Kampala, Uganda | URN | Ninety two per cent health workers in the country lack the training to manage snake bite injuries, Dennis Kibira, the Executive Director for Coalition for Health Promotion and Social Development (HEPs) has revealed.
According to Kibira, a study conducted in 2018 also shows that only 4 per cent health facilities across the country stock anti-venom. He explains that the study found that a lot of people don’t seek care at health facilities when bitten by snakes.
This he said is partly because even with big numbers of people being amputated and others dying of envenoming-a potentially life-threatening disease that typically results from the injection of a mixture of different toxins, snake bites have been largely overlooked by healthcare planners.
But, like Uganda, even countries elsewhere are only waking up now to pay attention to the problem after the World Health Organization (WHO) added envenoming to the list of the top 20 Neglected Tropical Diseases globally last year. Then, Uganda started a process of coming up with a strategy on prevention and management.
Dr. Jackson Amone, the Commissioner Clinical Services at the Ministry of Health, says they have started drafting guidelines for treatment for health workers.
He said the guidelines will be included in the general clinical guidelines and essential medicines lists that are currently being updated and will be released next year.
Apart from the clinical guidelines for already practicing health workers, the draft strategy also talks of developing a health worker’s training curriculum because nowhere in medical training is envenoming considered and also speaks of creating awareness and ensuring availability of right treatments.
Kibira says the available treatments on the market are not meant to treat snake bites that happen in Uganda.
James Ntulume, the proprietor of a snake farm who often treats people bitten by snakes, says what can work for Uganda well is the South African Antivenom but it’s quite expensive and only available on the private market. Each vial he says goes for about Shillings 400,000 and yet one may need up to 8 vials for a single treatment for a poisonous bite depending on severity of the injury.
However, even before the strategy which is yet to be approved by the Health Ministry is finalized, Kibira urges the public to drop dangerous practices that could aggravate injuries.
This was disclosed at a meeting organized by World Health Organization (WHO) and attended by among others officials from Ministry of Health, conservationists and snake handlers to review a draft strategy on snake bite management.
How are snakebites treated?
- Seek medical attention as quickly as possible.
- Apply first aid treatment:
- Remove any jewelry or watches, as these could cut into the skin if swelling occurs.
- Keep the area of the bite below the level of the heart in order to slow the spread of venom through the bloodstream.
- Remain still and calm. Moving around will make venom spread faster through the body.
- Cover the bite with a clean, loose-fitting, dry bandage.
- The main goal is to administer the correct antivenom as soon as possible. Knowing the size, color and shape of the snake can help determine the best treatment for a particular bite.
Antivenoms are made by immunizing a horse or sheep with the venom of a particular snake, then processing the animal’s blood serum (the watery part of the blood), which will contain antibodies capable of neutralizing the effects of venom.
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Monospecific antivenoms treat the bite of a specific type of snake, while polyspecific antivenoms can treat bites from a number of snakes found in a particular geographic region.
The following is a list of DO NOTs:
- Do not pick up the snake or try to wrap it up or kill it, as this will increase the chance of getting another bite.
- Even a dead snake is able to bite.
- Do not apply a tourniquet.
- Do not cut across the site of the bite marks.
- Do not try to suck out the venom.
- Do not apply ice.
- Do not immerse the wounded area in water.
- Do not drink alcohol.
- Do not drink beverages with caffeine.
What can be expected after treatment for a snake bite?
In most cases, it is necessary to remain in the hospital for up to 24 hours in order to monitor blood pressure and overall health. If blood pressure has fallen, intravenous fluids (through a needle in the arm) may be necessary. If there has been a great loss of blood, a blood transfusion may be needed.
A period of monitoring is also necessary because some people can develop a severe allergic reaction after receiving antivenom. Because of this risk, antivenom should be given only by a trained medical professional.
The time required for complete recovery will depend on the kind of snake bite. In most cases, children can recover from the bite of an adder in one to two weeks. Most adults will take more than three weeks for full recovery but 25% will need one to nine months.
Pain and swelling are common long-lasting effects in the area of the body where the bite occurred.