FATALITIES FROM SNAKEBITES

Public hospitals should be adequately equipped

The death of an Abuja-based rising singer, Ifunanya Nwangene, after she was bitten by a snake has raised concerns about one of the most neglected public health problems in Nigeria today. According to reports, the first hospital to which she was taken had no antivenom. The second, a Federal Medical Centre had an incomplete dosage. But many snakebite cases go unreported and thus do not appear in official epidemiological statistics. Besides, most health workers in Nigeria have little or no formal training in the management of snakebite. 

With a mortality of 12 per cent, hundreds of Nigerians die annually from venomous snake bites, yet authorities in the health sector do not take the challenge seriously.  From north to the south, inhabitants of our rural communities are frequent victims as they go about their daily food production and animal rearing activities, and sometimes even in the comfort of their homes. According to the World Health Organisation (WHO), snake bite particularly affects the most vulnerable members of society, which is why appropriate policies need to be put in place to tackle the menace. Treating snake bite requires at least two vials of anti-snake venom but with one vial costing as much as N85,000, most Nigerians in rural areas cannot  afford the medication. States with the most cases of snakebite are Gombe, Plateau, Adamawa, Bauchi, Borno, Nasarawa, Enugu, Kogi, Kebbi, Oyo, Taraba and Benue. Former governor of Benue State, Chief Samuel Ortom reportedly spent about N680m on treating thousands of victims over 22 years period, with some dying due to delayed arrival for care.

   Against the background that guidelines for the prevention and clinical management of snakebite have been developed by WHO/AFRO, we should not be witnessing the number of fatalities being recorded in the country. These guidelines, developed at the request of the federal government two decades ago, are meant to assist health workers to improve medical care for snake bite victims. They are also to serve as a source of information for the public on how snake bites can be deadly if not treated quickly.   

While the right anti-venom can save a victim, getting to an emergency room as quickly as possible is very important. If properly treated, many snake bites will not have serious effects. But the cost seems prohibitive. Since most of the victims are mainly subsistence farmers, it is important for the government to subsidise the treatment or make the anti-venom available in primary healthcare facilities. ‎Besides, government, at all levels, must strengthen public clinics and hospitals as well as engage residents of rural communities in enlightenment campaign on preventive measures.   

In 2011, the federal government promised to make Anti-Snake Venom (ASV) available and affordable but insisted on preventive strategies.‎ That led to the establishment of the Nigeria/UK Echitab Study Group to research and develop ASV, while exploring ways of providing free treatment for snakebite victims. The inauguration of the structure that houses the Echitab Snakebite Control and Research Centre in Kaltungo in Gombe State was part of the collaborative efforts aimed at finding lasting solutions to the menace of snakebite in the country. It has over the years developed three different brands of ASV, using venom extracted from local snakes purposely to address the Nigerian situation.   

While the idea to increase research activities and prepare room for the development of ASV in the country is good, there is an urgent need for sustained public enlightenment, particularly among dwellers of rural communities. To ensure the availability of the ASV before local production of the drugs begins, government should import large quantities. It is also important to train medical personnel to effectively manage cases of snakebite early since the venom usually worsens the health of victims by the minute and increases their likelihood of succumbing to death because of its potency.