By Maurice Oniango
Benjamin Menza was walking along a small bushy footpath on their farm in Watamu on a relatively warm evening when he suddenly felt a sharp burning sensation on his left leg.
Benjamin Menza is now a snake handling trainee at Bio Ken Snake Farm in Watamu. Benjamin is a victim of a deadly black mamba bite.
This was followed by another sharp pain on the same leg. He tried looking for what had caused the pain but did not see anything.
So he went home, and a few moments later, he started sweating profusely, vomiting, his vision was blurry and he fell unconscious.
His father checked his leg and noticed some tiny marks and he suspected it to be a snakebite. He went to their neighbor to get a black stone that his community believes ascertains a snakebite.
After that, he rushed Benjamin to Bio-Ken Snake farm, where they diagnosed his symptoms as signs of snakebite by a black mamba which are endemic in that area.
He was immediately taken to a local hospital along with a suitable antivenom from the snake farm. “I received treatment at the hospital and two days later, I was discharged,” Benjamin narrates of his ordeal with one of the most dangerous tropical diseases.
He had been bitten by one of the deadliest snakes in the continent, as a single bite of a black mamba can cause grown-up to collapse within 45 minutes of the bite.
His clock was ticking and what saved his life was the antivenom that was administered.
Deadly bite and a black stone
Even though some communities believe that the black stone can detect and cure a snake bite, this belief has not been scientifically proven. As of this moment, the only known treatment for snake envenoming is antivenom.
According to W.H.O., approximately 5.4 million people are bitten by a snake, of whom 2.7 million are injected with venom every year.
This leads to 400,000 people being permanently disabled and between 83,000-138,000 deaths annually, mostly in sub-Saharan Africa and South Asia.
In Kenya, it is estimated that there are over 8000 snake bites every year, with close to 1000 fatalities.
Unfortunately, there is no concrete data on this since most cases are not recorded or go unreported. W.H.O has classified snakebites as a Neglected Tropical disease that needs attention.
Most snakebites can be treated; however, some common reasons for fatalities in snakebite cases are delay in seeking medical treatment, using unproven treatment such as the black stone, seeking treatment from traditional healers, and the lack of antivenom or effective antivenom.
Unfortunately, just like the rest of the countries in the continent, Kenya has a shortage of antivenom. This is as a result of the nature of its production as well as the manufacturing companies.
Initially, there were two effective antivenom productions for sub-Saharan Africa known as SAIMR Polyvalent Snake Antivenom and FAV-Afrique.
However, the latter is no longer being produced, causing a void that has been filled by cheaper antivenoms made in India and Mexico, some of which are not effective.
Despite the antivenoms being promoted as specific for various species found in the continent, they differ from species found in the continent due to multiple reasons such as climate and habitat.
Furthermore, antivenom is manufactured from snake venom, and the performance of one is highly dependent on the species and its geographical origin, even if it’s the same species.
This means that the antivenom might be 100% effective treating a snakebite in India but not effective treating a snakebite of the same species in Kenya.
The cost of antivenom also disadvantages many victims. For example, a 10cc of antivenom costs about 20,000 shillings, and patients might need two to three vials to treat a snake bite, depending on the amount of venom injected by the snake.
Stepping on a puff adder
Msanzu Karisa has a similar experience to that of Benjamin’s yet is still different. One evening when he was 15 years old, Karisa was out hunting birds when he accidentally stepped next to a snake, and it bit him twice on the same foot.
Karisa had stepped on a puff udder, a deadly snake and cause of most snakebites in Sub Saharan Africa.
The Puff Adder is one of Africa’s most iconic snake species that is also responsible for the highest rate of snakebite fatalities in Kenya. The species usually is sluggish and relies on camouflage for protection. Its common behavior includes basking in the sun, mainly in the middle of footpaths, and they do not move away when they hear movement.
He rushed home, but there was no one to attend to him at the time. He waited for about two hours when his uncle came and took him to Bio Ken Snake Farm.
By that time his foot had swelled. The farm’s director rushed him to Kilifi Hospital, where he was taken into the emergency room.
