NEW AGE (Dhaka, Bangladesh) 08 July 04 Snakebite deaths likely to rise - Lack of antidote compounds flood, rain woes (Kishore Kumar Das)
The incidence of snakebite has increased markedly in and around the city because of monsoon floods.
The fatality rate is likely to rise this season as there are no treatment facilities available either in government hospitals or in private clinics.
At least 20 people were bitten by snakes, mostly children last month and four of them died, according to hospital reports.
The hospital records showed that most of the victims had come from the low-lying areas of the city and the suburbs.
Keraniganj and Tongi were the two main high snakebite-prone areas where the lowlands go under floodwater earlier than other parts of the city.
“Snake bites kill a good number of people during monsoon every year, but unfortunately there is no facility for treatment in government hospitals, not even at the Dhaka Medical College Hospital,” said professor of medicine FM Siddiqui of the medical college. Last month he treated two snakebite patients in the hospital but failed to save one of them.
“I had to borrow anti-snake venom from one of my doctor friends as it was unavailable in the market,” Siddiqui said while talking about the difficulty he faced in treating those patients.
During monsoon, as floodwater encroaches into the land area and displaces snakes from their underground holes, the snakes encounter human beings in their search for new abode and often bite them, he said. They do not bite unless they are provoked, he added.
Experts estimate that about 10,000 snake bites occur every year. The antidotes that are available in the market were also not always effective against the poisonous species of snakes that mostly bite people.
“A survey conducted in 1995-1996 estimated a snake bite incidence of 7 per 100,000 people with about 20 per cent mortality,” said Professor M Abul Faiz of Dhaka Medical College.
“There are 28 different varieties of venomous snakes in the country including 12 species of sea snakes.”
“The irony is that most people rely on traditional healers, ‘Ojhas’, as the hospitals are not adequately equipped with logistics and trained manpower for treating life-threatening venomous snake bite,” Faiz added.
He said, most of the reports come from Mymensingh, Rajshahi, Khulna and Chittagong but during monsoon it occurs all over the country.
An intern of ward 4 of the DMCH said last month one patient was referred to the DMCH from Mymensingh Medical College Hospital. The patient died because of the delay in starting the treatment that the MMCH should have initiated earlier, he added.
“More children are coming with bites by non-venomous snakes; for treating venomous snake bites we have to face difficulty as antidotes are not available in the hospital or in the market,” he said. Only Chittagong Medical College Hospital has facilities to treat poisonous snake bite in the country.
Most patients receive pre-hospital treatment from the traditional healers, which includes application of one or more tourniquets in the limbs to stop the circulation of the poison. Although immobilisation is the ideal first-aid for the management of snakebite it is not practiced, Faiz said.
“The Ojhas often drain the snake bite site and make the patients ingest herbal drugs that further complicate the condition of the patients.”
There is also delay in seeking medical attention. A study in Chittagong Medical College found the mean time between bite and hospitalisation was 7.7 hours due to the time spent on traditional treatment.
Snake bite survivors are left with chronic disability including physical handicap from necrotic effects of the venom requiring amputation of the limbs, chronic ulceration and cancer. Some complications also occur because of maltreatment at home.
The venomous snake bites are treatable. Training of healthcare professionals on snake bite management according to the available guidelines is required. Supply of logistics including anti-snake venom in all public and private hospitals needs to be ensured, experts said.
Snakebite deaths likely to rise