In Dera Ghazi Khan, the numbers are grim and growing. The fact that 81 individuals have resorted to suicide by ingesting wheat pills in intensive care units this year alone should be enough to shake us out of our complacency. When we consider how this figure adds to 215 similar cases last year, and over 270 attempts in the two years prior, the scale of this tragedy becomes horrifyingly clear. The wheat pill (aluminium phosphide) is sold as a grain preservative. But in some of Pakistan’s poorest districts, it has become a weapon of last resort. Cheap, potent, and almost universally accessible, it offers a ghastly certainty to those who have lost faith in all else. Within minutes of ingestion, it destroys vital organs. Survival is rare, and even when patients reach hospitals in time, most facilities lack the antidotes, equipment, or trained staff to reverse the damage. However, the problem extends far beyond its accessibility. It speaks to the raw nerve of poverty, mental distress, and neglect. Many of those who take this drastic step are young, often women, cornered by financial hopelessness, domestic violence, or untreated psychological trauma. And they live in places where there are no therapists, no helplines, and very little hope. Last year’s temporary ban on sales under Section 144 in DG Khan may have generated some feel-good headlines but it was, in essence, a kneejerk and unsustainable solution. The absence of a federal regulatory policy has allowed this pill to become the second most common means of suicide in rural Pakistan. This crisis demands more than sympathy. Pakistan has no centralized suicide data system. Only rough estimates. According to the World Health Organization, between 130,000 to 300,000 suicide attempts occur in Pakistan every year, resulting in up to 15,000 deaths. That’s 15,000 families shattered, with no national strategy to stop the bleeding. The solutions aren’t novel. Ban the over-the-counter sale of lethal pesticides and mandate licensing for procurement. The state could play a larger role by integrating mental health into basic healthcare services, especially in underserved districts on top of launching public campaigns that dismantle the stigma around depression and suicidal ideation. And above all, fund mental health like the life-and-death issue it is. We owe it to the invisible victims to stop pretending this is someone else’s problem. Because silence is not neutrality, silence is complicity. And looking at the number, silence is killing. *