It is a good article but California Mongabay is trying to publish their
best. There are many factors about snake bites as I could see from the
research articles I read as well as Guindy snake park talks I had long ago.
46000 are estimated as death in india whereas only double digit reported in
Australia; China the largest is hidden; Population and percentage were to
be taken, India and China will be behind Australia; also, people per area
living is not considered as a vital factor; where in Australia 3 people
live in India there are 400 plus which constitute target for snakes.
Australia may not have snake deaths but highest in EEL deaths in water.
Cause of death is the time it takes for people to die, in spite of the
first aaid, to reach the hospital. Our Vedas have mantras and verses in Rig
vedam and Atharvaveda.
   The world’s largest study of the causes and correlates of mortality in
India has undertaken by the Registrar General of India (RGI). The study,
called the Million Death Study (MDS) in India, is implemented in close
collaboration with the Centre for Global Health Research at the University
of Toronto, leading Indian and overseas academic institutions and ICMR.

 RGI-MDS conducted the first snakebite study in India and focused on the
incidence of snakebites in five regions of India and 13 states. Around
46,900 people die due to venomous snakebites in India annually. These
numbers are colossal, especially when compared with countries like the
United States and Australia, which report 10 to 12 deaths each year due to
venomous snakebites. Even though Australia is less populated, it has a
larger number of venomous snakes. Only 20 to 30 per cent of snakebite
victims in rural India seek treatment in hospitals, the study has suggested.
The low incidence of snakebites and the paucity of data on mortality and
socioeconomic burden make it difficult to understand the true impact of the
condition, it noted. Over 84 million people live in the studied areas,
covering states like Rajasthan, Maharashtra, Kerala, Tamil Nadu, Andhra
Pradesh, Odisha, West Bengal, Uttarakhand, Meghalaya, Arunachal Pradesh,
Mizoram and Tripura.

Cases and deaths related to snakebite 2016-20

Year                Snakebite cases                             Deaths

2016                         178,433                              1,068

2017                         158,650                              1,060

2018                         164,031                                 8,85

2019                          171,800                                700

2020                          126,927                                626

Source: National Health Profile

The article has been published in the international research journal PLOS
ONE. The study is led by researcher Dr Jaideep C Menon from preventive
cardiology and population health sciences at Amrita Institute of Medical
Sciences and Research Center and Dr Omesh Bharti, state epidemiologist,
department of health and family welfare, Himachal Pradesh government. The
study will  release real data on snakebite cases, mortality, the number of
deaths and the socioeconomic burden of snakebites for the first time in the
country, said Dr Bharti. This will help policymakers to prevent and control
snakebites in India. “The country still does not know the actual snakebite
burden, so there is a paucity of data when it comes to policymaking,” the
doctor said. This is the first such study to survey snakebite cases in
Southeast Asia, the researchers said. Sri Lanka carried out a similar
survey but covered only 1 per cent of the population, whereas India’s study
covered 6.12 per cent of the population. Snakebite case studies are being
conducted in 31 districts across six geographical regions of the country:
West, Central, South, East, North and North-East. Three districts of
Himachal Pradesh — Kangra, Chamba and Una are also included. The only data
on snakebites available in India is the mortality data from the RGI-MDS
study (Registrar General of India — 1 Million Deaths Study) and another
study on mortality from Bihar. Only two districts’ data on snakebites are
available in West Bengal.

*1*

China <https://www.cia.gov/the-world-factbook/countries/china/>

1,413,142,846

2023 est.

*2*

India <https://www.cia.gov/the-world-factbook/countries/india/>

1,399,179,585

2023 est.

*3*

United States
<https://www.cia.gov/the-world-factbook/countries/united-states/>

339,665,118

2023 est.




