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Snakebites, an underreported issue

Forty-five thousand people die annually in India from snakebites claims a survey conducted. Hospital underreporting of the issue, however, allows for widely varied estimates, ranging from 1,300 to 50,000.

Copyright: <a href=''>adogslifephoto / 123RF Stock Photo</a>The survey, published in PLOS Neglected Tropical Diseases, means that India potentially holds the highest number of snakebite deaths in the world. He study suggests that the numbers may be toned down by hospitals, in order to suppress this reputation.

Locality of the snakebites must also be considered. As the problem is endemic to rural areas, many individuals will not visit a hospital, and may instead seek treatment from local healers or the quacks that fill the void left by inadequate healthcare infrastructure. This again leaves the numbers far lower than the reported figure.

Many of these deaths are entirely preventable. Antivenom exists that could save thousands of lives. Supply chains for these antivenoms are not adequate to address the issue. Underreporting by the hospitals may be making this issue harder to address as the authorities do not know which areas need treatments most.

An example of this situation is that of a six-year-old boy from Aarey Colony, Raj Zhop. The child was transferred repeatedly between three hospitals following a bite by a cobra. Due to the absence of antivenom at each of the hospitals, the child eventually succumbed to the bite.

Snakebites have been linked to poverty in a recent letter published in The Lancet. The letter notes the majority of the people at risk of being bitten are rural workers, farmers and hunters. These occupations are typically paid a low wage.

Public healthcare in areas susceptible to snakebites is usually limited so those affected need to seek treatment in private healthcare facilities. The cost of treatment can vary from Rs 6,500 to Rs 1.1 lakh. This level of expense, often paid out of pocket can lead to poor rural workers being placed into huge levels of debt in order to save their own lives.

The letter attributes a number of debt related suicide cases related to snakebites. The recommendation is  that antivenom should be more regularly stocked by government run hospitals.

Preventative measures are also worth considering as a viable option of reducing snake bite related deaths. Simple measures such as the provision of public toilets in rural areas — a facility often found to be lacking — could allow for significant reductions in deaths:  Open defecation often involves people in rural areas walking through fields at night with consequent exposure to venomous snakes.

Through better access to treatments, as well as adequate preventative measures, death tolls could be reduced and fewer people would be reduced to poverty seeking access to lifesaving treatments.


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