The Global Snake Bite Initiative

Snake bites are an important issue worldwide, and particularly in India. It is an important issue specially for the rural population, which is around 70% of the total. Numbers are not fixed but it is accepted that between 45.000 and 50.000 people die in India every year and much more will suffer from permanent physical and psychological disabilities.

Snake bites (SB) are considered an occupational disease. As they affect frequently a bread earning member of the family, they will have economic consequences like indebtedness, infant malnutrition and even suicide. All this should be considered too when we think on snake bites.

This is a resources blog. What to me has been helpful to start navigating throug the world of snake bite related diseases and their mitigation. Epidemiolgy, basic research, biology, law, communitary and emergency medicine, pharmacology, many disciplines are interconnected here. I would like to go through them step by step.


I would like to start with the "Global Snake Bite Initiative" website:

GLOBAL SNAKE BITE INITIATIVE

http://www.snakebiteinitiative.org

"Working to save lives in the world’s poorest communities …" this is the first statement we can read. This initiative comes from some of the most relevant scientist on snake-bite envenomation of the world, like Dr. Robert Harrisson (Liverpool School of Tropical Medicine, Dr. David Warrell (Oxford University) Dr. David Williams (University of Melbourne) or Dr. Jose Maria Gutierrez (University of Costa Rica). You will find them in the Board of Directors and the Advisory Commitee. It also links you to research resources, professional societies related to snake bite envenomation or country specific resources (See the Indian Snakebite Project).

In the "home" page, there is a 7,30 minutes video (posted here). Please watch it. Many scenes are not easy to see and yet, is a worderful description, very accurate on the snake bites situation all over the world. I've decided to transcribe it as the main points around snake bites are all depicted here. It coul be used as an informative and motivating tool to create awareness on the general population about the burden of snake bites.

https://vimeo.com/167436988

SNAKE BITES CONSEQUENCES, MUCH MORE THAN PHYSICAL
Prof. Abdulrazaq Habib
Bayero University, Kano, Nigeria
"We have seen death, we have see disability, we have seen desfigurement, we have seen depravation, we have seen destitution... from snake bite".

Dr. Andrew Kwonyike
County Minister of Health, Baringo County, Kenya
"At the moment, as a Minister for this County, I'm extremely worried. I'm scared, I do not know what will happend"

Voice: 
"It is a daily reality, a race to traverse the isolated, rocky and unforgiving terrain while knowing that treatment may be hours or days away".

Dr. Robert Harrison
Liverpool School of Tropical Medicine
"Can you imagine the distress from running from your home, perhaps in the night, with your child in your back, suffering from snake bite, screaming in pain?"

ANTI-VENOM, THE LIFE SAVING TREATMENT NOT ALWAYS AVAILABLE. 
Voice: 
"and when you finally flight down a passing vehicle in the hope it will take you to the hospital, will the hospital even have the anti-venom needed to save your daugther's life?".

Dr. A.K. At the hospital's pharmacy
"This only one left" "Mean there is only one left in the whole hospital?"
"Anti-venom is very scarce. It comes and it gets finished and then we stay without it for some time".

Voice: 
"Every day it is a sadness that never goes away, your daughter buried next to your house, yet another young life taken during the night, and the sister left behing, she met her fate from the very same cobra that slid into their bed. Her hand now is severely deformed, she is blind, cannot walk, she will never marry, an innocent victim without a chance to a productive life"

A RURAL PLIGHT, INDEBTEDNESS.
Voice: 
"Every day is devastation without end. A Coconut farmer, in Southern India, who can only watch someone else climbing the trees he once climbed. Already left with nothing but years of debt. Selvarasu and his wife part with what little they have just so they can pay to keep their children in school".

Selvarasu: 
"This is something that should never happend to anyone. No one should ever suffer like this".

Prof. David Warrel
Oxford University
"Those victims of snake bite are amongst the most impoverished levels of the community. They are nearly all agricultors, farmers, herdsmen, who live in a snakes infested environment and, city dwellers may be genuinely ignorant of the plight of people that lives a few miles away and are the food producers for the country".

Dr. A.K.: 
It is a huge cost, that you cannot imagine.
... "they have to sell and dispose all the assets that are in the family to ensure that this person is taken care of". 

Africa, a community gathering: 
"OK, so the people raising their hands that have been bitten by a snake..." "I want to say that the people need to come from overseas to come and help us because the problem is really real".

A VERY SLOW AND PAINFUL HEALING PROCESS
Voice: 
"But, actually, this are the real cries. This three year old kenyan girl wont be up playing today, instead one of the multiple visits each and every ongoing week to treat her wound. In a few months she will undergo a major skin graft."

AN OVERVIEW, SOME FIGURES.
Dr. David Williams
Global Snake Bite Initiative
"Man has faced major health challeges on the past. The world has the capacity to deal with this problems, we got Neglected Tropical Diseases that are no loger being neglected and this is important. 
But today, 342 snake bite victims accross the tropics again are taken from their families. We know 125.000 die each year from snake bites and two to three times that number are leaved without limbs, disabled or permanently disfigured, and those are the people that actually might go to a hospital to be counted. Wharever the number might be, the true figures go beyond any data, beyond any study.
The only way you can truly understand snake bites is to walk into any hospital, any village. Everybody knows somebody whose life has been turned upside-down.
Comparison figures of SB with malaria, tuberculosis, HIV-AIDS (cannot fully understand)."

Voice: 
"From Vietnam to Pakistan, from the Central African Republic to Latin America, if you colour in a world map with reported death tolds and stimates of over 1.000 people per year, it is a map that rapidely becomes more colourful, and if you add the countries with 50 or more deaths per year suddently, the magnitude becomes clear"

WAKE-UP!
Prof. A.H.
"If we are to save lifes, limbs, this is the time for the whole world to wake up to this important problem that has, for many years, linged with no interest.

THE ROLE OF PREVENTION
Voice:
"Realistically, the best long term strategy is to prevent snake bites, not to treat them, in the first place. We have scientist, doctors, advocates all around the world that fight for this people on a daily basis. 
Educating people on the ground to encourage the simple use of footware, training rural health workers, even teaching people that visiting a traditional healer is not necessarily of any use and of course, we have effective an afordable anti-venoms that have been developed and are making huge differences in places like South Africa, Latin America and even here in Papua New Guinea. 
We have the tools to make a change now. 

IT IS TIME FOR A GLOBAL CHANGE
Prof. Jose Maria Guitierrez
Instituto Clodomiro Picado
University of Costa Rica
"It is about time that snake bite is stopped being ignored by the world. It is a matter of human rights, a matter of social responsability, a matter of using science for what should be used, for the well-being of people. 

THE WISH, THE GOAL
Doctor:
"Nobody should die of snake bites"

ॐ लोकाः समस्ताः सुखिनो भवन्तु ॥

Om Lokah Samasthah Sukhino Bhavantu

May all beings everywhere be happy and peaceful.