Thea Litschka-Koen leans over the hospital bed and grabs Qiniso’s swollen hand. While examining the huge blister on the back of her hand, the 36-year-old patient says: “I was woken by a sharp pain, I shook my hand and felt something fall to the ground.” Qiniso saw blood between the index and middle fingers and suspected a snake bite. His brother took him to a hospital in Manzini, a town in the small kingdom of Eswatini, which lies between South Africa and Mozambique and was called Swaziland until April 2018. At home at Qiniso you actually found a Moçambique spitting cobra in the drawer of a workbench, it is one of the most poisonous snakes in southern Africa.
“I have never had such severe pain in my life. It was like my flesh, my veins, even my bones were on fire, ”says Qiniso. He was injected with an antidote at the hospital. However, treatment had to be interrupted for a few hours because the patient began to tremble uncontrollably and developed a rash all over the body – side effects of the saving antiserum. That was three days ago. Since then, the hand and arm have swelled more and more. Thea Litschka-Koen explains that the snake’s venom has a necrotic effect and that he will need surgery to cut away the tissue that dies. Unfortunately, there is no magic bullet in such cases.
Ignorance and superstition aggravate the situation
Every year around five million people are bitten by a snake worldwide. 2.7 million of these bites lead to poisoning, resulting in 138,000 deaths and 400,000 permanent damage: Sometimes amputations are necessary, the bitten people go blind or suffer from post-traumatic stress disorders. However, these numbers are only estimates, official statistics are rare. The problem mainly affects the poor, rural population of Africa, Asia and South America.
There is often a lack of medical infrastructure, affordable and effective antidotes, and doctors who can treat snake bites properly. The situation is aggravated by ignorance and superstition among the population. Snakebite poisoning has not been considered a global health issue in the past and has received little attention. However, the World Health Organization, or WHO for short, added it to the list of neglected tropical diseases in 2017 and published an ambitious strategy in 2019 to halve the number of snake bites and their consequential damage by 2030.
In the Kingdom of Eswatini with 1.2 million inhabitants, 200 to 400 snake bites occur annually, an estimated ten percent of the victims die. Over the past decade, however, the country has made great strides in education, prevention, and better treatments, and could serve as a model for other countries concerned. This is mainly thanks to Thea Litschka-Koen. She was part of the WHO working group that helped develop the snake bite strategy. The 52-year-old is neither a doctor nor herpetologist, but the managing director of hotels and restaurants in northeastern Eswatinis.