In March last year, Jeetu Gujjar was walking home after dusk, along an unlit road towards Ballabhgadh village in Rajasthan. He stepped on something and felt a piercing pain. Reaching home, he saw blood oozing from his toes, and two clear fang marks. He had been bitten by one of Asia’s most dangerous snakes, the Indian saw-scaled viper.
Common and highly venomous, saw-scaled vipers live in close proximity to people and are feared for their high-speed strikes. Over the next three days, Gujjar’s condition deteriorated, his body developing dark patches as blood poisoning took hold. All his helpless family could do was pray.
Gujjar’s uncle, Timan Singh, who worked for the nearby Bhopal facility of the Bombay Natural History Society in Madhya Pradesh, asked scientists there for help. After an online introduction to Priyanka Kadam, the founder of the Snakebite Healing and Education Society (She), it emerged that Gujjar could be saved. He was taken to a hospital in Jaipur, 200km from the village, and given snake anti-venom, supporting medicines and eight blood transfusions.
Six days later, Gujjar was well enough to go home. He went on to make a complete recovery. Yet he was one of the luckier cases. The 2011 snakebite mortality survey estimated annual snakebite casualties in India at 45,900, making it the death-by-snake capital of the world.
Snakes are found close to human habitations due to the abundance of rodents, their staple diet. India has roughly 300 snake species, of which 62 are venomous or semi-venomous. It is the “big four” – the spectacled cobra, common krait, Russell’s viper and saw-scaled viper – that cause the most fatalities.
Revered in India as a symbol of supernatural power, snakes are worshipped by some communities. These beliefs encourage people to trust faith healers and avoid medical treatment, often resulting in the death of the victim.
Kaluram, a farmer from the village of Khawa in Rajasthan, has lost three family members to snakebites. His mother, Prembai, was bitten by a cobra and died while going to the temple for faith healing. His sister, bitten while sleeping, also died en route to the temple. His grandmother, Kanidevi, was bitten by a snake when alone in the house and was dead by the time the family returned.
The four snakes that cause the most human fatalities in India are, clockwise from top left, the spectacled cobra, the common krait, the saw-scaled viper, and Russell’s viper. Photograph: Priyanka Kadam/She
“Snakebite is an accident, not a misfortune,” says Kadam, who created She, a self-funded platform connecting families, doctors and social activists, in response to a rise in the number of snakebite victims.
“The large number of snakebite death cases per annum in India occurs due to three main reasons: lack of adequate medical infrastructure, strong belief in myths, and lack of trained doctors,” says Soumya Sengupta, a schoolteacher from Bankura, West Bengal, who works with Bharatiya Bigyan O Yuktibadi Samiti, an NGO that works to dispel myths and dogmas.
In rural and remote areas of India, where medical facilities are far removed and transportation limited, the impact of snakebites is severe. Kadam calls snakebites the world’s “biggest man-animal conflict”.
In June 2017, the World Health Organization added snakebite to the list of neglected tropical diseases’. However, in India – despite 50,000 deaths a year and tens of thousands of survivors suffering disability and trauma – snakebite is not a health priority.
Education helps in creating awareness. It helped Bhola, a daily wage earner from Sahamsapur village in the Varanasi district of Uttar Pradesh, to survive. His daughter, Geeta Kumari, saved his life.
“I studied in school that the only cure for a venomous snakebite is snake anti-venom,” says Kumari. She stood firm against villagers who wanted to faith heal her father, insisting he received medical treatment.
Dr Dayal Bandhu Majumdar, an ophthalmologist who has trained more than 3,000 doctors in West Bengal in snakebite management, is a member of the She advisory board. He encourages victims to go to hospital early: “We have popularised the slogan ‘rule of 100’ for snakebite in West Bengal. [If you] infuse 100ml ASV within 100 minutes of a bite, the patient is 100% protected.”
Sengupta’s team create awareness through puppet shows in schools and villages, emphasising the need for medical treatment of snakebites.
Bites create a socio-economic problem. Most victims are aged 20-50, and are often a family’s sole breadwinner. A bite can mean loss of livelihood. Many victims borrow from money lenders for treatment; when unable to repay their debts, they can fall prey to bonded labour.
The rise in snakebites moved Priyanka Kadam, centre, to create her organisation, a self-funded platform connecting families, doctors and social activists. Photograph: Priyanka Kadam/SHE
A WhatsApp group devoted to snakebites and managed by Majumdar, Kadam and others counts 240 doctors and social activists among its members. Case details are shared to seek advice and record field experiences of success and failure. This makes it easier to share information with doctors at referral centres before the arrival of victims, speeding up treatment and saving lives.
Making anti-venom using regional venom banks is an urgent necessity. Kadam says snakebite victims have died in West Bengal even when anti-venom was administered.
“The efficacy of the current Indian anti-venom is questionable as the drug is made using venom procured from Irula Cooperative in Chennai, Tamil Nadu,” says Kadam.
