…Plateau, Nassarawa, Gombe, Adamawa, others affected
…We watch patients die daily—Doctors
…Only one person imports anti-snake bite vaccine

By Marie-Therese Nanlong & Suzan Edeh

Snake bite is not new especially to people of Southern and Central parts of Plateau State.

Poisonous snakes like carpet viper, cobra, black mambas and puff adder have comfortable habitats in those areas.

It has become a common sight to see poisonous snakes in homes, on trees, and farmlands among other places the reptiles could hide to escape the scourge of the heat which the areas are known for.

Snake

Surprisingly, the government of affected states and residents have accepted these life-threatening reptiles as normal members of the affected environment.

However, it is not unheard of for farmers and hunters to go on snake hunting to reduce the rate of snakebites, especially among children.

Snakes invaded some communities

Given that in October 2015, snakes invaded some communities in the mentioned zones leaving about 20 people dead and the incident of   January 2017 which had more than 280 children bitten by snakes, one would have thought that issues of snakebites would be taken seriously not only in the state but the country.

The snakes which are often seen in rocky areas and in grasses, again, left many dead last month.

The development left the only snakebite treatment centre in the state, Jos University Teaching Hospital, JUTH Comprehensive Health Centre, Zamko overwhelmed.

The facility exhausted its stock of anti-snake venom leaving the people to resort to traditional healing homes.

Residents of the areas and survivors of the bites appealed to both the federal and state governments to as a matter of urgency come to their aid by fumigating the areas.

They also pleaded for the provision of needed drugs for treatment.

Medical personnel in the designated health centre and other clinics in the areas, who lamented the non-availability of anti-snake venom, said there was a need for urgent action to be taken.

Need for urgent action

One of them, Elisha Timan said: “This issue of snake bite is actually a very serious one. We are creating awareness so that people will know about it. And we need all the necessary help urgently because the people in the grassroots are actually suffering because of this situation.

“The situation is worse during the harvest season because people go to the farms without putting on boots and gloves. During this period the weather is very hot and anti-snake venom is in high demand because many people get bitten. We should know the trend and make provision accordingly. A vial of anti-snake venom ranges from N27, 000; N30, 000   to N35, 000. This is rather high and many victims, who could not afford that amount, usually seek alternative treatments.

“We advice that people should rear pigs and ducks because they are sources of biological control of snakes, the two are natural predators that eat snakes and deplete their population.”

Non-availability of anti-snake venom

However, the Medical Superintendent, JUTH Comprehensive Health Centre, Zamko, Dr. Dajel Titus who disclosed that the centre had stopped admitting snakebite victims two weeks ago due to the non-availability of anti-snake venom,   urged the federal government to go into Public-Private Partnership and produce the drug to guarantee its availability.

He mentioned that over 800 cases had been received since January, adding that the mortality rate increased in October as a result of the non-availability of the drug.

He said: “After the research to produce anti-snake venom for the snakes in Nigeria, the next phase of the project was for us to domesticate the production of anti-snake venom but that was not sustained.

We have to rely on importing the anti-snake venom from the United Kingdom and Costa Rica. Somebody has the sole right to import that but due to the challenges of getting foreign exchange and other logistics, the man got his last supply in August 2017 which was distributed to all the centres. Usually, people buy from him.

“We exhausted our supply around the first week of October and since then, we don’t have any anti-snake venom anywhere. The major Centres that treat snake bites are JUTH Zamko and Kaltungo General Hospital in Gombe. All of them do not have anti-snake venom.

For us in Zamko, from 1st January to 30th of October, 2017, we have seen 864 patients but we recorded 10 deaths in October only due to the inability to get anti-snake venom for them. So the total number of deaths from January to October in our centre is 20. We had to stop admitting patients when we didn’t have the anti-snake venom.

He, however, cautioned people against patronizing traditional homes.

