The alarm bell on snakebites in Assam

The inclusion of Assam among the five states for piloting the Snakebite Helpline No. (15400) by the Ministry of Health is good news. Awareness of snakebite prevention must remain a key focus area, but immediate medical care and assistance in snakebite incidents are crucial to saving lives. The helpline number will ensure prompt medical care and provide information to the public in the five states. Puducherry, Madhya Pradesh, Andhra Pradesh, and Delhi are the other four states for this pilot project. The initiative has come under the National Action Plan for Prevention and Control of Snakebite Envenoming (NAP-SE) in India, which has been rolled out with a vision to reduce snakebite deaths by half by 2030. The reported death of a teenager due to the deadly bite of a highly venomous Russell viper in Assam’s Sonitpur district last year has already sounded the alarm bell on snakebite incidents. The objective of the NAP-SE is to reduce morbidity, mortality, and associated complications due to snakebite. Key strategies included in it are capacity building of health professionals for first aid, diagnosis, and management of snakebite cases, accessibility of treatments, strengthening the emergency care services at district hospitals and community health centres, including services for ambulances, strengthening surveillance of snakebite cases and deaths, establishment and strengthening of regional venom centres, and operational research on anti-venoms and diagnostics, among others. Official data shows that in India, an estimated 3–4 million snakebites occur annually, which claim around 50,000 lives, or almost half of all snakebite deaths in the world. Assam has also recorded rising incidents of snakebites, which is a cause for grave concern. The NAP-SE highlights that around 90% of snakebites are caused by the ‘big four’ among the crawlers: common krait, Indian cobra, Russell’s viper, and Saw-scaled viper. It notes that administration of anti-snake venom is effective in 80% of snakebite cases, but a lack of trained human resources and health facilities to treat snakebites remains a critical gap. Incidents of taking a person bitten by a snake to a quack or a faith healer instead of taking the patient to the nearest hospital galore in the state are reflective of poor awareness in some areas. The availability of anti-snake venom in the hospital is another crucial factor in ensuring timely medical care. A key challenge in ensuring the right line of treatment is that often family members or other people accompanying the patient cannot identify if it was a venomous or a non-venomous snake. Most people are also not aware of the first aid that needs to be provided immediately after the snake bite and as the person is being taken to the nearest hospital with anti-venom stocks. Building awareness of the dos and don’ts in the case of snakebites is crucial to ensuring correct medical care. Supporting the NGOs, nature groups, wildlife biologists, and wildlife activists in raising awareness in the community about snakes and snakebites will help spread the knowledge. More emphasis should be laid on an awareness drive prioritising farm households and tea garden workers’ households, as they are among the most vulnerable to snakebites at agricultural fields or tea gardens. Mistaking Russell’s viper for a young python is an area of great concern. Python being non-venomous, people coming across it on agricultural fields or residential areas rescue it and hand it over to forest authorities for releasing it back to its natural habitat in the wild. Conducting awareness camps in educational institutions will help protect young children from snakebites. Care must be taken to train them to acquire safety skills without being afraid so that they can take care of themselves when they encounter snakes while on a jungle trail, hiking, or playing on cropped land. Awareness of snakes and snakebites will help fight the superstition around snakebites and bust the myths of quacks and faith healers having the capacity to treat an individual bitten by snakes. Such awareness drives must be sustained and need to cover all sections of society to get the desired results. Apart from educational institutions and panchayats, local bodies can play a crucial role in building awareness and providing necessary information on the availability of the treatment for snakebites through the display of information on office premises, marketplaces, community halls, etc. Leveraging social media, community prayer hall gatherings, and printing snakebite helpline numbers on ration cards can help speed up the spread of awareness among the targeted communities. Pressing the panic button will not help. Authentic and scientific information on snake species available in different geographical areas will educate the masses to take adequate precautions to prevent a snake bite and prevent indiscriminate killing of snakes out of panic. The State Health Department putting in place the monitoring of anti-snake venom stocks will ensure their availability. Hospitals having adequate stocks is crucial to boosting people’s confidence in medical care for snakebites.