides. Self-immolation accounted for 69 (0.6%) of all nonnatural deaths and 69 (9.9%) of all suicides. The subjects had a mean age of 31.2 years and were predominantly female (76.8%) and black (81.2%). The mean burn surface area was 63.3%, and the mean injury severity score was 36.9. Accelerant use was documented in 53 (76.8%) of cases, and paraffin was preferred. All cases occurred indoors. The proportion of suicides due to self-immolation in our study is excessive when compared with international studies that report figures between 0.9% and 2.2% of suicides. Additional studies are necessary to further elucidate the reasons for this discrepancy.