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Background Durkheim defines suicide as all death resulting directly or indirectly from a positive or negative act of the victim himself or herself, which he or she knows will produce this result. Suicide is as old as human history itself. It is most frequently seen as a fatal sequel of psychiatric illnesses and it is thought that suicide only occurs in a state of insanity, and that it is by itself a special form of insanity. Health workers, especially family practitioners, are constantly confronted by family tragedies, which they have to deal with competently. It is therefore imperative that a health worker contextually understand a family tragedy, such as when a family member commits suicide through self-incineration. Between 1987 and 1998, Matsulu Township, Mpumalanga experienced a high incidence of suicide through self-incineration. Each victim either ingested or doused him or herself with inflammable liquid (usually kerosene) and set his or her body alight. This gruesome form of suicide, and the increased frequency of occurrence, horrified the families and reverberated through the township. This phenomenon drew the principal researcher's attention and resulted in this study. The principal researcher was the only family practitioner in the township during this period. It was hoped that the knowledge gained from this study would form the basis for interventions in similarly affected families in the future. The focus was on the surviving family members, in order to learn about the family dynamics before and after the events, and how the family dealt with the event. Although studies that focused on the role of doctors in suicide prevention found that there is little predictive power for the suicide candidates, which means that there were no identifiable factors directly associated with suicide outcome, information gleaned from the affected families could be used profitably in community campaigns and by support groups. Methods The aim of the study was to understand how the families of those who committed suicide through self-incineration functioned before and after the event. In-depth interviews were conducted with six focus groups selected purposively from 36 affected families. Interviews were conducted in Siswati, audiotaped, transcribed and translated into English. Themes and sub-themes were identified. To enhance the trustworthiness of the information gathered, the data were triangulated. Results Themes identified were a shocking experience, no chance of survival, triggering factors, mystery, emotional and physical scars, and coping strategies. The perception of witchcraft being responsible for suicide featured prominently in the data analysed. Conclusions The functioning of the families affected by the suicide of a member through self-incineration was markedly reduced after the events. It is recommended that attention be given especially to the perception of witchcraft being responsible for suicide, and that grief support groups be established in the community to assist affected families cope better with the loss.

How the families of the victims of suicide through self-incineration function before and after the event—a qualitative assessment