Community Health Workers share experiences addressing snakebites in Kajiado, Kenya

As the world marked the first World Neglected Tropical Diseases Day today, snakebite envenoming remains one of the major neglected tropical diseases in the country. We speak to survivors of snakebites and Community Health Workers in Kajiado County.

Fred Ntuyian is  a Community Health Volunteer (CHV) covering 66 households in Singiraine, Kajiado West, Kenya. Fred makes daily visits to these homes to ensure that the locals are well informed on health matters. As part of his work, he also sees community members who have been bitten by a snake. “As a CHV, when I get a snakebite victim, we advise them to seek medical attention from a reputable health facility. We also teach them the need to stay calm as they await help.”

Fred’s day starts with his own domestic chores before making house to house visits in the area. His work entails recording and reporting any cases of snakebite envenoming and other diseases.

Fred Ntuyian is  a Community Health Volunteer (CHV) covering 66 households in Singiraine, Kajiado West, Kenya, PHOTO: Boniface Mutinda

Between January and June 2021, Fred has recorded three cases of snakebites from the households he manages. Men, he says, are mostly affected either during their daily work as herders or as they walk home late at night.

Stephen Kakunyu is one of the cases Fred attended to this year. It was a rainy afternoon on 25 April 2021 in the Singiraine area of Kajiado county. To the residents, the heavy downpour was a source of hope, as it meant better pasture for their livestock and more yield in their farms. But for Stephen Kakunyu, this day was to present a challenge that would keep him temporarily away from his daily chores.

Stephen shows the scar on his foot after the snakebite. PHOTO: Boniface Mutinda

Stephen, a father of nine, was walking home late in the evening. It was still raining when what felt like a thorn pricked him on his right foot. When he got home, he started feeling nauseated. He tried to attend to his sore foot when he realised he had been bitten by a snake.

When his leg started swelling and the pain intensified, Stephen decided to seek medical attention at the Singiraine Health Centre. He was treated and allowed to go back home.

Hope beyond the snakebite

According to the World Health Organization, snakebite envenoming, is a neglected tropical disease that affects 1.8–2.7 million people each year, claiming 81 000–138 000 lives and causing 400 000 cases of permanent disability. Stephen also still suffers from the consequences of the snakebite. His leg is not as strong as it was, and he experiences periodic pains in his lower back. However, he tries to go about his daily business.

Stephen Kapunyu showing the rocks under which snakes find their habitation in the area. PHOTO: Boniface Mutinda

“I still take care of my family and livestock as before. I also do casual work as a loader with local transport companies,” he says.

The village elder encourages other survivors to keep fulfilling their role in the community and urges community members to seek medical attention in case of a snakebite. “I am alive because of God and the health workers who have given me valuable advice regarding the snakebite,” he added.

Health workers like Fred are actively involved in sensitising the community on how to manage snakebites. “We do regular training sessions with the community to inform them on what to do in case of a snakebite.”, he says.

Rose in the consultation room at Singiraine Dispensary. PHOTO: Boniface Mutinda

Rose Melita is the nurse in charge at Singiraine dispensary, a Level 2 health facility in Kajiado County in Kenya, where Stephen sought help after the snakebite. According to her, community sensitisation is crucial to address snakebites. For a community that largely looks to traditional ways of treating snakebites, Rose says informing the people on snakebites and adequate health seeking behaviour will go a long way to improving the situation.

Fred talking to a healthcare worker at Sinigraine Dispensary and visiting the pharmacy. PHOTO: Boniface Mutinda

Rose has basic training in first aid. This expertise, she says, comes in handy, especially in a region with a poor referral system and one where essential drugs are sometimes out-of-stock. Shortage of antivenom is common in most parts of the county; something that forces some patients to opt for treatment at private clinics. Here, a vial of antinvenom costs between Sh5,000 and Sh7,000.

The situation at Singiraine dispensary is no different. “After a snakebite, we give the patient hydrocortisone and other antibiotics for tetanus prevention. After that we refer within 24 hours. Unfortunately, these commodities are currently out-of-stock for a month. They are supplied quarterly from the national government.”

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