“JUTH as an institution has not had any collaboration or discussion with traditional caregivers but I learned one of the doctors in the Echitab study group took time to educate them on the dangers of delving into treating cases of snake bites because most of their claims cannot be substantiated.

“It is important for us to know that if 100 people are bitten by a snake, about 50 percent of them might die if they are not given anti-snake venom. Some of the bites are just dry bites and did not result in any envenomation.

That is when the snake injects the venom into the victim. So, it is possible that some of those that survive under traditional care are actually people who did not have any envenomation or people who ordinarily were able to fight off the venom themselves.

Criteria for requesting re-stocking

“It is difficult for us to confirm that the traditional healers are offering any better care. Our advice is that anybody bitten by a snake should seek care in the hospital.

“We just got information that the Minister of Health said there are some small stocks of the anti-snake venom. But they said they did not give out because Gombe and Plateau states did not fulfill the criteria for requesting re-stocking of anti-snake venom.

“Currently, we have received the data template to fill and apply for the supply but most importantly, the supply of this anti-snake venom is passing through a very difficult moment due to difficulty in getting foreign exchange.

“We already have a research on anti-snake venom for our country endorsed. We have the anti-snake venom that is suited for our country, the next phase is for us to import the technology and start the production. Our doctors are ready.’’

495 bites in every 1000 people

Continuing, he said:”In Nigeria, states like Taraba, Benue, Gombe, Adamawa, Borno, and Nassarawa are well known for snakebites because of their climatic conditions. The incidents of bites are quoted to be about 495 bites in every 1000 people. In Plateau State, the bite is estimated to be about 30,000 per year. Other states like Kogi, Katsina, Enugu, and Kaduna also have high incidences of bites from poisonous snakes.

Meanwhile, the owner of the Patency Right to import the anti-snake venom especially the Echitab G and Echitab Plus, Dr. Nandur Durfa told Saturday Vanguard thus: “We are expecting the first consignment this (yesterday) evening.   We did not envisage this upsurge in the demand.

“We have requested an increase in quantity and if this thing was produced, it would have been shipped but due to some logistics problems, there was a delay in bringing it into the country. The aircraft could not bring it from Costa Rica on time.

“We have submitted the report that the collaborators are ready to partner with the Federal Government to produce it locally because they know it is our local problem. It affects the rural dwellers but most of them don’t have the money to buy the anti-snake venom.   We were using the Indian anti-snake venom before but we discovered it does not work.’’

Alarming rate in Gombe

A visit by Saturday Vanguard to Gombe State revealed that the situation had attained an alarming rate.

For instance, it was gathered that one of the treatment centres in the state, received an average of 50 victims of snake bite daily, while the Kaltungo General Hospital, attended to 139 patients in one week.

A medic with Aliyu Mega Pharmacy in Gombe, Dr. Abubakar Aliyu said: Some arrive here in very critical conditions and we just had to watch them die because we were helpless. More than 70 victims had died in the last one month following the lack of ASV to treat them. Many came from Adamawa, Taraba, Bauchi, Borno and Plateau States

“An average of six deaths are recorded daily. If you go to the snake treatment centre at   Kaltungo General Hospital, you will pity the victims. The lucky ones among them get supportive treatment, while many are left to fate since the drugs are not available.

“Between August and October, we received 750 victims. We were given 700 vials of the anti-venom on August 31, but we exhausted them before October. Many people are just dying. It is a major crisis.’’

Also, Snakebite Treatment Officer at the Kaltungo General Hospital, Dr. Abubakar Ballah, corroborated his story.

“It is a sorry situation. It is disgusting when one has to watch helplessly as patients gasp for breath and eventually give up. It is sad and unfortunate.’’

Centre received 139 patients in one week,

He said the center received 139 patients in one week, with 77 absconding when the hospital appeared helpless following the non-availability of vaccine.

“In the last few days, we have recorded 21 deaths.

The figure should be more because many of those that absconded were in bad shape. Others did not even bother to come here because of the fore-knowledge of lack of ASV in the centre.”