* Australia*

*India*

Population:

*25,979,000*

*1,425,776,000*

Inhabitants/km²:

3.4

433.7

Life expectancy males:

Ø 81 years

Ø 66 years

Life expectancy females:

Ø 85 years

Ø 69 years

CHINA     world which is an associated with high global mortality and

morbidity. Snake-bites are common in rural areas of tropical

and subtropical regions, and they are more common in

the South Asia, Southeast Asia, Africa, and Latin-America

in the world. Snake-bites are considered as a neglected

extrinsic disease by the World Health Organization. It is

reported that five million people are bitten by snakes every

year around the world and about 12,000 patient deaths and

400,000 were crippled or disfigured for life. Snakes are

usually divided into non-poisonous snakes and poisonous

snakes. There are more than three thousand species of snakes

in the world, among which there are more than 660 kinds of poisonous snakes
and about 60%-80% are nonvenomous

bites. Poisonous snake-bite can cause severe local and

systemic symptoms and signs, including systemic muscular

toxicity, systemic bleeding, tissue damage, and acute kidney

injury and even non-poisonous snake-bites have the possibility

to cause moderate or severe damage, because there

is a conceivable fear for a bite, such as numbness in the

extremities, vasovagal shock, extreme agitation and loss of

reason. Study showed that most patients of snake-bite

were adult males who are working outdoors, such as farmers,

herder, and soldier who were little knowledge of snake-bites

before they were bitten. In China, most of the snakes are

distributed in the south and southeast of the country. There

are about one hundred thousand person-times of snake-bite

every year, and the fatality rate of snake-bite is 5%-10%.

The poisonous snakes with more than 50 species found are

mainly distributed in Guizhou, Guangdong, Guangxi, Fujian,

Yunnan, Sichuan and other places in the south of the Yangtze

River. In recent years, the rescue level of critically injured

snakes has been greatly improved. However, existing epidemiological

data are limited and fragmented, and so, the

true impact of snake-bites may be underestimated and the

full burden of human suffering from snake-bites remains unknown. Snake-bite
and their management have also some

reports in China. There are still many problems in

the treatment of snake bites, which are worthy of clinical

attention. At present, China has not a unified standard for

the diagnosis and treatment of snake-bite. Therefore, the

prevention and treatment of snake-bite is still a huge challenge

faced by all countries in the world. Zunyi of Guizhou

province is a subtropical city in southwest China and the

average altitude is 1-1.5 km. There are many mountains

and mountain forests and people are often bitten by snakes

and there is no study has been reported about of snake-bites

in Zunyi city, China. This study investigated the snake-bite

patients admitted to the emergency department of the affiliated

hospital of Zunyi Medical University in recent years,

and we report, for the first time, the incidence and distribution

of snake-bite in Zunyi. We survey the characteristics

of the incidence and distribution of snake-bite in this region.

The goal of this study was to provide some epidemiological

data and improve the medical knowledge of snake-bite and

provide help for the prevention and treatments of snake-bite,

so as to reduce the morbidity and mortality of snake-bite in

China.



Garuda Upanishad

Introduction:

The Hindu God "Garuda", an ardent devotee of Vishnu, the Supreme Being, is
of the form of Eagle, and is supposed to have extreme control over snakes
and other poisonous animals .This Upanishad, named after the Garuda, is
supposed to contain certain vital mantras which can annihilate poison
inflicted by any sort of snakes / animals.

The Upanishad:

Om ! That (world) is a complete whole. This (world) too is a complete
whole. From the complete whole only, the (other) complete whole rose. Even
after removing the complete whole from the (other) complete whole, still
the complete whole remains unaltered and undisturbed.



Om Shanti ! Shanti ! Shanti !



I will preach the Brahman – science. Brahman taught it to Naradha, Naradha
to Brhatsena, Brhatsena to Indra, Indra to Bharadvaja, Bharadvaja to his
puils who desired to preserve their life.

(He taught them the science) which achieves this, which achieves good,
removes poison, destroys poison, overcomes poison and annihilates poison:



“Struck is the poison, annihilated is the poison, destroyed is the pouison;
it is struck by Intra’s thunder-bolt, Svaaha ! May it originate from
snakes, from vipers, from scorpions, from cankers, from salamanders, from
amphibious animals or from rats”.



