31 Aug Snakebites in India: a great burden on the lives and livelihoods of rural communities
India recorded an average 58,000 deaths from snakebites annually, reports the recent ‘Trends in snakebite deaths in India from 2000 to 2019 in a nationally representative mortality study’. The study conducted by the Centre for Global Health Research (CGHR) at the University of Toronto states that 97% of these deaths were in rural areas. This is a serious problem that needs more attention because the number of deaths due to snakebites exceeds many other tropical diseases. While Rabies accounts for 20000 deaths annually, the number of deaths due to dengue is around 200.
This Neglected Tropical Disease (NTD) also results in long-term physical and mental disabilities. Limb amputations, depression and post-traumatic stress, often in the main income earners of a family in the rural areas, result in severe economic impacts for the families affected. In a study conducted in Sri Lanka, more than one-fourth of victims reported that snakebite resulted in a negative change in their employment and 10% had stopped working altogether. The study also concludes that an ongoing psychological disability can be experienced for up-to 4 years after the incident. Snakebites therefore result in devastating outcomes on the lives and livelihoods of rural households.
The World Health Organization (WHO) has come up with a comprehensive strategy with an aim to reduce these deaths and cases of disability to half by 2030. The four strategic aims listed are:
- Empower and engage communities
- Ensure safe, effective treatment
- Strengthen health systems
- Increase partnerships, co-ordination and resources
With respect to empowering and engaging communities, participation of NGOs could be a game changer. NGOs are spread across India and operate even in the remotest parts of the country. They can educate the communities on reducing occupational and environmental risks, partner with private organizations to bring down the costs of prevention equipment, and engage the communities to improve solutions in quick time.
Reducing occupational and environmental risks: Farming activities and snake movements are at peak during the monsoon. Educating communities on simple practices like using rubber boots and gloves while working in the farms, and using torchlight while going out in the dark to turn on the water pump could reduce a large number of cases.
Apart from safe farming practices, environmental risk education regarding rodents, garbage, firewood, and cattle-sheds, all of which attract snakes, is necessary. Encouraging eradication of rodents, proper garbage management, and avoiding firewood and cattle-sheds close to homes will prevent snakebite envenoming.
Reducing costs through partnerships: The average monthly surplus of a rural Indian home is Rs.1413. It is also as low as Rs.95 (per-capita) in states like Andhra Pradesh, which have a high incidence of snakebite cases annually, according to All India Rural Financial Inclusion Survey (2016-17) of NABARD. The costs of prevention equipment like rechargeable solar lamps, rubber boots, mosquito nets, etc. need to come down and payment methods like instalments should be adopted by the producer organizations. While production costs might not change significantly, by leveraging the reach of NGOs (plus the trust people have in them) to market products, aggregate demand, sell and collect money with no or low associated cost will bring down the overall price per product.
Such agreements despite coming at reduced profit margins will result in greater market for producer organizations in quick time and better health outcomes and livelihoods for NGOs.
Increasing engagement to improve solutions: Humane Society International (India) and The Liana Trust are using radio telemetry through engaging communities, to track important information relating to the movements of snakes, ecology and behaviours. The team is developing a snake safe guide based on this information to give precise guidance to people. Similarly, engaging communities to prepare database on geographical distribution of snakes will help in distributing appropriate anti-venoms to the local hospitals.
In India 1 dies in every 10 minutes due to snakebite. The WHO’s measures to mitigate this severe neglected health concern would require collaboration with and participation of NGOs for faster success.
Abhishek Reddy M
Assistant Manager – Communications