So too has the Japanese designer Issey Miyake who has commandeered the same principle for his latest Pleats Please

So too has the Japanese designer Issey Miyake, who has commandeered the same principle for his latest Pleats Please flagship, which opened last Saturday in London’s Brook Street. “Before, yes they were downtrodden, but they were not quite as aware of it as they are now,” says Dr Phillips.Dr Phillips believes the results of his work could prompt a rethink in accepted theories of suicide, which have tended to focus on patterns in developed Western countries. “I would contend that developing countries have a lot to say about suicide, and if they develop their own theories based on their own data, they may come up with quite different conclusions,” says Dr Phillips. “This is a guess, but I think the problem may be worse in the rural areas that have seen some improvement in the standard of living with the economic reforms.” In these villages, women watch television and see how much better off the urban Chinese women are, they see women with equal status to men, and women able to assert themselves. That went wrong because she could not have any more children, and many other attempts to find another man to support her also failed. Despondent, she returned to her mother-in-law’s home, and the next evening was found dead in bed with an empty pesticide bottle on the floor.Dr Phillips and the CAPM project have completed a pilot study in three sites, covering 55 suicides, most of which were women.

The main causes identified so far were family conflicts including unfaithful husbands, and arguments about household finances. Dr Phillips believes that between one-third and one-half of the suicides “are impulsive acts that do not have an underlying major depression”. A suicide may be a “cry for help” that ends in death because of limited medical care, or the lethal methods that are readily available – some pesticides are so strong that two tablespoons can kill a woman in two hours.Dr Phillips also suspects that the worst hit areas may not be the poorest. Reluctant to marry her idle brother-in-law, according to local custom, she left the village the next year and remarried.

Even if this is so, however, it would still leave China’s female suicide rate at about four times that of the rest of the world combined.The question of how to prevent such a large number of unnecessary deaths is urgent. The anecdotal evidence from the cases collected so far is that social stresses may be as much to blame in China as serious psychiatric disorders or alcohol abuse. In a country where the birth of a baby girl in backward agricultural regions still produces condolences rather than congratulations, Chinese rural women often have a miserable life. Many young girls are virtually sold into marriage, and wives generally have little status in their husband’s household.Huang Chunfang’s husband died in 1993 leaving her with four children to look after. In particular, they assumed that a certain proportion of accidental deaths where the cause was unknown were probably suicides. This seems a reasonable adjustment, but Dr Phillips has taken a closer look at the Chinese raw data for 1990 and found that there was an atypically high number of accidental deaths of unknown cause that year, possibly inflating the study’s final figures by as much as one-third. China’s men were also disproportionately suicidal with a rate of 27.2 per 100,000, compared with 14.4 per cent for the rest of the world.To arrive at these figures, however, the authors made various adjustments.

“The Chinese government realises that it is a big problem and it is willing to do something about it This is a really positive sign,” says Dr Phillips. He is hoping that his research, which is being done in collaboration with the Chinese Academy of Preventive Medicine (CAPM), will provide a clearer understanding of why Chinese women are committing suicide in such large numbers and thus lead to effective interventions.The figures for China in the “World Burden of Disease” study, published last September, were based on raw data from the 145 Disease Surveillance Points operated by CAPM. The study estimated that there were 343,000 suicides in China in 1990, and that the annual rate of suicide in Chinese females was 33.5 per 100,000, compared to 7.1 per 100,000 on average for females in the rest of the world combined. After a year of this, the daughter began to talk of “joining her mother”. After making seven pairs of cloth shoes for her younger brothers as a parting gift, she too drank pesticide and died.The dismal status of women in China’s countryside is the backdrop to much despair, says Ms Xie. “Suicide is not a new problem, it has existed for a long time. In traditional Chinese culture, rural women do not value themselves and are not valued by others They take their lives very lightly.