“May you be Anantaka’s messenger, or be Anantaka himself ! May you be
Vasuki’s messenger, or be Vasuki himself ! May you be Taksaka’s messenger,
or be Taksaka himself ! May you be Karkotaka’s messenger, or be Karkotaka
himself ! May you be Samkhapulika’s messenger, or be Samkhapulika himself !
May you be Padmaka’s messenger, or be Padmaka himself ! May you be Mahaa
Padmaka’s messenger, or be Mahaa Padmaka himself ! May you be Elaapatraka’s
messenger, or be Elaapatraka himself ! May you be Mahailaapatraka’s
messenger, or be Mahailaapatraka himself ! May you be Kalika’s messenger,
or be Kalika himself ! May you be Kulika’s messenger, or be Kulika himself
! May you be Kambalasvatara’s messenger, or be Kambalasvatara himself !”.



For twelve years snakes do not bite him who hears this great science on the
new moon night. The snakes do not bite him as long as he lives who, having
recited this great science on the new moon night, wears it (as an amulet).



He who teaches it to eight Brahmanas he releases (from the effects of snake
bite) by merely touching with grass, with a piece of wood, with ashes. One
who teaches it to a hundred Brahmanas, he releases by a mere glance. One
who teaches it to a thousand Brahmanas, he releases by the mere thought –
he releases it by the mere thought.



Thus spake the exalted Brahman – the exalted Brahman. This is the essence
of the Garuda Upanishad.



Om ! That (world) is a complete whole. This (world) too is a complete
whole. From the complete whole only, the (other) complete whole rose. Even
after removing the complete whole from the (other) complete whole, still
the complete whole remains unaltered and undisturbed.





ATHARVA VEDAM:  HYMN LXXXVIII  A charm to cure a snake-bite

1Depart! thou art a foe, a foe. Poison with poison hast thou

   mixt, yea, verily poison hast thou mixt.

  Go to the serpent: strike him dead.





Hymns to Cure Snake Bite From the Rig-Veda - Book I

HYMN CXCI Water. Grass. Sun.

1. VENOMOUS, slightly venomous, or venomous aquatic worm,-

Both creatures, stinging, unobserved, with poison have infected me.

2 Coming, it kills the unobserved; it kills them as it goes away,

It kills them as it drives them off, and bruising bruises them to death.

3 Sara grass, Darbha, Kusara, and Sairya, Munja, Virana,

Where all these creatures dwell unseen, with poison have infected me.

4 The cows had settled in their stalls, the beasts of prey had sought their
lairs,

Extinguished were the lights of men, when things unseen infected me.

5 Or these, these reptiles, are observed, like lurking thieves at evening
time.

Seers of all, themselves unseen: be therefore very vigilant.

6 Heaven is your Sire, your Mother Earth, Soma your Brother, Aditi

Your Sister: seeing all, unseen, keep still and dwell ye happily.

7 Biters of shoulder or of limb, with needle-stings, most venomous,

Unseen, whatever ye may be, vanish together and be gone.

8 Slayer of things unseen, the Sun, beheld of all, mounts, eastward, up,

Consuming all that are not seen, and evil spirits of the night.

9 There hath the Sun-God mounted up, who scorches much and everything.

Even the Aditya from the hills, all-seen, destroying things unseen.

10 I hang the poison in the Sun, a wine-skin in a vintner's house,

He will not die, nor shall we die: his path is far: he whom Bay Horses bear
hath turned thee to sweet meath.

11 This little bird, so very small, hath swallowed all thy poison up.

She will not die, nor shall we die: his path is far: he whom Bay Horses
bear hath turned thee to sweet meath.

12 The three-times-seven bright sparks of fire have swallowed up the
poison's strength.

They will not die, nor shall we die: his path is far: he whom Bay Horses
bear hath turned thee to sweet meath.

13 Of ninety rivers and of nine with power to stay the venom's course,-

The names of all I have secured: his path is far: he whom Bay Horses bear
hath turned thee to sweet meath.

14 So have the peahens three-times-seven, so have the maiden Sisters Seven

Carried thy venom far away, as girls bear water in their jars.

