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Snake bites: Be careful how you treat them
For a snake bite victim to be told not to panic is unrealistic. And yet, that is one of the things they must do. Do not panic, try to limit movement in the affected area and have it immobilsed while you wait to recieve treatment.
At least every adult especially those who practice farming, forestry and construction has encountered a snake at one time in their life.
Snakes are are longated, legless, carnivorous reptiles found all over the world especially in warm tropical climates. Common snakes including the black mamba, king cobra, banded krait, saw-scaled viper and rattle snakes.
These can be found in a variety of habitats, including forests, deserts, and in water, depending on their species. They can also enter any shelter to warm up or cool down, according to scientists.
Defense mechanism
Snakes bite as a defense mechanism because they don’t have limbs or claws, or any other means of defense. A snake bite can be life-threatening if the snake is venomous. In that case, one should seek medical care as soon as possible. Unfortunately, there are many myths about the right first aid for snake bites. Giving the wrong first aid may result in permanent damage or death.
Management
According to Dr Jackson Amone, the commissioner for clinical services at the Ministry of Health, many times, rudimentary first aid is applied to victims of snake bites such as; tying the bitten areas with a cloth or bandage.
This stops blood from flowing to that part of the body and if circulation is cut off for a long time, that part of the body will ‘die’ (gangrene). As a result, it will have to be cut off.
“The most important thing to do is reduce activity in the area. Make that part immobile.
Immobility reduces the speed and amount of venom reaching the vital organs because the blood will be pumping slowly,” Dr Amone says.
He further explains that with this kind of first aid the speed with which the venom reaches the blood stream will be reduced and this lengthens the time the venom takes to reach the vital organs such as the heart, lungs and all the other organs.
Denis Kibira, a pharmacist and executive director Coalition for Health Promotion and Social Development, a non-government organisation, explains that only 50 per cent of the snakes we have in Uganda are venomous.
“Most health workers don’t have a lot of training on managing snake bites. So, they can’t tell which symptoms come from being bitten by venomous snakes” Mr Kibira states.
Also only 50 per cent of the venomous snake bites actually inject venom because the snake has to bite several times for it to be able to inject venom,” Kibira says.
He cautions health workers that majority of the people who report to health centres with snake bites need to be managed properly so as to understand whether the snake is venomous saying that health workers don’t have the knowledge to identify snake types.
Kibira says the available clinical guidelines are wanting and sometimes wrongfully propose tying up bitten areas which is wrong , hence the need for government to train health workers.
Myths
Both Dr Amone and Kibira disapprove of the use of black stones commonly recommended for treating snakebites. They say the stones do not work at all.
“The best thing is to reach out to the nearest health centre so that the patient can be treated with antivenom,” Kibira advises.
Prevention
James Ntulume, a specialist in treating both reptiles and victims of their bites advises that when one encounters a snake, they should step back. That way, he says, the snake will crawl away instead of attacking.
“Do not shout or try to beat it because it will bite you in self defense,” Ntulume cautions.
“We have snakes that are of average length and those that are fat and short. Most times the average sized ones run away when exposed but the short and fat ones stop and play blind. When you come near or step on them, that is when they strike in defense,”Ntulume says.
Types of snake venom
Ntulume explains that there are three different types of venom which are carried by the different snakes, including cytoxic, neurotoxic and heamotoxic.
He warns that someone who has been bitten by a snake that carries cytoxic venom risks dying faster if the affected part is tied because it makes the part swell and quickens the spread of venom, stating that such a patient should be rushed to the doctor so fast.
“When beaten by a snake, one can die in between six minutes and seven days depending on the type of venom. But, if you get the right antivenom, there is 100 per cent recovery chance,”Ntulume adds.
The experts call upon government to promote awareness among the communities on how to manage snakebites when they happen in order to avoid reckless mistakes like tying the affected parts that can lead to amputation and death. Through awareness programmes, the experts say, myths about snake bites with be debunked.
Challenge
However, the country has also faced setbacks in the management of snakebite victims caused by rampant stock outs of antivenom and their complementary drugs in various parts of the country.
A study conducted between 2017 and 2018 titled: Neglected Tropical Diseases programme, by Makerere University School of Public Health (MSPH), showed that most health facilities across the country lack anti-venom drugs to treat snakebites.
“All districts in Uganda report snake bites although most cases are reported to lower health facilities and yet National Drug Authority stocks the anti-venom drugs only at the levels of health centre IVs,” Suzan Kizito, the lead researcher, says.
Experts have also raised concerns that the antivenom available in the public sector is from India which makes it less effective than that made from South Africa. The experts explain that antivenom is made from snakes in a particular area, yet their snakes are different from the ones in the African region.
Therefore, the adverse effects like anaphylactic shock (an extreme, often life-threatening allergic reaction to an antigen to which the body has become hypersensitive),
Cases of snakebites
In Uganda, a snakebite research carried out by Health Action International, a global health non-governmental orgnisation, in partnership with the Coalition for Health Promotion and Social Development, showed a total of 593 snakebite cases in more than 144 health facilities were reported in six months.
The research that was carried out between October 2017 and March 2018 also indicated that 92 per cent of the healthcare workers have not received any training in treating snakebites, while only four per cent of the facilities stock antivenom at the moment.
However, the total number of snakebite cases, as well as deaths recorded in Uganda on an annual basis, remains unknown as no research has been conducted and a 70 per cent of the same is estimated to go unreported.
