The 365 Ways Blog

Michael Norton is author of "365 Ways to Change the World", which provides an issue for each day of the year, interesting facts, inspiring case studies of people doing things to address the issue and ideas for action. Originally published in the UK, versions with local content have been published in Australia, Canada, India, South Africa and the USA. To find out more visit our website:

21 November 2006

Snakebite: doing the RIGHT thing

According to the World Health Organisation (WHO), our planet contains approximately 3,000 species of snakes of which 600 are venomous. Snakes are found in all parts of the world apart from Antarctica, but are most common in equatorial and tropical regions.

There are no accurate figures for the incidence of snakebite or for the number of deaths caused. But snakebite is a serious problem.

A recent estimate suggests 2.5 million envenomations and 125,000 deaths annually. The two regions where snakebite is a particular problem are Southern Asia and Africa.

A study in Bangladesh suggests an annual incidence of 4.3 bites per 100,000 population, with a 20% fatality rate. A study in India suggests 10,000 deaths annually. In Sri Lanka in 2000, more than 37,000 patients were treated for snakebite in government hospitals. A community-based study in South East Nepal estimates 162 deaths per 100,000 population.

In Africa the incidence of snakebite varies greatly – from 300 to 500 bites per 100,000 population in forested regions to 50 to 100 bites per 100,000 in dry savannah and the Sahara.

So what happens if you are snakebitten. The traditional “Boy Scout” response would be to use a tourniquet to stop the blood flowing, to cut the skin to allow the venom to come out, or to suck it out with your mouth. None of this actually works. A tourniquet could cause body tissue to become damaged through lack of oxygen; a snakebite reduces the blood’s clotting power, so making an incision could lead to catastrophic bleeding; and sucking the venom out in practice does not work.

So instead of doing the WRONG thing, you need to do the RIGHT thing, which according to a leading WHO expert is the following:

R is for “Reassurance”. Tell the victim that only 20% of snakes are venomous, and that anyway with treatment, survival rates are really good.

I is for “Immobilisation”. Keep the affected part of the body immobilised, as this reduces blood flow – and the spread of the venom throughout the body.

G and H are for “Get to Hospital”. As quickly as possible, so that the victim can be treated.

T is for “Tell the doctor” of any symptoms. This can be done by the victim or by those looking after him or her.

Treatment requires the use of anti-venom. This is made by injecting horses with snakebite venom. Bu giving a human being anti-venom as a side effect can cause a strong allergic reaction, which itself will need treatment. But anti-venom IS the answer to snakebite.

With 30 deaths annually in Europe and 15 in North America, snakebite is only a marginal danger to people in these regions. But what can we all do about it at a global level?

1. Spread the word virally. Tell people that fatalities are preventable provided people do the RIGHT thing. Do this by circulating this e-mail to your address book, requesting recipients to do the same. Provide a viral solution to a venomous problem.

2. Ask governments in the worst-affected regions to make sure that there are supplies of anti-venom and doctors and paramedics trained to deal with snakebite. Send one letter to one health minister of one government. If you are visiting that country, it might even save your life!

Of the major world’s killers, snakebite may not create the most serious threat, but death from snakebite is largely preventable.

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