05 June 2013

SNAKES






 Snakebite deaths
Those who have seen the BBC serial the ‘Speckled Band” know how deadly a snake could be. Every year thousand die due to poisonous snake bites in Orissa, many are reported, others go undiagnosed and unreported. We have anti-snake venom for four common land venomous snakes of India. They are Cobra (naga), Russell’s viper (Bada), Saw-scaled viper (small – bada sapa) and kraits (Chiti). Kraits are of different colors and sizes but in Orissa we have banded kraits and common kraits (kaudia chiti, speckled band). The incidence of snakebites is highest during the end of summer and beginning of rainy season or at times due to unseasonal rains. We have transgressed into their territory by building houses and roads, as a result of which they come out of their hiding place and bite human beings. The venom is used by the snake to paralyse its victim so that it becomes easier for it to swallow. Also, the venom has digestive properties for the snake. They bite human beings for self-protection and a majority of snakebite incidents are accidental. All marine snakes are highly poisonous but seldom bite.
The problem with snakebite and snakebite poisoning are different. They are not synonymous. A person may be bitten by a poisonous snake but may not die due to many factors: First, biting over a thick cloth or on the shoe, or biting after a fight/meal. Another reason could be broken teeth. Also, there could be a possibility of a dry bite. We call a bite a dry bite when no venom has entered the victim.
Many die due to fright, shock, running after the bite, and not coming for treatment in time. People have misconceptions about snakes hence they go to quacks and snake charmers and arrive very late in hospitals and blame the doctors and authorities. A full-grown cobra and King Cobra inject a huge amount of poison which is enough to kill a horse and the time taken to kill a human being may be as short as fifteen minutes to one hour. Running after the bite hastens death as the poison spreads faster and reaches the brain and other vital organs within a very short time.
Krait bites kill a person slowly but surely as the bite is usually less painful compared to vipers and cobras. Krait snake (Chiti) bites without indication whereas cobra gives a warning before a bite.
The only treatment to neutralise the poison is by injecting anti-snake venom (ASV) which is in short supply due to various reasons. Majority of snakebite victims die due to respiratory failure and some due to internal bleeding and shock. The treatment is highly specialised and majority of doctors are not trained in treating snakebite and respiratory care. Most victims of snakebite first go to Government-run primary health centres where there is a limited or no stock of ASV, plus there is no electricity or inverters to run a ventilator at the time of need, which is required for respiratory support! The doctor in peripheral villages and headquarters hospitals must be given a short course of training on how to put a tube in trachea (respiratory pipe) and connect it to an Ambu Bag or ventilators, before shifting him or her to a better-equipped center. If cheap ventilators of substandard quality are used in PSCs which are situated in far-off places, the victim may not survive long enough to reach another hospital. Many might not be aware that our ex-PM’s elder sister died due to snakebite in a village of Uttar Pradesh without getting any medical treatment.
From years of experience in a tribal belt of Orissa, majority of doctors will agree that many lives can be saved through public awareness, preventive measures and timely shifting the victim to proper place. Probably some celebrity may earn crores by projecting these deaths of innocent victims as doctor’s negligence or Government’s callous attitude or something else. However, before that we must do something, because many healthy people die every year due to snakebites. Our MLAs did not attend Assembly for days together just because someone told them that a snake had been spotted in the vicinity of Orissa Assembly Hall. To the contrary, our villagers spend their life amongst snakes, rapists, bears, thieves and ruffians. Hope this message reaches to the people who are victim of man-made environmental changes and to the administrators; so that many valuable lives can be saved by timely intervention in future.
Sanjoy Kumar Satpathy
Bhubaneswar

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