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Feature Neglected diseases

Snakebite: a forgotten problem

BMJ 2013; 346 doi: (Published 31 January 2013) Cite this as: BMJ 2013;346:f628
  1. Soumyadeep Bhaumik, medical doctor, independent researcher, and freelance writer, Kolkata, India

India has the worst snakebite problem in the world, largely affecting poor people and children from rural communities. This might explain why treatment and the training of doctors in India are lacking, explains Soumyadeep Bhaumik

When Alexander the Great invaded India in 327-325 BC he was said to be impressed by the arrow heads poisoned with lethal venom from the Russell viper and the advanced clinical acumen of Indian doctors in managing snakebite.1 In 2009 the World Health Organization added snakebite to its list of neglected tropical diseases, hoping to reduce its burden on so many marginalised populations.

“We need to act now to deal effectively with this problem, which causes severe disability, brings misery to families, and which kills thousands of people,” said Lorenzo Savioli, director of the department of control of neglected tropical diseases at WHO.2 However, policy makers, clinicians, and the general public have largely ignored the snakebite problem, even though it kills thousands of people each year and causes social, economic, and personal misery to many more.

Ghulam Nabi Azad, the union health and family welfare minister of the government of India, told the Lok Sabha, India’s lower house of parliament, in April 2012 that only 1440 people had died from snakebite in India in 2011.3 WHO, however, predicts as many as 1 841 000 envenomings and 94 000 deaths globally, with India having the most of any country, with an estimated 81 000 envenomings and 11 000 deaths a year.2 The Million Death Study4 estimated some 45 900 deaths from snakebite in India in 2005, about the same number as those from HIV/AIDS.5

Experienced doctors

“Worldwide, snakebite has been neglected and forgotten and its victims abandoned by medical science and public health systems,” said David A Warrell, emeritus professor of tropical medicine at the University of Oxford …

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