SNAKEBITE-A Fatal Disease Un-Noticed in India

Snakes

India is home to 300 species of snakes. Only socially educated knows, not all snakes are poisonous. Out of 300, only 62 species are poisonous. Most dangerous are saw-scaled Viper, Kriat, Russel’s Viper and of-course Indian Cobra. These species account almost fatalities in India.

Casualties

Annually, 54 Lakhs (approx) cases of snakebites are reported worldwide according to World Health Organisation. To your surprise, out of 54 lakhs, 28 lakhs (approx) are reported in India only. If death data is to be believed then 1 lakh deaths are reported annually worldwide. Out of 1 Lakh, 50,000 deaths are reported only in India.

Snakebite-A fatal Disease Un-Noticed in India

Why & When

Why data is alarming in India. Many factors contribute. Most of population in India resides countryside. In rural as well sub-urban areas, people go to jungle to earn daily bread e.g collecting firewood, cattle grazing, fishing etc. These are high potential zones where reptiles attack.Urban areas are no exception too. Snakes thrive in homes, gardens and gutters. Many videos are often circulated where reptiles are seen in bikes, pillow-covers, shoes and flushes etc. Awareness and keeping self-being safe, specially in monsoons, can help a long way.

Monsoon is high time when these reptiles are furious. Sawan month is auspicious month for mating. Reptile come out to mate, lay eggs and new mothers stay furious in full course. Their dens are flooded furthermore. They refuge in frustration and come cross path with humans. More than 70% cases of snakebite are reported in monsoon.

Administration & Management

Snakebite management and treatment has to go a long way in India. Snakebites are managed by junior doctors at block level hospitals. Junior doctors are first line of defense. Very few cases are countered by this first line of defense. Non availability of anti-venom, non-availability of doctor, lack of experience, inability to identify symptoms, lack of faculties to counter side-effects, victims are referred to distant district level hospitals. Tedious cycle often leads to time-lapse and death.

Identification plays crucial role. In many cases victim doesn’t know what bite him/her. In that case symptom identification is only key.

Lack of experience leads the doctor to inject anti-biotic instead of antivenom which ensures death. In other cases, identification is right. Anti venom is given in right time in right way but faculties are not there to cater side-effects. Victims succumb to side-effects. Apart from faculties, snakebite management is studied only on sidelines in MBBS syllabus. Isn’t it need of the hour, snakebite management be added to main stream treatment in MBBS colleges.

Cost of Antivenom

Another crucial player. 100 ml of antivenom within 100 minutes of bite is required to save life. A vial of antivenom costs between Rs 300 to Rs 500. Loading a dose for venomous bite require 10 vials. Poor victims hesitate to reach hospital and land up in occult practices and local healers. Snakebite treatment is free in government hospitals. But government hospitals are distant in many areas. Furthermore, all government hospitals don’t have antivenom. Sometimes hospitals are available, antivenom is available but lack of administer (doctor) forces victim to run to another hospital. Again time lapse and undesired results.

There is need to streamline resources, set up proper administration and well trained staff to deal with snakebite emergencies.

Disbelief, Education & First Aid.

A major concern is how we can educate people on ground zero. Population in super-rural areas have ages ago belief in local healers. The belief is based on little practicalities. People believe in results when healers heal the victim with his/her occult practices like cow dung etc. The logic behind , out of 100 cases only 10 are venomous snakebites. Healers do nothing. They earn free publicity in 90% of non-poisonous cases. Uneducated population is not even clear of poisonous and non-poisonous nuances. Every snake is poisonous for them.

Well a long way is yet to travel OR whether we have started even OR Are they poor who are victims so nobody is notifying this fatal disease.

Solutions

Add basics of poisonous and non-poisonous snakes, Do’s and don’ts during snakebite, first aid and treatment in basic seduction system.
Snakebite management should be included in mainstream study in MBBS colleges.
Local healers to be advised to direct snakebite cases to hospitals.
Block level teams to be constituted to deal with snakebite emergencies. Same teams can organise awareness camps in panchayat level.
Snake Catchers be appointed on panchayat level and to be ready just a call away. Same skilled persons can showcase live snakes and people can have practical appreciation.