Snakebite: A neglected menace claiming thousands of lives annually in Nepal

In a recently-organized program, experts said that the lack of awareness among people in the communities of the Terai region is resulting in the loss of more than 3,000 lives, with the actual number potentially even higher.

NL Today

  • Read Time 3 min.

Kathmandu: Some six months ago in Buddhabhumi Municipality in Kapilvastu, a 12-year-old boy was taken to Buddhabhumi Clinic with complaints of weakness, abdominal pain, vomiting, difficulty in swallowing, fever and difficulty in breathing. The medics at Buddhabhumi, suspecting a snakebite, immediately referred the kid to be admitted to Sarpadansha Upachar Kendra in Gorusinghe.

However, ignoring the calls from medics, his parents instead took him home. But his condition further deteriorated, and then he was taken to the Lumbini Provincial Hospital. The kid, who was in a worse medical condition, was given an anti-snake venom injection. Sadly, the kid succumbed, and was pronounced dead by doctors. It was even worse as his nine-year-old brother was also brought dead to a clinic with fang marks in his right hand. 

Both of them had died of negligence, shared Dr Hemant Ojha, section chief at Epidemiology and Disease Control Division.

During a program organized by Rotary Club of Kathmandu Mid-Town on “Snakebite Prevention Project”, Dr Ojha said snakebite is a neglected tropical disease, and from a lack of attention largely due to insufficient awareness, it results in thousands of fatalities annually.

“People have been dying because communities are unaware of measures to prevent snakebites. They are adopting harmful traditional practices such as tight tourniquets. Also, they have not been reaching healthcare facilities on time due to these traditional methods,” he said. “As people follow methods like tight tourniquets, there have been cases where hands should have been amputated.”

The government data shows Nepal has been recording 1,000 snakebite-related deaths annually. However, different independent studies and research show more than 3,000 die from snakebite a year. According to Ojha, the number is underreported, as many cases where people die in communities are not properly reported.

The government of Nepal is committed to achieving the national target, which is aligned with the World Health Organization’s goal of a 50 percent reduction in deaths and disabilities due to snakebite envenomation by 2030.

As per the plan, the government joined hands with Rotary Club which initiated this program. This program, also supported by the World Health Organization, B.P. Koirala Institute of Health Sciences to raise awareness on various aspects related to snakebite and to reduce the life-threatening impact as well as to prevent disability resulting from snakebites, is focused on the 26 most affected districts and is being implemented nationwide.

According to experts who spoke in the program, the majority of deaths related to snakebite occur before reaching a treatment center, either during transportation or in the village. “At least 40 percent of individuals die during transportation, another 40 percent die in communities, and the remaining 20 percent die in health facilities,” said Ojha, highlighting a significant lack of awareness among people. “If individuals are taken to the nearest health facilities on time, thousands of lives could be saved.”

The lack of awareness has led to difficulties in identifying snakebites, according to them. “Signs and symptoms, such as local gangrene from tight tourniquets, abdominal pain, and vomiting due to the use of substances like chilies and herbal medicine, can resemble those of snake envenoming. Tight tourniquets may cause pain, swelling, and congestion, which can be mistaken for local envenomation.”

According to experts, individuals engaged in activities such as collecting fodder in fields, farmers, and children playing in open areas face an increased risk of snakebites. “Also, those residing in thatched-roof dwellings, often families from lower-income backgrounds, are at significant risk as snakes seek rodents in such houses. Particularly in the Terai region, where rising temperatures prompt people to sleep outdoors, the likelihood of snake encounters increases.”

Experts also recommended the use of mosquito nets while sleeping to reduce the risk of snakebites. “Residents in the Terai should carry torchlights when venturing outside at night, and they can tap the ground with a stick to deter snakes from approaching. In emergency situations, opting for motorcycles instead of waiting for ambulances is the best option.”

This four-year Rotary-funded Nepal Snakebite Prevention communication campaign aims to impart awareness and prevention knowledge about the several venomous snake species in Nepal, how snakebite can be prevented, and the immediate steps to take when someone is bitten.

The campaign includes FM radio broadcasts (radio magazine and PSAs), in-person outreach activities (kickoff meetings and other face-to-face engagements), and knowledge products (posters, social media content, YouTube videos, and web resources). “”We transmit on over 41 local FM radio stations and also on two national carriers. Also, we have been organizing awareness programs in most affected districts,” said Dr Nirmal Rijal of Rotary Club of Kathmandu Mid-Town, claiming that awareness among people has increased following the program.