By Adewale Kupoluyi
Of recent, cases of snakebites in the northern parts of the country seem to be on the increase. What is more worrisome is that despite the severity of the problem, relevant authorities do not appear to be doing enough to put adequate control on what can be described as a national crisis. This is not too surprising. There is a general pattern that the nation usually takes when it comes to tackling serious issues. We take things with levity until they become so severe, devastating and chaotic such that any meaningful intervention may not be helpful by the time they are applied. It is on this premise that the prevalent cases of snakebites should be given due priority and attention without further delay.
More than 80 victims alone were said to have died in the last few weeks following the absence of anti-venom for victims from the northern states of Adamawa, Bauchi, Borno, Gombe, Plateau and Taraba, among others. Statistics of snake bites obtained across the country revealed that there is a steady rise on a daily basis, of people either suffering from the attacks or have outrightly died due to poor access to medical facilities. Most of these victims – because of the expensive cost of orthodox medicine – allegedly ended up visiting herbalists because they could not afford the anti-snake venom. Unfortunately, what the herbalists do have been described by observers as mere ‘trial and error’ in the sense that most victims bleed in the brain because the venom is vicious, which makes traditional healers incapable of tackling the problem, since they concentrate on healing the wound alone.
Snakes usually attack people when they are threatened, picked up mistakenly or trodden on. Such attacks can become deadly if not treated quickly, but when properly treated, many snakebite cases would not have serious implications on victims, as less than 10 per cent of snakebite victims were said to visit hospitals in Nigeria when attacked. To show the severity of the problem, a World Health Organisation (WHO) report shows that Nigeria records 174 snakebites per 100,000 population per annum, of which the carpet viper or saw-scaled snake has been blamed for about 90 per cent of bites, out of which 60 per cent of the cases eventually result into deaths. WHO, however, warns that snakebites remain a neglected public health problem for most of African countries including Nigeria. That is why the country needs to work hard by ensuring that necessary mechanism is put in place to overcome this challenge headlong.
Additional insights were provided by the Kofi Anan Foundation, in a 12-page report titled, “Snakebites in Africa: Challenges and Solution”, which carefully examined the issue at stake with inputs from diverse representatives, drawn from the scientific community, public health organisations, civil society and philanthropic institutions, among others. Findings from the report showed that many health problems were linked to snakebites such as induced death and disability in many African nations. The foundation found out that snakebites negatively affect the lives of thousands, mostly the rural poor and resulting into declining subsistence agriculture and overall quality of life of the people. It further disclosed that an estimated 32,000 deaths and 100,000 disabilities had been attributed to victims on the continent, causing chronic anxiety, depression and Post-Traumatic Stress Disorder (PTSD). Beyond that, people that are bitten are found to be economically-insecure. Rural hospitals were found to be inadequately equipped to manage snakebite patients coupled with the problem of lack of quality control and regulation of anti-venom.
Despite this worrisome trend, many of these snakebite cases still go unreported and are not captured in official epidemiological records kept by appropriate bodies that should ordinarily do so in Nigeria. Snakebites should be taken seriously like Ebola, Monkey Pox, Lassa Fever and HIV/AIDS. This lack of important documentation is not limited to health records, as many other important and reliable statistics on all areas of human lives are usually very difficult to obtain, making effective national planning a daunting task in the country. Another problem that could have fueled the problem is the low advocacy on the hazards of snakebites coupled with the fact that many health workers in the country were found to have little or no formal training in the management of snakebites.
With the current realities on ground, there is the need to beaming more searchlights on this area. Furthermore, rural populations that are prone to frequent victims are not well protected while they go about their normal daily farming activities with palpable fear. This should change. Embarking on public enlightenment among rural communities on how to prevent snakebites would involve giving timely first aid. Such emergency and vital information should be made available in the languages that local farmers are familiar with.
Not only that, more medical personnel should be trained throughout the country, beginning with the endemic areas in the north, where cases are rampant, as this measure would reduce deaths associated with poor handling. People should clear overgrown grasses around their homes, premises and stop keeping snakebite attacks to themselves. Furthermore, snake anti-venom drugs; EchitabPlus ICP Polyvalent and Echitab G Monovalent, which were said to have been last supplied to the country several months ago, should now be imported with immediate effect. Late placement of order for production should be avoided. This would not only reduce the scarcity, but discourage the tendency for people to either tamper with normal supply or adulterate the drugs. Already, some people were recently reported to be faking the scare drugs and selling at almost N45,000 per vial, contrary to the original price regime sold by a study group, which ranged from between N13,500 to N30,000.
A more sustainable effort would involve manufacturing the drugs through Public-Private-Partnership (PPP), to increase access and minimise adulteration. The government should painstakingly identify serious and local organisations with requisite experience that could come in at this critical moment. The intervention of few individuals and corporate bodies is commendable. For instance, Governor Samuel Ortom of Benue State recently procured N31m worth of the drugs for the state. More state governors should follow suit in helping to curb the snakebite menace, especially now that the country is experiencing hot weather when snakebites are likely to be on the increase.
The Kofi Anan Foundation report also gave far reaching recommendations, comprising short and long-term measures. Short-term strategies includepublic health education campaigns that encourage the people to sleep under bed-nets, media advocacy using and mobile phones in informing and educating people about simple steps to take to avoid snakebites while long term measures include incorporating inexpensive snake-proofing design in homes and wearing of anti-snake boots. Beyond these approaches, governments at all levels should urgently treat the problem as a national priority in tackling the growing snakebite menace in Nigeria.