Assam Doctor develops comprehensive treatment plan to ensure zero snakebite death

Snake bites are becoming more common in Assam as a consequence of deforestation, constant rain, and sudden temperature rise. A doctor of a rural health Centre in Assam’s Sivasagar district has developed a comprehensive care model to ensure zero death of Snakebite victims by 2024.

Dr Surajit Giri, an anaesthesiologist with the National Health Mission and a member of staff at the Demow Rural Community Health Centre (DRCHC), is working with the state government to overcome gaps in the snake bite management system in his model.

Giri has cured more than 1,200 snakebite victims from across the state.

Following an incident, where he saw a young woman bitten by cobra, died on the way while trying to shift her fron a private hospital to a bigger state-run medical college in Dibrugarh. At that time Giri, who was in his mid-twenties at the time, began his path to become Assam's leading snakebite specialist.

Giri's first snake bite victim was a 50-year-old farmer in Sivasagar who was bitten by a pit viper in 2008. 
By then, Giri had been posted at a community health centre in Demow, where not just the lack of infrastructure was a problem but also people were loath to be administered antivenom.

"Those days people trusted faith healers, I had to literally beg victims to take antivenom. After some victims were cured, they started trusting my treatment," Giri told the media.

Usually, any patients with snakebites are kept under observation and administered antivenom — purified snake venom that acts against the whole venom — once the patient shows symptoms.

When a patient develops signs of a snake bite, he or she is usually kept under surveillance and given antivenom, which is purified snake venom that acts against the whole venom.

Giri's reputation expanded quickly as a result of his effective treatments. Notably, in 2008, just a few people approached him for therapy, but now he sees 60-65 individuals every month.

Every year, an estimated 58,000 people are killed by snakebites. This accounts for roughly half of all snakebite deaths in the world.

Giri and his team healed each of the 464 snakebite patients who came to the Demow community health centre in 2021. Of these 464 snakebites, 53 were bitten by venomous snakes.

Recently, Dr. Surjit Giri wrote a book titled "SAP ARU AMI" (Snake and Us) for the public's benefit.

According to the World Health Organisation (WHO), 1.38 lakh people die globally due to snake bites annually, and out of this, 50,000 are in India.

“Lack of coordinated comprehensive care in snake bite management is the key factor for the high death rate in the North-eastern region and the country but there is no robust data regarding this,” Giri told media on September 20.

Coordination of the transportation of snake bite patients from the field to the hospital is lacking, and the problem of the large gap between care in pre-hospital, point-of-source hospitals, and secondary care hospitals must be addressed to ensure the victims' survival, he added.

Giri stated that the DRCH has been working on a model for snake bite victims' preventative, curative, emotional, and socioeconomic treatment since 2018.

A Venom Response Team has been developed as part of the District Disaster Management Authority's 'Apada Mitra' programme, and they will alert and securely transfer sufferers to a local hospital.

A Fast Response Team comprising an on-duty doctor and nurses was set up to effectively administer anti-snake venoms (ASV) and other medicines if needed.

There is also a small ‘snake bite room’ where all medicines required in such cases will be available while protocols and photographs of venomous snakes of Assam have been mounted on the walls.

“We are trying to replicate this in other health centres across the state with the help of doctors posted there so that we can ensure zero snake bite deaths by 2024,” he said.

Senior Medical Officer of Sivasagar district, Dr Simanta Taye, said, “The project has greatly benefitted those who are bitten by snakes. People now do not hesitate to come to hospitals for treatment immediately.”

According to the reports, since 2018, 1048 snake bite patients have been documented at DRCH, with only one death. There are various reasons why individuals choose to go to faith healers rather than hospitals.

Lack of knowledge, inadequate training of rural healthcare personnel to administer ASV, and a lack of ASV in health centres are among the causes.

“Our goal is to educate, empower, train public and health care workers, strengthen community centres and make the public believe that there is a full proof medical management of both venomous and non-venomous snake bite cases,” Giri said.

'Sanke bite rooms' have been set up in medical college hospitals in Jorhat and Lakhimpur districts, besides a private facility in Sivasagar.

Prashant Tanti and his 10-year-old son Subham were almost killed by a pit viper in March of this year. They returned to regular life after nearly two months when an alert neighbour took them to the health centre.