Snakebite Management Project in Southern Nepal

Snakes are an important part of Nepali religion and culture. The Hindus of southern Nepal associate Nag, the king of snakes, with the provision of adequate rain for their crops. In mid-monsoon (July/August) Nepalis celebrate Nagpanchami, the snake festival in which certain devotions are performed, and offerings of milk and money made, not just to assure the monsoon but also to avoid snakebite. Snakebite is a constant fear for the farmers of Nepal, particularly during the monsoon when the rains flood the reptiles' dens and force the snakes to find refuge - often in the farmers' rice fields or even their homes!

To date, seventy-seven species of snakes have been identified in Nepal, twenty-one of them venomous. Three species of cobras, five species of kraits, as well as coral snakes, all with powerful neurotoxins, are the common snakes of the family elapidae, while twelve species of vipers and pit vipers represent the family viperidae. Because of the tropical climate and rural nature of much of southern Nepal, snakebite is very common. WHO has estimated that there are over 20,000 snakebites each year in Nepal, one thousand of them fatal. Unfortunately, transportation and medical facilities are grossly inadequate. Most victims of snakebite seek assistance first from faith healers and death frequently occurs before the victim is brought to a hospital. For more information on snakes and snakebite in Nepal, see Snakes and Snake Bite in Nepal, an article by Sanjib K Sharma, MD, Associate Professor, Department of Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.

Snakebite is a major but neglected public health problem in southern Nepal. Insufficient studies have been conducted to date concerning snakebite management in Nepalese hospitals. There is a need to provide accurate records of mortality and morbidity in venomous snakebite in relation to types of snake, time taken to arrive at hospital, and practice of treating before arrival in the hospital. Tribhuvan University and Bharatpur Hospital will, with the support of the America Nepal Medical Foundation, undertake a field study to develop the information needed to improve the management of snakebites. This study will be conducted by Dr. Deb Prasad Pandey.

For more information about this project, including the final report, see Snakebite Management or contact ANMF.

*Images of snakes are from Wikipedia.