I was looking forward to my trip to Madhavpur (Ghed) in the Porbandar district of Gujarat. I had been exchanging notes with Arun Bhai who is the local expert treating snakebites at Krishna Health Centre under the supervision of Dr Ashwin Vanza. Arun Bhai has been a snake rescuer for 40 years and has been medically treating snakebites for the last 10 years. He is now quite famous in the region and in a snakebite situation most people call him first before calling the 108 ambulance services.
Arun Bhai had shared details of a Russell’s viper bite victim who had got admitted two days before I reached Madhavpur Ghed. Santokben Navghan Kadachha aged 45 years and mother of two grown up children had gone to cut grass to be used as fodder for the cow. That fateful morning she had cooked food for the family, milked the cow and then around 9 a.m. set out to cut grass from a spot about half a km away. The grass was overgrown and she didn’t see the adult 1.5 ft long Russell’s viper lurking in the grass. As she gathered a clump of grass with her left hand the snake bit her on the thumb.
Santokben walked back home. The house was empty as her husband and son were out on work. The neighbours helped her board an open rickshaw to be transported to Krishna Health Centre in Madhavpur Ghed where Arun Bhai treats snakebite victims.
Kadachha village is about 13 kms away from Madhavpur Ghed. Santokben managed to reach Madhavpur almost 45 minutes after the bite. Arun Bhai administered 2 vials of ASV as she was experiencing intense pain in the local area. The 20 BTCT (Bleeding time clotting time) test was fine.
Despite being in stress about the bite, what worried Santokben the most was her beloved cow. The Kadachha community treat their cattle as family. The bovine didn’t allow anyone except Santokben to milk her. Who would milk the cow? And if the cow was not milked, her teats would engorge making the animal terribly sick.
Santokben experienced local area swelling and pain. However the BTCT tests done on intervals of 2 hours didn’t show signs of envenomation. This was due to the ASV being administered immediately; before the venom got a chance to attach itself to vital organs. After no symptoms of anti-coagulation in repeated tests conducted at regular intervals, Santokben was discharged around 4pm, a good seven hours after the fateful bite.
Santokben developed considerable amount of swelling on her left hand. On day two after the full blown swelling manifested, Arun Bhai treated the condition by applying a mix of Magnesium Sulphate and glycerine bandage. The author met the victim on the 3rd day of the bite. It was difficult to imagine she had been bitten on her thumb as there were no tell-tale bite marks. Santokben was administered 3 sittings of Magnesium Sulphate bandage and the arm came back to its ordinary shape in a matter of 4 days.
Timely treatment and absence of use of tourniquet ensured Santokben didn’t suffer local area necrosis or other symptoms of envenomation which can result in renal failure in a viper bite.
Written by Priyanka Kadam.