A Serious Menace

Snake Bite Deaths

Bharat Dogra

Everyday, mostly in remote villages, about 160 people die a very sudden death due to snake bite in India. Many of these victims are bread-winners of their families, many others are children on whom the future hopes of their parents rest. This is a tragedy that should have been largely avoidable in the 21st century, but instead appears to be increasing due to neglect and apathy of a health system more focused on urban needs and having an elitist bias.

A recent study published in early July this year has focused attention on the need for improving steps for preventing snake bite deaths by presenting estimates that snake bite deaths in India are likely to be significantly higher than the estimates available higher. This latest study was carried out by the Centre for Global Health Research (University of Toronto) and participants from India were also involved in this.

This study has estimated that there is an average of 58000 snake bite deaths in a year in India. A total of about 1.2 million or 12 lakh deaths took place in India since around year 2000. There has been an increasing trend. There were 55000 deaths in 2001 and 61000 deaths in 2014.

Before this latest study (2020) was published, the most widely quoted estimates were those of the MDS (Million Death Study) which presented an estimate of 46000 deaths in a year in 2011.

According to WHO data the number of amputations and serious disabilities related to snake bites is roughly three times the number of deaths. This gives an idea of the annual tragedy related to snake bites.
However a message of hope is that the number of snake bite deaths can be reduced significantly by an integrated effort involving several steps at various levels.

At the simplest level a number of basic precautions can save several precious lives. Snake bites are much more in monsoon months and at the time of night. Those who lived in kutcha or mud houses (particularly where there are more rats or frogs), or work in farms, forests and orchards ( etc.) are more at risk. The risk is much higher at night. A torch is a basic precaution while walking or working at night, even if it is a very short walk within a mud house. Use of mosquito nets is also helpful. Wearing thick gloves and boots while working and walking in risk-prone places is a good precaution to take.

It is important to spread information of basic precautions as well as first-aid. In this publicity using simple pamphlets and radio, including community radio, as well as print and social media, the nearest hospitals or health-centres where snake bite treatment is available can be identified.

In particular the need to rush victim of snake-bite to treatment place as early as possible should be emphasized. In remote villages ambulance service should be improved for this as well as for other reasons.
Unfortunately at present in many health-centers and hospitals sometimes essential snake-bite medicines are not available. This deficiency should be removed on the basis of urgency.

Due to the increasingly urban-oriented education several medical staff and sometimes even doctors are not adequately trained for treating snake bite victims. Hence special training for snake-bite treatment should be organized wherever needed.

Arrangements for medicine are generally made keeping in view the four dominant species of poisonous snakes in India. It is true that at the level of country as a whole, four species of poisonous snakes predominate. However in significant regions, other poisonous snake species are also common. Hence there is need to keep in mind this diversity of poisonous snake species while providing the most appropriate medicines and treatment. Although around 80 per cent of the total snake species in India are reported to be non-poisonous, still the number of important poisonous snake species is also significant.

Hence there has to be an integrated approach combing efforts at several levels. The entire effort should have a reliable data and information base. Unfortunately the government information base is mainly based on government hospitals and it is well-known that a very small percentage of snake-bite deaths take place in hospitals as the main problem is to rush a victim to a hospital within safe limits of time. Hence the government records only about 1500 deaths in a year mainly in its own hospitals. The government should have a much wider and much more reliable information base.

Unfortunate snake bite victims have suffered from neglect in the past and it is important now to leave behind this neglect and give them high priority. Distress caused by snake-bite deaths is very sudden and so all the more difficult to bear for family-members, while the longer-term problems caused to victims and family members in the case of snake-bite related disabilities can also be very severe, particularly when most victims are from poor households. Clearly more efforts for preventing snake-bites as well as for improving their treatment will be very rewarding in terms of the reduction of massive distress.

[The writer is a freelance journalist who has been involved with several social movements.]

Vol. 53, No. 21, Nov 22 - 28, 2020