15 The poison-insect is so small; I crush the creature with a stone.

I turn the poison hence away, departed unto distant lands.

16 Forth issuing from the mountain's side the poison-insect spake and said:

The scorpion's venom hath no strength Scorpion, thy venom is but weak.

K Rajaram  IRS   811223

---------- Forwarded message ---------
From: 'gopala krishnan' via Thatha_Patty <[email protected]>
Date: Thu, 7 Dec 2023 at 19:30
Subject: More than 50% worldwide snakebite deaths are in India – what is
the antidote? FORWARD
To: Patty Thatha <[email protected]>, Kerala Iyer <
[email protected]>


More than 50% worldwide snakebite deaths are in India – what is the antidote?
FORWARD



Dear friends,

The above article appeared in the opening page of Yahoo, I found quite
interesting and thought of forwarding.

Gopalakrishnan 7-12-2023.



A key takeaway from a government study is the need for state-specific
antivenoms and increased awareness , especially among rural communities.

A1     Arathi Menon,Dec 05, 2023 · 07:30 pm

More than 50% worldwide snakebite deaths are in India – what is the
antidote?

Ganesh VS from Chowdikatte, a village in Karnataka’s Mysuru district, had
lost his wife to renal failure, a little over a year after she was bitten
by a snake. In Karnataka, Rs 2 lakh is given as compensation for the loss
of life from snakebite. However, Ganesh, who had spent Rs 15 lakh of his
money on his wife’s treatment before she died, had to jump through hoops to
claim compensation because the hospital recorded the cause of her death as
renal failure, and did not mention snakebite, as it is difficult to prove
that death was due to snakebite.

Snakebite, in India, is a medico-legal case, where both medical and police
departments are involved. In the case of a death from snakebite (in
Sujatha’s case, the incident happened on the farm adjacent to her house),
the revenue department that compensates the next of kin, demands a no
objection certificate from the police department, as well as clearance from
the hospital to rule out any foul play.

 “There is a lot of paperwork, red tape and bureaucracy involved, all for a
compensation of Rs 2 lakh when the family may have already spent much more
than that for treatment,” said Sumanth Bindumadhav, director of Humane
Society International India. According to him, some doctors even refuse to
treat snakebite cases due to potential legal hassle in the event of a death.

India accounts for over half of global snakebite deaths

With an average of 58,000 deaths from snakebites annually, which is more
than half of all snakebite deaths in the world (81,000–1,38,000), India
continues to be the country most significantly affected by snakebite
cases. According
to a comprehensive study in 2020, eight states – Bihar, Jharkhand, Madhya
Pradesh, Odisha, Uttar Pradesh, undivided Andhra Pradesh (which includes
Telangana), Rajasthan and Gujarat – carried the most burden of snakebite
deaths accounting for more than 70% of deaths during the period between
2001 and 2014.

The experts Mongabay-India spoke to said that that was a conservative
estimate since many cases go unreported, as snakebite is not a notifiable
disease.

 “Some cases do not even get to hospitals. They go to faith and herbal
healers and quacks,” said Karnataka-based snake researcher Gerry Martin. As
a consequence, the real scale of the problem remains obscure.

“Most policymakers go by the Integrated Disease Surveillance Programme data
or the Central Bureau of Health Intelligence data, which are inaccurate,”
said Bindumadhav, emphasising the need to declare snakebite as a notifiable
disease. The Central Bureau of Health Intelligence reported a total of
13,043 snakebite deaths in the country from 2010 to 2020, which is far
removed from reality, say the experts. Apart from deaths, snakebite
envenomation also causes long-term health effects and has a high social and
economic impact on families.

Taking cognisance of the enormous health burden from snakebites, the World
Health Organization recognised snakebite as a neglected tropical disease in
2017 and in 2019, set a target to halve the global burden of snakebite by
2030. “Meeting the global target is possible only if India performs better,
considering more than half of all snakebite deaths are reported from
India,” said Soumyadeep Bhaumik, head of Meta-research and Evidence
Synthesis Unit, Health Systems Science, George Institute for Global Health,
India.

