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Although we live on opposite ends of Africa, we have both witnessed the tragedy of snakebite.
In Siaya, Kenya, just a few weeks ago, Akoth (Her real name is not availableA 9-year old girl was bitten in the leg by a rhombic evening adder. Because of childrens’ small body mass, they are far more likely to die from a bite from this species and if it doesn’t kill, the bite often causes permanent disability and limb amputation.
The girl was suffering from swelling and pain and needed immediate medical attention. The nearest clinics did not have antivenom, and the district hospital was 35km away. The cost of transport, treatment and hospital admission was around 10,000 shillings (about USD 100) – a massive sum for rural families living on less than a dollar a day. Although she was at high risk of death, she was discharged from hospital after two days. She was also instructed to continue with an injection course. She had to travel 15km to a clinic for three days. This cost $25 and required additional transportation. She is now somewhat limping but has made some progress.
Gunduma was bit by a snake in Shipadna, Nigeria, a few months prior. However, Gunduma was treated first at home with herbs. Nigerian antivenom costs are high. They cost around 30,000 Naira (about 75 dollars) per dose. Most cases will require three to four doses, plus a blood transfusion. The 20-year-old died after he began bleeding from his nose. He was treated with antivenom, and received a blood transfusion. However, he died one week later. He lost his life because he delayed seeking treatment.
Snakebite is a long-standing public health problem in Africa. According to the World Health Organization, snakebite was added to its Neglected Tropical Diseases list in 2017. 5.4 million people are bitten each year with up to 2.7 million developing clinical illness and up to 138,000 dying. Around 30,000 of these deaths occur in Sub-Saharan AfricaAnother 60,000 people were also left disfigured. It is estimated that approximately 1,000 of these deaths occurred in Kenya while about 2,000 in Nigeria. These numbers are similar to those in other African countries, but they are likely to be underreported.
Poor rural communities are most at risk. Farmers, rural workers, and children walking barefoot from school to work are all at greatest risk. However, droughts, deforestation, rising temperatures and economic activity are leading to changes in snakes’ distribution patterns, meaning some venomous snakes are venturing into new areas, potentially posing greater risks to humans.
Because of the many snake species found in Africa, snakebite is not always easy to treat. Also, data is not consistently collected. Three snakes in Nigeria are poisonous: the cobra, viper and puff adder. Most deaths can be attributed to the latter. carpet viper. Puff adders are the main reason for injuries and deaths in Kenya. They are nocturnal and well camouflaged. Many injuries occur when people go to the bathroom or return home at night. The black mamba, also native to Kenya, is considered the world’s largest and fourth most-venomous snake. It injects a neurotoxin which paralyzes its victims and can kill in as little as 30 minutes. The cobra is the third most dangerous animal in Kenya. There are several sub-species, including the black-necked, spitting cobra. It injects a neurotoxin into its victims’ eyes, causing swelling, pain, blistering, and tissue damage.
There are many myths and misinformation about snakes in Africa. Snakebite patients are often cited as having bad luck or being accused of witchcraft. Victims can be stigmatized after being bitten by snakes, and they can become social outcasts. Many myths are associated with what to do if you get bitten. snake bite patients to rely on traditional or herbal medicine rather than seeking clinical treatment.
The lack of a global coordination point is a major obstacle in tackling the problem of snakebite deaths. This global focal point should be established within the World Health Organization (WHO) which should also require cases of snakebite to be made notifiable – as is the case with rabies and other neglected tropical diseases. By collecting accurate data we can begin to ensure that the correct antivenom is available and affordable in the areas where it is needed most – and that communities are educated about what to do if they are bitten. These steps would reduce fatalities significantly.
Most snakebite victims are from the poorest communities, often with other diseases. They are also more likely to suffer the impact of climate change – which is changing snakes’ habitats and distribution. It is important to include this in remedial measures as a consequence of climate change. UN Climate Change Conference commitments (COP26) made in Glasgow late last year. As we write, a person or child somewhere in a remote village in Africa is fighting for their lives or dying from a poisonous snakebite – all of which can be prevented if we act now.
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Tijani Salaami and Roseline Owa are 2021 Aspen New Voices Fellows. Roseline Orwa, the founder and director of the Rona Foundation in Kenya, is a grassroots organization that supports orphans and vulnerable children. Twitter: @RoselineOrwa. Dr Tijani Salami is a physician and sexual and reproductive health specialist. She is also the founder of Sisters Caregivers Project Initiative. This initiative provides social and medical support to women and advocates against child marriage and maternal malnutrition. Twitter: @DrSalamiTijani1.