Karisa was admitted in the hospital for three months, and doctors decided to amputate his right leg. “This has affected my life so much. Today I have to depend on well-wishers,” says Karisa.
Even though Karisa and all other snakebite victims qualify for compensation, this has not been the case.
In a shocking surprise to snakebite victims and conservationists, the ministry of Wildlife and Tourism was pushing for an amendment of the Wildlife Management and Conservation Act to remove snakebites from the compensation scheme due to the high volume of claims.
According to Kenya Wildlife Service, snakebite constituted over 60 percent of the claims annually.
According to the law, compensation for any life lost from an attack from a wild animal is five million shillings, three million shillings for injury with a permanent disability, and up to two million shillings for other injuries.
Even as the government compensates victims attacked by elephants, hippos, lions, leopards, crocodiles, buffalos and cheetahs, snakebite victims have not been considered for years now.
Snakebite is regarded as a poor man’s disease due to the nature of most of its victims and the impact it leaves on victims.
The move by the government is aggravating an already devastating problem since most victims of snakebites are poor people living in rural areas.
Contrary to the belief that the primary purpose of snake venom is to attack human beings, its primary function is to help snakes immobilize and digest prey.
However, when they feel threatened, venomous snakes will bite in self-defense. Before attacking some venomous snakes, give a warning sound like hissing or puffing, or for the spitting cobra species, they spit the venom to a victim’s eyes.
Each snake’s venom has different toxins depending on the species, and each has a different effect on the human body.
Kenya Horned Viper is a small venomous viper that is one of the most spectacular and rare of Kenya’s endemic species. As a result, very few cases of snakebites have been recorded.
The common venom types include; Neurotoxic venom, which attacks the nervous system. Without timely and appropriate antivenom treatment, it affects the respiratory centers in the brain, causing respiratory failure, cardiac failure, and death.
With this venom, death can occur within 30-120 minutes of the envenoming, depending on the amount the snake injected on the victim and the time they access treatment.
Snakes with this venom in Kenya include Black mambas, Eastern Green Mamba, forest cobra, the Egyptian cobra, red spitting cobra, and Black-necked spitting cobra among others.
Eastern Green Mamba is a large, tree-dwelling, highly venomous snake species. This snake mainly inhabits the coastal regions of southern East Africa. They are shy and elusive snakes that are rarely seen; this elusiveness is usually attributed to the species’ green coloration, which blends with its environment, and its arboreal lifestyle.
The latter two have a combination of another venom; Cytotoxic venom. This venom destroys the tissue and causes pain.
It also causes swelling of the bite area and eats away the flesh. This has caused many victims to amputate an arm or leg that was bitten.
Some of the common snakes with this venom are adders and vipers like puff adder and gaboon viper.
The other venom type is the Heamotoxic venom which attacks the red blood cells, stops blood from clotting, and causes internal bleeding. Some of the snakes with this venom include Boomslang and Vine snake.
Prevention and actions when bitten
Learning about the different snake species in our localities is also crucial in helping to understand them and avoid snake bites.
Also, when moving through footpaths, tall grass or bush, rocky areas, fallen logs and dead leaves, watch where you step so as not to step on a snake.
Some snakes, such as the puff adder, have mastered the art of camouflage, and without being keen, you could step next to one. Wear boots and use a flashlight when it is dark to see where you are stepping.
Finally, never handle a snake if you are not an expert. Most people get bitten by deadly snakes by misidentifying them as harmless.
Even when you think it is dead, don’t handle it because a newly dead snake can still bite by reflex.
If a snake has bitten someone, keep that person still and calm. This can help in slowing down the venom if envenoming happenened.
Try to see the color and shape of the snake because this will help get the proper treatment faster. If it’s a victim of a spitting cobra, wash their eyes with clean water or a saline solution or milk. Any delay might cause permanent loss of vision.
Do not try to pick up the snake to take it to the hospital for identification. Do not try to suck out the venom or use a knife to slash the wound.
Avoid caffeinated beverages or anything that would increase the heart rate of the victim. Lastly, all snakebites are treatable and the time taken to seek medical assistance matters a lot on the victim’s fate.