End snakebite deathsSitting on data and doing nothing about it is a problem bigger than any public health issue that plagues Nepal.
Snakebite is a life-threatening emergency which mostly affects women and children with a lower socio-economic status in rural Nepal. But the issue remains neglected. In a country which is largely agrarian, encounters with venomous snakes are also an occupational hazard for plantation workers, herders and fishermen. While most snakebite deaths and disabilities are preventable, many people continue to die for lack of first aid measures, access to healthcare and anti-snake venom.
Snakebites have resulted in deaths and serious impairments in communities, mostly in remote areas where access to health care remains a challenge, and where locals tend to favour faith healers over medical professionals. According to the World Health Organisation, some 20,000 people are bitten by snakes each year in Nepal, resulting in over 1,000 deaths. But health researchers say the actual numbers could be much higher as several studies suggest.
Most snakebite deaths, according to public health experts, are caused due to the lack of awareness of simple measures to prevent encounters, and the continuity of traditional methods like applying tight tourniquets and suctions as popularised by pop culture. The Epidemiology and Disease Control Division also points to inadequate training of health care professionals, the delay in victims reaching hospitals on time and the practice of using the same type of anti-snake venom for all cases. According to the division, the delay in reaching hospitals is one of the major causes of snakebite morbidity.
Nepal’s mid-hills and southern plains receive high seasonal rainfall and have a hot climate, which makes it a perfect breeding ground for snakes. It is only natural that for people living in these belts, encounters would be common. While most of the snakebite incidents happen outdoors while people are working in the fields, nocturnal and domestic incidents are also common due to the poor standard of shelter and the preference to sleep on the floor.
In 2019, following an international conference in the capital, Nepal committed to attain the national target in line with the UN body’s target to reduce deaths and disabilities due to snakebite envenomation by 50 percent by 2030. The division also published a National Guideline for Snakebite Management in Nepal to ensure a standard and effective management of snakebites across the country.
According to the guideline, some 89 snake species have been recorded in Nepal out of which 17 are considered highly venomous and dangerous. The literature also notes that most snakebite cases in Nepal are caused by the Indian spectacled cobra and the common Indian krait while acknowledging that other species have also contributed significantly.
While the guideline is a rich source of information and prescribes precautionary measures against encounters and key steps to deal with snakebite patients as practised internationally by first responders and medical professionals, implementation of community-based interventions is negligible. Every year, cases of snakebite rise with the onset of summer; and with Nepal’s fragile health system currently concentrating on combating the pandemic, there is concern that snakebite emergencies may face further hurdles and more people could be killed.
To end snakebite deaths, what public health officials and nonprofits must first do is visualise data that record incidents and snake species as per region, and look at how they can intervene by launching effective community-level campaigns. Decision-makers must also look into setting aside a budget to ensure that first aid and healthcare is accessible, and that anti-snake venom is stocked well. It would also be wise for the Ministry of Health and Population to work with various other ministries and sensitise the general public and medical practitioners through formal or informal modes as well as the guidelines it sits on to save preventable encounters and deaths.
The practice to sit on data and do nothing about it is a problem bigger than any public health issue that plagues Nepal. It puts people’s lives at risk. This must stop.