Save Lives of Snakebite Victims in Rural India

25 June 2019, Pithora, Chhattisgarh, India: Harishchandra, a 25-year-old male with viper bite on the right big toe, was brought to Anjali Health Centre at 2.40 pm on 23^rd June, 2019. He was bitten at 12.30 in the afternoon while working in his field (harvesting okra) in his village - Dumarpali. Other people from this village had been treated earlier at Anjali Health Centre (AHC) for snakebite and he was quickly brought there on motorbike.

Harish had been bitten on the side of the right big toe near the toenail. On arrival, he had been bleeding profusely from the small puncture wound. He presented with very low blood pressure (70/60) and a weak pulse. He was conscious and talking but very frightened and in shock. He was reassured by Dr. Archana at AHC and slowly calmed down. He was also in severe pain and stated that the pain extended as far up as his right knee. By evening the same day, the pain had decreased and his blood pressure had improved.

A total of 25 vials of ASV were administered to the patient and it took more than 24 hours for his blood to clot normally. Four rounds of 20-minute whole blood clotting test (20WBCT) had to be drawn before normal clot formation was seen on 24^th evening. Discolored urine threw up concerns of kidney damage but, thankfully, renal function tests were within normal limits. Had that not been the case, Harish may have had to be referred to Raipur which has specialized hospitals, as AHC does not have a dialysis unit.

Harish’s blood test on admission also showed signs of infection for which he was treated with IV antibiotics. On arrival, he had a mild swelling in the foot, but that increased as the hours passed. At the time of discharge, the foot was still swollen and a cause for concern as it could result in tissue necrosis. Harish was switched to oral antibiotics and has been asked to return for followup every two days.

Viper venom is hemotoxic and the patients present with bleeding or clotting abnormalities and cardiovascular abnormalities. Patients may develop excessive bleeding from local bite site and also can suffer from severe internal bleeding if intervention is delayed. Patient can also develop cardiovascular symptoms like dizziness, fainting, visual disturbances, low blood pressure, heart rate abnormalities (arrhythmias), etc.

Snakebites kill close to 45,000 people in India every year. The first step to reducing this number is implementing 3A’s – Awareness, Ambulance, Antivenom.

With monsoons already setting in across the country, awareness is the need of the hour. Having knowledge of simple precautions and first aid measures can prevent snakebite and significantly decrease mortality. We have set ourselves the target of conducting 100 snakebite awareness workshops during the monsoons as this is when maximum snakebite cases are reported. It costs less than $40 to conduct a workshop that can reach out to about 100 people. The workshops have already begun and we will be sending you a report on them soon.

Thank you so much for helping us to take care of Harish and others like him. But we can’t rest… not just yet… not when every 5 minutes, somewhere in India, a person dies of snakebite.