Agom Ibrahim, Nigeria
Snakebite is a critical public health problem in Africa and Nigeria in particular. The precise incidence of snakebite is difficult to determine and is often grossly underestimated. However, recent data estimates that about 500,000 cases of snakebite occur annually in Africa resulting in over 30,000 deaths, 35,000 permanent disabilities -many of which require amputation, and up to 55,000 chronic mental disorders. In Snakebite Hospital and Research Centre Kaltungo where I work as a clinician and researcher, over 4,000 cases are managed annually (arguably the highest managed by any single healthcare facility in the world) and this represents only 8.5% of patients that presents to a healthcare facility. 97.5% others are treated at home by traditional healers many of whom end up dead or maimed for life.
Like most neglected tropical diseases (NTDs), snakebite affect mainly the rural poor in under-served communities and contribute to multiple issues that challenge the overall quality of life in many settings. Unlike most NTDs however, it has potent treatment which if instituted early could result in almost total reversal of symptoms within a relatively short time. Bites occur more often while victims were farming, herding, or walking; although spitting Cobra bites may occur when victims role on them in their sleep.
Conventional anti snake venom (ASV) remains the hallmark of treatment and has been shown to reduce mortality by up to 80%. In SSA, where the burden is second only to that of Asia, there is only one AV producer based in South Africa. The majority of other African countries depend on AVs produced in Asia, Europe and Latin America. This presents unique challenges in availability, standardization, efficacy, distribution and cost dynamics. Additionally, venom varies widely between species but many hospitals/healthcare personnel do not have appropriate training to different between species and to effectively manage snakebite envenoming.
The Snakebite Control Network (sconetafrica.org), a non-profit I founded last year is poised to provide practical, sustainable and innovative solutions to the public health challenges of Snakebite envenoming in SSA by focusing on five cardinal objectives: Training, Research, Antivenom Supply, Advocacy and Community engagement/enlightenment detailed as follows:
TRAINING
To fill the knowledge gaps among healthcare personnel on current modalities in the prevention and management of snakebite envenomation while entrenching professionalism, transparency and honesty.
RESEARCH
i. To provide coherent answers to the clinical, epidemiological, and laboratory questions arising from snakebite envenomation and associated complications.
ii. To collaborate with individuals and other organizations in this regard in order to foster evidence-based interventions in patient management and control measures.
iii. To fill other identified knowledge gaps in the field.
ADVOCACY
Advocate for snakebite-related policy development, reviews and implementation towards coordinated multi- sectoral responses to the physical, social and economic challenges posed by snakebite envenoming.
ANTI-SNAKE VENOM SUPPLY
Ensure prompt and regular supply of qualitative anti-snake venom for free or at a highly subsidized rate to patients while sustaining engagements across various organizations towards local production of anti-snake venom in the region.
COMMUNITY ENGAGEMENT
i. To bring to the consciousness of rural and urban communities, the multi-faceted challenges posed by snakebite envenomation to victims and their immediate families;
ii. to enlighten individuals and communities on preventive measures and standard first-aid procedures in the event of snakebite;
iii. to combat mis-information and misleading traditional beliefs pertaining to snakebite;
iv. to encourage individual, group and communal efforts towards ensuring early presentation of patients to recognized healthcare facilities and other positive measures.
Our vision is to ensure equitable provision of qualitative healthcare services in the prevention and treatment of snakebite envenoming across sub-Saharan Africa. We desire to bridge the gap between the helpless, and often poor victims in hard-to-reach, underserved communities with cutting edge and affordable treatments. Through the network, we are building national and international partnerships with individuals and organizations so that together, we can reverse the vicious cycle of death, disfigurement, disability and poverty that is often associated with snakebite envenoming as well as other neglected tropical diseases.
The Mandela Washington Fellowship has further equipped me with not just knowledge and skills but also the network to increase equitable access to quality healthcare services, advocate for strategic global health efforts, coordinate the inputs of development partners and encourage robust research. Through several synchronous sessions and engaging contents from asynchronous materials, I have gained unique insights into the strength-based approach to leadership, project management, public speaking, various aspects of the US culture, government structures and function among others. I have also had engaging discussions and formed friendships with other fellows, institute staff and CEOs of various organizations via the several networking opportunities we were afforded. I am thankful to the United States government, IREX and my institute, Wayne State University for this life-time opportunity.