Understanding the scale of the problem

India jumped on the bandwagon immediately with a national programme for
prevention and control of snakebites that identified key areas of
interventions and strategies to control cases in the future. The Indian
Council for Medical Research set up a task force in 2022 and launched a
nationwide survey to understand the incidence, mortality, morbidity and
socioeconomic burden of snakebites in India.

Dr Jaideep C Menon, professor of adult cardiology and public care at Amrita
Hospital, Kochi, who heads the task force, said the survey has covered
eight of the 14 states to be studied for the purpose and that the remaining
states will be done by the end of this year.

One of the takeaways from the study, according to him, is that the Indian
polyvalent antivenom in the market doesn’t work across geographies and
venom types, which points to a need for state-specific antivenoms.

The study has various recommendations, including training community health
workers, like the Accredited Social Health Activists, or ASHAs, in carrying
the messages of effective prevention and management to vulnerable
populations, considering more than 70% of cases happen in rural India.

Early this year, the government also took the decision to appoint nodal
officers in every state for snakebites. President of Mumbai-based Snakebite
Healing and Education Society, Priyanka Kadam, said that the decision is
going to be a game changer since there would be a better flow of funds for
the purpose. “I’ve been working with the government on this issue since 2015,
but there has never been funding for snakebites in the past,” she said. The
states have also been asked to come up with action plans. Moreover, the
Ministry of Environment, Forests and Climate Change released
a10-species-specific
guidelines to address human-wildlife conflict where snake is featured as an
animal in conflict.

Policy gaps

Experts point to multiple gaps in policies that need immediate
intervention. Bindumadhav finds the lack of quality control of the
antivenom in the country worrisome. “A batch of antivenom may not be as
potent as you think it is because the Central Drug Standards and Control
Organisation has no prescribed standard for potency for antivenom,” he said.

Menon recommends extending the support of the government’s health insurance
scheme, Pradhan Mantri Jan Arogya Yojana for those below the poverty line,
to all snakebite cases and not just the critical ones needing ventilator
support as is the case now.

Bhaumik, who was a part of the study on global mortality of snakebite
envenoming, however, believes that the focus should be on preventing
snakebite cases and a good portion of the global funding for the purpose
must reach institutes, organisations and nonprofits as well as governments
working on reducing snakebites in India.

While focusing on better antivenoms and adequate compensation are
essential, those expenses can be avoided by preventing snakebites, he said.
He suggests community-based interventions like training the first
responders of a community on prevention and making formal healthcare
systems acceptable to community members.

The essentials for the prevention of snakebites in rural areas like boots,
torches and mosquito bed nets, need to be made available to the
vulnerable. Another
intervention would be home environment modifications. “Ensuring logs of
woods are not stacked near the house or food waste not lying around close
to the house may seem simple but go a long way in preventing snakebites,”
Menon said.

A study conducted by Bhaumik and colleagues in West Bengal’s Sundarbans and
Hooghly districts on snakebite care during Covid-19 found that communities
affected by snakebite are immensely challenged by weak healthcare systems,
which was accentuated during the pandemic. The study also revealed a strong
need for community-based programmes on snakebites.

The conversation on snakebite management is often centred around better
antivenoms or awareness building. While both are pertinent interventions, they
are ineffective in the absence of an adequate healthcare system.

“We can come up with very effective antivenoms but if there are no quality
doctors or nurses to administer it or if the hospitals lack electricity or
other facilities, these interventions are not effective,” said Bhaumik.

Bhaumik also recommends making first aid kits easily available to the first
responders who are trained in administering them. “People’s faith in
traditional healers is not just cultural. The common understanding that
with better awareness, the affected will approach primary healthcare
facilities is not always true. The outcome often depends on the location
and accessibility of the primary healthcare facilities,” he said.

There are no magic bullets to deal with the burden of snakebite cases. The
key, according to the experts, lies in a combination of interventions and
sustained, collaborative efforts.

This article was first published on Mongabay.



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