Kenya's desperate need for more snake antivenom
Writhing in pain on a hospital bed in a Kenyan coastal town, teenage snakebite victim Shukurani Konde Tuva faced the grim reality of his left leg from above the knee being amputated. The 14-year-old was bitten by a puff adder -- a venomous snake and the most common snakebite in sub-Saharan Africa -- while eating outdoors in his village near the town of Malindi more than a month ago.
His family rushed him to hospital two hours away by motorbike, but the antivenom he received did not help. "My son's leg is totally rotten and maggots are even emanating from it. They'll have to cut it," said his distraught mother, Mariamu Kenga Kalume. Some 5.4 million people are bitten by snakes each year globally and roughly half are poisoned by venom, according to World Health Organization (WHO) data.
Up to 138,000 people die and 400,000 suffer permanent physical effects, though the WHO says the numbers are a "gross underestimation" since an estimated 70 percent of cases go unreported. Traditional beliefs and myths skew the data as some victims turn to home-grown remedies or attribute bites to voodoo "sent by their enemies" instead of seeking medical care.
Wathuto Ogopotse prepares venom samples for analysis.
Wathuto Ogopotse prepares venom samples for analysis.
Wathuto Ogopotse analyses the progress of an SDS-Page test.
Valentine Musabyimana analyses the result of an SDS-page test.
Vials of desiccated snake venom from various species is stored in a cold storage space at the Kenya Snakebite Research and Intervention Centre.
Head herpatologist, Geofrey Maranga, shows vials of desiccated snake venom from various species in cold storage.
Head herpetologist, Geofrey Maranga, retrieves a black mamba from it's enclosure.
Veterinary doctor, Allan Ragi (right) with assistant herpetologist, Morgan Kirwa (second right) assist Head Herpetologist, Geofrey Maranga (left partially concealed) moving cases holding various species of venomous snakes on a trolley into a room prepared for extraction of venom.
Head herpetologist, Geofrey Maranga (right), is assisted to control an Egyptian Cobra during extraction of venom from various snake species.
Head herpetologist, Geofrey Maranga, handles an African puff adder during an extraction of it's venom.
Head herpetologist, Geofrey Maranga, handles a black mamba during an extraction of it's venom.
'Snake stone'
A few kilometers (miles) from where Shukurani lay in pain, traditional healer Douglas Rama Bajila showed AFP the concoctions he uses to "suck out" venom. One popular remedy is the "snake stone", made from a cow's bone and sold for about $1.
Bajila said it can be reused multiple times: it simply needs to be soaked in milk for a few hours to "recharge". One was placed on Shukurani's leg as he was transported to hospital but unfortunately fell off along the way, his mother said.
Experts worry that by using traditional snakebite remedies, patients are losing precious time but they are popular because antivenom treatments are expensive. Antivenoms cost up to 8,000 shillings (about $62) per vial, and some patients require as many as 20 doses.
Ruth Kintalel, 30, from a pastoralist community in Kajiado county near the capital Nairobi, said she spent over five months in hospital after a red spitting cobra bit her in her sleep. "My husband sold our livestock to cover the rising hospital bill," said Kintalel, who is still paralysed in her right arm seven years later.
Head herpetologist, Geofrey Maranga (right), is assisted by Veterinary doctor, Allan Ragi (center) assistant herpetologist and Morgan Kirwa (left) to control a black mamba during extraction of it's venom.
An African puff adder takes on a defensive posture in its enclosure at the Kenya Snakebite Research and Intervention Centre.
A Jameson's mamba moves in its enclosure at the Kenya Snakebite Research and Intervention Centre.
A black mamba moves in its enclosure at the Kenya Snakebite Research and Intervention Centre.
Head herpetologist, Geofrey Maranga, gestures at a beaker containing venom from a puff adder.
Head herpetologist, Geofrey Maranga, uses a pipette to collect droplets of venom on a membrane covering a beaker containing venom from a African Puff adder.
Shukurani Konde Tuva (left), 14, sits on his hospital bed, suffering with necrosis to the tissue on his left-leg caused by the Cytotoxic venom from the bite of a Puff adder snake.
Mary Mumbi (right), 31, returns an Ashe's Spitting Cobra into its box that she and her colleagues have just finished cleaning out at the Watamu Snake Farm in Watamu.
A Boomslang, with potentially the most potent venom of all venomous species in Sub-Saharan Africa sits in its box at the Watamu Snake Farm.
Villagers who have experienced one or more encounters with snakes in their home environments raise their hands during an education and awareness campaign conducted by snake handlers from the Watamu Snake Farm.
'Bad reactions'
Experts say Kenya receives between 10,000 and 30,000 vials of antivenom per year and needs 100,000. Antivenom is made by "milking" venom from the fangs of snakes, which is then diluted and injected in small doses into animals such as horses, which produce antibodies that can be extracted for use in humans.
Using snakes from different regions, even of the same species, can reduce the effectiveness of the antivenom and cause "really bad reactions", said Kyle Buster Ray, a curator at the Watamu Snake Farm on the Kenyan coast. Kenya's stock of antivenom is not always effective because much comes from other countries like India, he said.
His farm houses over 400 venomous and non-venomous snakes and seeks to re-establish faith in antivenom that has been undermined by too many shoddy treatments. It offers free antivenom to critical cases locally, but stocks are limited. The farm also trains communities in life-saving snakebite responses. During a session attended by AFP, about half the community said they had been bitten at least once, and nearly all had initially turned to traditional medicines. Many showed signs of paralysis, with one suffering partial blindness.
A villager who has experienced one or more encounters with snakes in their home environments reacts as she narrates the ordeal during an education and awareness campaign conducted by snake handlers.
Villagers mill around wooden boxes containing venomous snakes to catch a glimpse of a Cobra during an education and awareness campaign conducted by snake handlers.
Kyle Ray, the curator at Watamu Snake Farm, speaks during an interview at the farm as he cradles a Sand Boa snake in his hands.
Kyle Ray, the curator at Watamu Snake Farm, holds a vial of antivenom during an interview at the farm in Watamu.
Snake handlers give a demonstration to visitors on safe methods for containing venomous snakes in domestic environments at the Watamu Snake Farm in Watamu.
Douglas Bajila, a traditional healer holds powder in his hand at his makeshift clinic, where he claims to treat venomous snake-bites using traditional medicine extracted from plant and snake derivatives.
Douglas Bajila, a traditional healer stands at his makeshift clinic where he claims to treat venomous snake-bites using traditional medicine extracted from plant and snake derivatives in Malindi.
Zakaria Muturi, 37, a puff adder bite survivor conducts an education and awareness campaign.
Zakaria Muturi, 37, a puff adder bite survivor conducts an education and awareness campaign.
Villagers react to the sight of a snake handled by Zakaria Muturi (left), 37, a puff adder bite survivor conducts an education and awareness campaign at a village endemic for high incidents of snake bites on humans in rural Malindi.
'Trauma'
In Nairobi, the Snakebite Research and Intervention Centre within the Kenya Institute of Primate Research is working on an antivenom specific to the country and applicable to multiple species. Valentine Musabyimana, a research fellow at the institute, said they "are aiming for an antivenom where a patient will require only one vial with great potency". Government subsidies should make it affordable, she hopes, though it is expected to take about two years before the antivenom is available.
That is too late for 14-year-old Shukurani. At the snake farm, Ray warned that the boy faced psychological as well as physical consequences. "Someone has watched their limb completely rot... there's a lot of mental trauma," Ray said. - AFP
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