Kenya declares war on snakebites • FRANCE 24 English

Key Concepts

• Snakebite Envenomation: The process by which venom injected by a snake causes systemic effects in a human.
• Antivenom: The only effective treatment for venomous snakebites, produced by extracting venom and using it to generate antibodies (typically in horses).
• Neglected Tropical Disease: A classification by the WHO for diseases that affect millions, primarily in low-income countries, and receive insufficient funding and attention.
• Traditional Healing Practices: Locally-rooted methods of treating illnesses, often involving herbal remedies and rituals, which can delay access to effective medical care.
• Regional Specificity of Antivenom: The necessity for antivenom to be produced using venom from snakes native to the region where it will be used, due to variations in venom composition.

Snakebite Crisis in Kenya: A Fight for Treatment and Prevention

This report details the critical situation surrounding venomous snakebites in Kenya, highlighting the challenges of treatment, the prevalence of traditional practices, and ongoing efforts to improve outcomes. The video follows Mary, a professional snake handler, and a British doctor working to combat the high rates of snakebite fatalities and morbidity in the region.

The Scale of the Problem & Increasing Incidence

Sub-Saharan Africa experiences a disproportionately high number of snakebite deaths, with the World Health Organization (WHO) recording over 20,000 fatalities annually. In Kenya alone, more than 15,000 people are bitten by snakes each year. The increasing frequency of snakebites is attributed to human encroachment into wildlife habitats – building houses and roads leading to greater interaction with snakes in their natural environment. Mary notes that snakebite cases have increased in the last 20 years due to this human expansion. Kenya is home to 140 snake species, 33 of which are considered dangerous to humans, including the highly venomous black mamba.

The Emergency Response & Prevention Measures

Mary, as a professional snake handler, responds to emergency calls to safely remove snakes from populated areas. She emphasizes the need for speed in these situations, as delays can lead to the snake being killed or escaping, increasing the risk to humans. Preventative measures are crucial. Mary recommends avoiding storing woodpiles near houses and clearing surrounding vegetation, as these attract snakes seeking shelter and food. These rules apply across diverse Kenyan landscapes, from arid regions to coastal areas. She illustrates how easily snakes can access homes through openings like holes and uncovered water jars, particularly during hot weather when they seek cool, moist environments.

The Ineffectiveness of Traditional Healing & The Importance of Antivenom

A significant obstacle to effective treatment is the widespread reliance on traditional healing methods. The video showcases a traditional healer who employs practices like making incisions and applying a paste made from burned snake heads. The British doctor explicitly states that these methods are “clinically…nothing” and dangerously delay access to proper medical care.

Antivenom remains the only clinically proven remedy for venomous snakebites. However, access to antivenom is severely limited by its high cost – approximately €60 per injection – and the potentially large quantities required for severe cases (up to 80 doses). The WHO recognizes snakebite envenomation as a “neglected tropical disease” due to its disproportionate impact on impoverished populations and the lack of sufficient attention and funding.

Case Studies & Treatment Challenges

The video presents two case studies illustrating the challenges of snakebite treatment. The first patient, a woman with a history of previous bites, received antivenom quickly (within an hour of the bite) and responded well. The doctor highlights the importance of swift intervention. The second case, a 17-year-old boy (Kamisi) bitten on the lip and chin, presents a more complex scenario. Assessing the progression of symptoms and determining the appropriate antivenom dosage is difficult, even with multiple doses already administered. The doctor uses photographs to track the swelling and adjusts the treatment plan accordingly, administering only two vials in this instance.

Antivenom Supply & Local Production Efforts

The availability of antivenom is a constant concern. A doctor recounts a period in August 2022 where limited stock resulted in patient deaths due to insufficient antivenom administration. She has since worked to increase minimum stock levels. The current antivenom used in Kenya is primarily produced in India, which presents logistical and potentially efficacy concerns.

Recognizing the need for a sustainable solution, the Kenyan government has allocated €1 million for the construction of a local antivenom production center, scheduled to open in 2025. This initiative aims to produce antivenom specifically tailored to the venom of Kenyan snakes, improving its effectiveness and accessibility. The process of antivenom production involves injecting venom into horses, collecting their antibody-rich plasma, and refining it into a usable antivenom.

Bridging the Gap: Engaging Traditional Healers & Raising Awareness

The doctor emphasizes the importance of engaging with traditional healers to improve healthcare outcomes in rural communities. He acknowledges the skepticism surrounding “high-income country medicine” and advocates for understanding and collaborating with traditional practitioners. Mary and her colleagues at the Watumu Snake Farm are actively involved in educating the public about snakebite prevention and safe practices. They extract venom from snakes, with the intention of contributing to local antivenom production once their license is approved.

Quote: “You know, there's much skepticism around high-income country medicine. There's a lot of skepticism around that. So if you really want to improve the the health care of villages, in fact you have to engage with these type of people and understand what they are doing to improve the outcomes of their patients.” – British Doctor

Conclusion

The situation surrounding snakebites in Kenya is a complex public health issue requiring a multi-faceted approach. While antivenom remains the cornerstone of treatment, addressing the challenges of cost, accessibility, and the prevalence of ineffective traditional practices is crucial. Investing in local antivenom production, promoting preventative measures, and fostering collaboration with traditional healers are essential steps towards reducing the burden of snakebite envenomation and saving lives. The ultimate goal is to ensure that snakebite envenomation is no longer a “neglected tropical disease.”