Sunday, July 11, 2010

Snake Bite in the Garden of Eden

Many early travelers to Sri Lanka believed they were standing in the original Garden of Eden. Among the verdant growth serpents slid; not to offer apples but to feed on the similarly abundant wildlife. But at times people and serpents would meet and usually it was to the serious disadvantage of one or the other.

Sri Lanka, though an island of relatively small size, has the richest collection of herpetological wealth in South Asia. There are around 100 amphibian and 190 reptile species of which 96 are snakes. Despite only 5 being seriously venomous the death rate in Sri Lanka is one of the highest in the world being 6 in 100,000 population. Australia is blessed with many more lethal snakes in the scrub but has far fewer deaths from bites.

Factors which contribute to this high incidence of death by snakebite are primarily the socio-economic condition of the people, preference among victims for seeking traditional treatment for snakebite as well as clearing natural vegetation and habitats for settlements, agriculture and plantations.

While the island possesses a rich flora of nearly 3500 species of plants it has been an agricultural economy for the past 10,000 years. As a result, over the years many natural ecosystems have been transformed into agro-ecosystems which appeal to highly venomous snakes such as Cobras, Russell's Viper and Kraits.

Sri Lanka’s has also been an hydraulic economy with over three hectares of inland waters for every square kilometer of land. This is one of the highest densities of inland lakes, ponds, man made canals and still waters in the world. Combined with the warm coastal waters around the island are many coastal lagoons and estuaries that provide engaging habitats for both people and snakes.

The snakes are responsible for most deaths can be divided into 3; big snakes (Cobra) medium snakes (Common Krait and Sri Lanka Krait) and small snakes (Russells's Viper, Saw-scale Viper, Hump-nose Viper and Green Pit Viper. Then of course there are the 13 species of wet snakes (Sea snakes) which inhabit the coastal waters and estuaries around the island.
Being cunning buggers most venomous snakes are camouflaged to blend into the environment increasing the chances of treading on them. Vipers are particularly good at this and also at not moving much so are much better represented among snakebites. The green, yellow and black colour of the Green Pit Viper merges into the foliage of the trees, shrubs and creepers on which they rest, resulting in a fair number of people being bitten (or given apples) by Green Pit Vipers while plucking tea leaves, clearing forests and weeding.

Our Driver explained happily after a snake crossed the road in front of us;
“Oh it’s not dangerous! The ones you see a never dangerous!”

But the most apparent reason for the high incidence of snakebite is the food resource humans bring to the ecosystem. Rats, which come into paddy fields to feed on grain attracts vipers, cobras and other snakes. Other creatures also take advantage of human agricultural practices including frogs, mice, house geckos, skinks, land monitor lizards, house sparrows and poultry.
Some prey animals, such as skinks which are commonly found near houses have a disturbingly curious habit of getting on to beds in the night and creeping under pillows, mattresses or bed sheets. If you have a skink under your pillow you may well have a snake!

Many species of snakes come on to roads or tracks at dusk or night and especially immediately after rain, increasing the chances of people being bitten. According to one epidemiological study “15% of snakebites had been inflicted on roads”, a seemingly strange activity for snakes to undertake and there is no information on how many roads died.
A further useful fact is that most krait bites are preceded by rain. Since Sri Lanka is either in monsoon or inter-monsoonal and it rains every month the probability of rain preceding bites is not surprising.
Since around 45% of the population is engaged agriculture, animal husbandry, forestry, fishing and hunting it is similarly not surprising that 85% of snakebites occurred while people were working directly or indirectly in agricultural activities or related pursuits such as weeding, preparation of fields, harvesting, guarding fields etc. Strangely all the known sea snake bites were on fishermen during fishing related activities.

According to the Sinhala Palmleaf Manuscripts;
“Among the snakes found in Sri Lanka, the most venomous and the most feared is the cobra, popularly known as the 'naya', which is highly respected, sometimes honoured and even worshipped by those who consider cobras with high esteem. If a person were to come across a cobra by accident, he speaks to it nicely to move away from the path, and never attacks it or tries to chase it away. There is a saying that a cobra never bites a blind man, even if he were to tread upon it by accident. This is said to be a sublime quality of cobras.”

There are some other interesting facts including almost all snakebite involving the Common Krait occurred in wattle and daub huts while the Hump-nose Viper, being rather short inflicts bites only on the feet in 85% of cases. Someone’s done some serious research here!

Regardless of where you get bitten there are some local beliefs and practices that may assist the patient’s demise from snakebite:
a) Application of a cut lime or onion, (something I heard also as a child in Australia)
b) When bitten by snakes, some do not wish to speak of it, fearing that enemies might "bind the venom" (visha bandeema) resulting in difficulty of curing the condition.
c) The belief that if bitten by snakes on certain inauspicious day, time or place (for example a cemetery), it presaged a poor prognosis.
d) Seeking non-scientific first aid techniques such as cauterizing, cutting, application of snake stone, tight tourniquet, drinking alcohol or urine etc.
The reputation of Auyvedic medicine and use of snake-stones still exists. Snake stones are often nothing more than pieces of partially burnt bones, chalk or bezoars. Bezoars are stony concretions found in the stomachs of goats, antelopes, llamas, chamois, etc., and formerly esteemed as an antidote to all poisons. Many people still hold that native treatment is better than western treatment to save victims from the venomous snakebite and in most rural areas; the 'sarpa-vederala' (snake-healer) has his place as the saviour of mankind bitten by snakes and on the verge of death.

However among most victims bitten by venomous snakes, shock is believed to be the cause of death, when they become aware that their lives are at stake. This fear is followed by emotional symptoms, such as faintness, stupor, feeble pulse and shallow breathing, which are different from systemic envenoming.

In the end though, it is only a few who succumb to the serpent’s sting and taste the forbidden fruits in the Garden of Eden.

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