21 February 2013

Uganda: Snakebite Victims Buried Alive

Every Ugandan who grew up in the village remembers that old man or woman who was famed as a traditional healer. They had all sorts of concoctions and would challenge villagers to bring people who had died from snakebites.

They claimed they could resurrect them in two days.

The fact is that yes, they could "resurrect people." But the person is not just really dead, but his brain has just been forced to go to sleep by the snake venom, which scientists say can take over three days. Whether these people knew the power of their drugs or were only playing on people's psyche, is not known.

Victims buried alive

The truth is that a number of snakebite victims are buried alive because of ignorance and the crude ways we use to confirm that people are dead. Though in normal circumstances a person is declared dead when the heart stops pumping, in medical language, the person is not dead until his brain, which has been referred to as the engine of the body, is dead.

It is assumed that when the heart stops pumping, the brain is denied oxygen and someone can die within 20 seconds. However, when it comes to snake bites, the situation is different because the brain itself goes to sleep as the venom closes out the end of the nerves, forcing the brain to shut down.

It also shuts down most organs of the body, though the person is not dead. In a society where access to medical services is not only expensive, but not easily accessible, dead people are checked by the heartbeat. They, therefore, end up burying their loved ones while still alive.

"It sometimes takes over two days when someone is still in comma. The brain response system is paralysed. This forces the heart and all the other organs to pause," says Lydia Lwabidongo, a medical worker at London's Guys and St. Thomas hospital.

Unlike in London and other developed countries where someone cannot be buried before all checks are done, in Uganda, people look at a post-mortem as a waste of time and money.

"That is why some medicine men in the village boast that they can resurrect snake bite victims after some days. They are just playing on people's minds because of that," says Dr. Charles Musoke, a physician at Mulago Hospital.

According to herpetologist Dr. Mathias Tibengana of Makerere University, people might be buried alive due to the fact that the public has no access to information about the effects of snakebites.

"This information is available but very few people read it," he says, adding that although many, mostly of the Muslim faith that bury people within a day, might have lost some people, they prefer to forget everything and lead a new life.

Venom can be useful

Tibengana has written a number of papers about snakes. He explains that venoms are concentrated proteins so they perform different duties, depending on the snake that has bitten you and why.

"What they (venoms) need is to be digested in the body system but because at times they are more than what is required, they become toxic, with others killing in less than one hour after the bite. But other venoms can digest themselves and after some time, the victim can heal without getting medication," says Tibengana.

But for one to heal without medication, one must have been bitten by a snake that produces neurotoxic venom, which attacks the nervous system.

Such snakes always protect themselves against enemies, though sometimes the protection venom is mixed with the hemotoxic venoms, which attack the white blood cells, and render them helpless to transport oxygen. Hence, this suffocates their target and leads to blood clotting, which results in some limbs swelling and at times, someone might lose the limb.

"But these are only 30% of the total snake population in the world. The other advantage is that snakes are scared of people and tend to always run away when they hear them approaching," says Tibengana

Keep snakes out of your home

Snakes are crawling reptiles that mostly live in bushes, but can be drawn to homes when they are looking for mice and frogs.

Tibengana advises that people should also know the different types of snakes and how harmful they are.

He explains that house snakes are not venomous, while even those that are venomous can at times bite you without injecting the venom into your body. According to Dr. Charles Musoke, most victims are up country.

Treating snake bites

In many traditional societies, the commonest first aid was using paraffin to wash the site of the bite. Some people chewed dried tobacco leaves but spat out the nicotine. Others try to suck out the poison through the wound although this is risky if you have a wound in the mouth. However, Tibengana says any small portion that you suck out can save the victim.

National Medical Stores (NMS) distributes Penta anti-venom as treatment for snake bites. Tibengana says in normal cases, you need to kill the snake and take it to hospital with you as it will help the medical staff to know the type of venom and how it reacts with the body for better treatment.

Though the NMS spokesperson, Dan Kimosho, says about sh34m is spent on this drug, Sunday Vision was unable to get details of the number of health facilities with the drug. Uganda generally has 140 types of snakes belonging to 45 genera and seven families.

Black stones or snake-stones are also common in Africa, Asia and South America as a first aid for snake bites. The 'stone' which is really a carbonised piece of bone, is placed on the site of the bite and believed to suck out the venom before it drops off by itself.

It is generally noted that over reliance on vague first aid methods like the black stone contributes to the delay in seeking appropriate medical care which can lead to deaths.

First aid for snake bites

Keep the person calm. Restrict movement and keep the affected area below heart level to reduce the flow of venom to the heart.

Remove any rings, bracelets or anklets because the affected area may swell. Do not apply a tourniquet (tie near the site)

Note that if the area of the bite begins to swell and change colour, the snake was probably poisonous.

Monitor the victim's vital signs - temperature, pulse, rate of breathing and blood pressure if possible.

If there are signs of shock (such as paleness), lay the person flat with feet slightly raised and cover them with a blanket.

Get the victim to the nearest medical facility as soon as possible.

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