Neglected Tropical Diseases: The Hidden Danger of Snakebites in Kenya

Snakebites are an insidious but often overlooked danger in Kenya and other low- and middle-income countries. Despite their potentially devastating effects, they receive little attention from governments, international organizations, and the broader public. The World Health Organization (WHO) has classified snakebites as a Neglected Tropical Disease (NTD) due to the low priority it receives despite its deadly impact, particularly on poor, rural communities. In Kenya, snakebites are prevalent, especially in regions like Baringo, Kitui, Kilifi, Wajir, Garissa, Machakos, and Taveta, where the rural environment provides ideal hideouts for venomous snakes, making it more difficult to prevent and treat incidents.

The Scope of the Problem

Globally, snakebites affect 1.8 to 2.7 million people annually, with 81,000 to 138,000 fatalities and about 400,000 permanent disabilities, according to the WHO. In Africa alone, an estimated 435,000 to 580,000 people suffer from snakebites that require medical intervention each year. In Kenya, about 50,000 snakebite cases occur annually, but only around 15,000 are reported. The Kenya Institute of Primate Research (KIPRE) estimates that about 4,000 people die annually from snakebites in the country, while 7,000 suffer paralysis or other severe health complications.

Venomous snake species in Kenya include puff adders, black spitting cobras, black mambas, and boomslangs. These snakes pose significant risks to rural communities, where access to healthcare facilities is limited, and many people are unaware of the proper treatment for snakebites. For example, black mambas can kill within 15 to 30 minutes of a bite, making timely access to antivenom critical to saving lives. Yet, in many cases, healthcare facilities in rural areas do not have the necessary antivenoms available, further compounding the problem.

Rural Communities at Risk

Rural communities in Kenya are disproportionately affected by snakebites due to several factors. The bushy environments in which many rural Kenyans live provide ideal hiding spots for snakes. These communities often lack access to proper footwear, such as boots, that could provide protection from snakebites. Many people in these regions walk barefoot, especially when tending to farms, fetching water, or moving through thick bushland.

Access to healthcare is another major barrier for rural populations. Poor road networks and the lack of emergency transport services, such as ambulances, often mean that victims rely on motorbikes or other improvised means to reach healthcare facilities. However, even when they reach these facilities, the availability of treatment is not guaranteed. A study conducted in Kenya found that only 20% of healthcare facilities had the necessary medicines to treat snakebites, and antivenom was available in less than one-third of these facilities.

This lack of preparedness is further exacerbated by the low level of formal training in snakebite management among healthcare workers. In fact, only 12% of healthcare staff in Kenya have received specialized training on how to treat snakebites. This creates a vicious cycle, where victims often do not receive timely or appropriate treatment, leading to preventable deaths and lifelong disabilities.

The Role of Poverty and Systemic Inequities

Snakebites in Kenya predominantly affect the poorest segments of the population, who are most vulnerable to health risks due to their lack of resources. Poverty limits access to antivenom and proper medical treatment, as victims often cannot afford the high costs associated with snakebite treatment. The high production costs of antivenom, coupled with limited demand due to poverty, discourage pharmaceutical companies from developing affordable antivenom products.

Médecins Sans Frontières (MSF), also known as Doctors Without Borders, has highlighted this inequity. Matthieu Chevallier, the organization’s Global Health Advocacy Officer, notes that traditional healers are often the only recourse for snakebite victims in remote areas. This reliance on traditional medicine is not due to a lack of awareness about modern treatments but because many people cannot afford hospital care or do not have access to trained medical professionals. Chevallier also points out that snakebite victims rarely have a voice in the decision-making process, as they come from marginalized areas and are not well-represented in health policy discussions.

The Cost and Availability of Antivenom

Antivenom, the life-saving treatment for venomous snakebites, is often out of reach for many Kenyans. In Kenya, the availability of antivenom is restricted by a combination of high production costs, logistical challenges, and limited government investment. The price of existing antivenoms is relatively high, making it unaffordable for most snakebite victims. Furthermore, different types of antivenom are required to treat bites from different species of snakes, adding to the complexity of providing care.

Even when antivenom is available, there is a critical need for polyvalent antivenom, which can treat bites from a range of local snake species. Unfortunately, polyvalent antivenom is rarely stocked in healthcare facilities due to supply chain issues, including delays in production and distribution.

The Kenya Institute of Primate Research has been working to address these issues by conducting research to develop locally produced antivenom. The institute’s research is aimed at reducing the country’s dependence on imported antivenom, which is often expensive and in limited supply. In January 2024, Kenya inaugurated a new Board of Directors for the institute, signaling the government’s commitment to improving access to antivenom through local production.

Government Efforts and Challenges

The Kenyan government has made some efforts to address the snakebite problem, but systemic challenges remain. The Division of Vector-Borne and Neglected Tropical Diseases under the Ministry of Health has proposed innovative solutions, such as using drones to deliver antivenom to remote areas. This would address the problem of slow delivery, especially in cases involving fast-acting venom, like that of the black mamba, where victims can die within minutes without treatment.

However, despite these efforts, the government has been criticized for not doing enough to subsidize the cost of treatment for poor communities or to ensure that antivenom is available in all healthcare facilities. Competing priorities and limited resources often result in the neglect of snakebite prevention and treatment programs, even though snakebites affect thousands of people every year.

Lack of Awareness and International Attention

A significant barrier to addressing the snakebite crisis in Kenya is the lack of awareness about the scale of the problem. Snakebites are often seen as isolated incidents rather than a public health emergency, and few studies have been conducted to accurately assess the prevalence and impact of snakebites in the country. This lack of data makes it difficult to allocate resources and develop comprehensive prevention and treatment strategies.

Internationally, snakebites receive little attention from donors because they are not perceived as a global health security threat. Unlike other diseases that have the potential to spread across borders, snakebites are confined to specific regions, primarily in rural, underdeveloped areas. As a result, funding for snakebite research and treatment is limited, and victims remain neglected.

Conclusion

Snakebites in Kenya, and in many other low- and middle-income countries, continue to be a significant but under-recognized health crisis. The combination of rural poverty, lack of healthcare infrastructure, and systemic inequities has left thousands of people vulnerable to injury, disability, and death. While there have been some efforts to address this neglected tropical disease, much more needs to be done.

Investments in research, local production of antivenom, and improved healthcare access in rural areas are essential to reducing the burden of snakebites. At the same time, greater international attention and funding are needed to ensure that snakebite victims receive the care and treatment they deserve. Addressing this issue requires a comprehensive approach that includes prevention, timely treatment, and broader social and economic development to protect the most vulnerable members of society.