Karuna Kumari Bamjan, a local of Kamalamai Municipality in Sindhuli, has been admitted to the Shukraraj Tropical and Infectious Disease Hospital for a week to be treated for snakebite.

The 32-year-old was bitten by a venomous snake while she was collecting fodder in the field on June 17.

Bamjan was first taken to the Sindhuli District Hospital for treatment but doctors asked her relatives to take her to an advanced hospital in the Capital, saying that the patient’s condition was deteriorating fast and that the hospital was not equipped to handle the case.

“We came to Kathmandu at midnight in an ambulance,” Bamjan told the Post. “Doctors say I have to stay in hospital for a few more days.”

With the start of monsoon, more incidents of snakebite have been reported across the country.

According to Shukraraj Hospital, 12 snakebite victims of Kathmandu Valley and its adjoining districts receive treatment at its emergency ward regularly.

“There are currently seven serious snakebite cases in our hospital,” Dr Sher Bahadur Pun, a virologist at the hospital, told the Post.

In the fiscal year 2017/2018, 5,606 people who were bitten by snake received treatment at various health facilities, according to the zoonosis section of the Epidemiology and Disease Control Division.

Among the victims, 4,812 were bitten by non-poisonous snakes and 794 by poisonous snakes. Twenty of them died in course of treatment.

“We do not have data on those who do not reach health facilities for treatment,” Dr Samer Kumar Adhikari, chief of the section, told the Post.

While health facilities are ill-equipped and short of anti-snake venom, there is also a lack of awareness among many people in rural areas, who often go to shamans instead of a physician.

According to Adhikari, only a few people die of snakebite in Kathmandu Valley and hill districts, as snakes in these areas are less venomous in general.

Doctors say women who go to the fields to collect fodder for cattle or farmers who do plantation or harvest and children who play in open areas are vulnerable to snakebite.

Poor people living in thatched-roof houses are also highly vulnerable to snakebite, as snakes visit such homes in search of rats.

On Monday, Sanjaya BK, a three-year-old boy from Dhapgaun of Belbari Municipality, Morang, died of snakebite.

BK was pronounced dead upon arrival at a snakebite treatment centre in Damak run by the Jhapa chapter of Nepal Red Cross Society.

“The boy was bitten by a snake at 4:30pm but was brought here at 7:40pm,” Bhupendra Prasad Adhikari, a technical officer serving at the center, told the Post, over the phone.

He said that Ishani Sah, a four-year-old from Miklajung of the district, died some two weeks ago due to snakebite. The boy was bitten by a cobra at 4am while he was sleeping in bed.

The family members first bathed the boy, then took him to a shaman for treatment, before taking him to the pharmacy and the hospital at last. Sah too was reportedly pronounced dead upon his arrival.

Doctors say the conservative belief of consulting shamans instead of going to health facilities at the earliest is the chief reason behind the death of a lot of people like Sah.

Moreover, due to poor infrastructure in health care facilities—lack of doctors, anti-snake venoms, ventilator support system, and kidney dialysis facilities, dozens of people are dying of snakebite every year.

Neeraj Nepal, a health assistant at Damak Hospital, Jhapa, said his hospital has no means to treat snakebite victims. “We are not in a position even to keep a patient under observation so we refer victims to other centres, which have such a facility,” said Nepal. Due to the lack of treatment facility in the hospital, some patients die on the way to other health facilities.

Aasis Kumar Pokhrel, a health worker serving at the Kankai Sahara Snake Bite Treatment Center in Kankai Municipality of the district, said that his centre has a ventilator to keep serious victims of snakebite but does not have people trained to use it. “We do not have a medical officer and anesthesiologist to operate the ventilator,” Pokhrel said.

Doctors say that a lot of deaths from snakebite can be avoided if victims get ventilator support.

“Venom first affects the victim’s respiratory system,” said Pokhrel. “If we could put the patients on ventilator support and provide cardiac support, we can save a lot of victims.”

However, a lot of health facilities lack the equipment.

Pokhrel said that his centre treated 70 snakebite cases in the last three months. Five of them were bitten by venomous snakes.