BEWARE OF SNAKES!

The authorities must do more to prevent cases of snakebites, writes Adewale Kupoluyi

Of recent, cases of snakebites in the country, specifically in the north, seem to be on the increase. What is more worrisome is that despite the severity of the problem, relevant authorities do not appear to be doing enough to put adequate control on what could best be described as a national crisis. This is not too surprising. There is a general pattern that the nation usually takes when it comes to tackling serious issues. We have cultivated the habit of treating things with levity until they become so severe, devastating and chaotic such that any meaningful intervention may not be helpful by the time they are applied. It is on this premise that the prevalent cases of snakebites should be given due priority and attention without further delay.

More than 100 victims alone were said to have died in the last few weeks following the absence of anti-venom for victims from the northern states of Adamawa, Bauchi, Borno, Gombe, Plateau and Taraba. Statistics of snakebites obtained across the country revealed that there is a steady rise of people either suffering from such attacks or have outrightly died due to poor access to medical facilities. Most of these victims - because of the expensive cost of orthodox medicine - allegedly ended up visiting herbalists because they could not afford the antisnake venom and desire to live. Unfortunately, what the herbalists do have as ‘cure’, with due respect, has been described by observers as mere ‘trial and error’ in the sense that most victims that patronise them are known to have bled in the brain because the venom is vicious, which makes traditional healers incapable of really tackling the problem, since they concentrate on healing the wounds alone.

Snakes usually attack people when they are threatened, picked up mistakenly or trodden on, though some cobras and black mambas can be cocky. Such attacks can become deadly if not treated quickly, but when properly treated, many snakebite cases would not have serious implications on victims, as less than 10 per cent of snakebite victims were said to visit hospitals in Nigeria when attacked. To highlight the severity of the problem, a World Health Organisation (WHO) report shows that Nigeria records 174 snakebites per 100,000 population per annum, of which the carpet viper or saw-scaled snake has been blamed for about 90 per cent of bites, out of which 60 per cent of the cases eventually result into deaths. WHO, however, warns that snakebites remain a neglected public health problem for most of African countries including Nigeria. That is why the country needs to work hard by ensuring that necessary mechanism is put in place to overcome this challenge headlong.

Additional insights on this discourse were provided by the Kofi Anan Foundation, in a 12-page report titled, “Snakebites in Africa: Challenges and Solution”, which carefully examined the issue with inputs from experienced representatives, drawn from the scientific community, public health organisations, civil society and philanthropic institutions, among others. Findings from the report indicated that many health problems were linked to snakebites such as induced death, paralysis and disability. The foundation found out that snakebites negatively affected the lives of thousands, mostly the rural poor and resulting into declining subsistence agriculture and overall quality of life of the people. It further disclosed that an estimated 32,000 deaths and 100,000 disabilities had been attributed to victims on the continent, causing chronic anxiety, depression and Post-Traumatic Stress Disorder (PTSD). Beyond that, people that are bitten by snakes were discovered to be economically-insecure, rural hospitals were found to be inadequately equipped to manage snakebite patients while the problems of lack of quality control and regulation of anti-venom still persist.

Despite this worrisome trend, many of the snakebite cases in Nigeria still go unreported and are not captured in official epidemiological records kept by appropriate bodies that should ordinarily do so. Snakebites should be taken seriously like Ebola, Monkeypox, Lassa fever and HIV/AIDS. This lack of important documentation is not limited to health records, as many other important and reliable data on all areas of human lives are usually very difficult to obtain, making effective national planning a daunting task in the country. Another problem that could have fueled the problem is the low advocacy on the hazards of snakebites coupled with the fact that many health workers in the country were found to have little or no formal training in the management of snakebites.

With the current realities on ground, there is the need to beam more searchlights on this area. Rural populace that are prone to frequent victims are not well protected while they go about their normal daily farming activities with palpable fear. This neglect of vulnerable people should stop. Embarking on public enlightenment among rural communities on how to prevent snakebites would involve giving them timely assistance and first aid. Such emergency and vital information should be made available in the languages that local farmers are familiar with.

Not only that, more medical personnel should be trained throughout the country, beginning with the endemic areas in the north, where cases are rampant, as this would reduce deaths associated with poor handling. People should clear overgrown grasses around their homes, premises and stop keeping snakebite attacks to themselves. They should avoid leaving their doors opened carelessly in a bid to get fresh air. Snakes are reputed to be stealthy and very quiet, making it difficult to monitor their movement. Furthermore, snake anti-venom drugs; Echitab Plus ICP Polyvalent and Echitab G Monovalent, which were said to have been last supplied to the country several months ago, should now be imported with immediate effect. Late placement of order for production should be avoided. This would not only reduce the scarcity, but discourage the tendency for people to either tamper with normal supply or adulterate the drugs. Already, some people were recently reported to be faking the scarce drugs and selling at almost N45,000 per vial, contrary to the original price regime sold by a study group, which ranged from N13,500 to N30,000.

A more sustainable effort would involve manufacturing the drugs through Public-Private Partnership (PPP), to increase access and minimise adulteration. The government should painstakingly identify serious and local organisations with requisite experience that could come in at this critical moment. The intervention of few individuals and corporate bodies is commendable. For instance, Governor Samuel Ortom of Benue State recently procured N31m worth of the drugs for the state. More state governors should follow suit in helping to curb the snakebite menace, especially now that the country is experiencing hot weather when snakebites are likely to be on the increase because the snakes would naturally seek refuge in cool locations, where human beings would prefer to stay.

The Kofi Anan Foundation report also gave far reaching recommendations, comprising short and long-term measures. Short-term strategies include public health education campaigns that encourage the people to sleep under bed-nets, media advocacy using and mobile phones in informing and educating people about simple steps to take to avoid snakebites while long term measures include incorporating inexpensive snake-proofing design in homes and wearing of anti-snake boots. Beyond these approaches, governments at all levels should urgently treat the problem as a national priority in tackling the growing snakebite menace in the land. Kupoluyi wrote from Federal University of Agriculture, Abeokuta