Nepal project achieves dramatic drop in deaths by using motorbike helpers to rush the stricken to hospital
PHILADELPHIA — Enlisting volunteers with motorbikes to rush snakebite victims to regional hospitals has slashed the fatality rate in such emergencies to almost nothing in a part of Nepal where snakebites are frequent, physician Sanjib Kumar Sharma reported December 5 at a meeting of the American Society of Tropical Medicine and Hygiene.
Sharma, an internist in Dharan at the B.P. Koirala Institute of Health Sciences, works in lowland southeastern Nepal, a region bordering India. Bites from poisonous snakes such as kraits, cobras and vipers are the leading cause of death in this rural area, he said. This is in large part because the population is poorly educated in handling such bites, and victims often don’t get proper treatment in time.
In an earlier study in Nepal, an analysis of 20 fatal snakebites showed that only four of the victims died in a hospital. The other 16 died en route or in a village, Sharma said.
Another survey, conducted in nearby Bangladesh, revealed that 86 percent of people bitten by snakes were taken to a snake charmer or other traditional healer instead of to a hospital.
For the new study, Sharma and his team trained paramedics for six weeks in snakebite treatment, distributed 5,000 leaflets that explained basic precautions people can take to limit risk, and enrolled owners of motorbikes in villages to serve as emergency transport — with reimbursement for gasoline.
In the 14 months preceding the program, 305 people were bitten by snakes and 32 died. In the 14 months afterward, 187 bites occurred with only one death, Sharma reported.
“Snakebites constitute an unrecognized burden of human suffering,” said David Warrell, a tropical medicine physician at the University of Oxford. Eastern Nepal has the highest incidence of fatal snakebites ever reported — around 162 per 100,000 people per year, he said.
The new study “shows a demonstrable reduction in mortality — that’s impressive,” said Warrell, who wasn’t involved in this project. “This is highly relevant work that emphasizes the importance of community education.”
Aside from the lives saved by the motorbike ambulances, the reduction in snakebites that occurred after the leaflet education program appears to have resulted from precautions taken by women when they were doing outdoor chores, Sharma said. The leaflets even had a slogan, which Sharma translated as, “Bitten by snake/catch a motorcycle volunteer/get to treatment center/save a life.”“This is actually very catchy in Nepali,” he said.
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