People in remote, rural areas of Kenya tend to run the greatest risk of dying from snake bite. Photograph: bio-ken.com
The cost of hospital care, which will include a fee for useless anti-venoms, is unaffordable for many, says Katana. To prevent the sale of such treatments, the WHO has started work assessing different anti-venoms, with the aim of recommending certain products for use in particular countries.
“It’s hoped that will [offer] support from a global level to give more guidance to countries as to how to strengthen the regulation, and also what is an anti-venom that is seen to be effective,” says Benjamin Waldmann, programme manager for snakebites at Health Action International.
David Warrell, emeritus professor of tropical medicine at Oxford University, believes too many unscrupulous producers are marketing products that don’t work. “In some cases, their specificity is inappropriate to the country in which they are being marketed,” says Warrell.
“For example, Indian manufacturers ruthlessly promote their products in countries in Africa where the English name may sound the same – like cobra – but the actual species being targeted is quite different.”
It is hoped that the addition of snakebites to the
list of neglected tropical diseases, along with the forthcoming resolution, will increase the number of products being developed and bring down the price.
“Already, in the past six to 12 months, we’ve had a number of enquiries from potential new manufacturers,” says David Williams, head of the University of Melbourne’s Australian Venom Research Unit, and now chair of the WHO’s snakebite envenoming working group. “And there are a number that are likely to come into market in the next few years.”
“At the moment, anti-venom is working out at [the cost of] two goats,” says Taylor. “If you could bring it down to the price of a chicken it would make a big difference to who could afford it.”
The venom of a black mamba is milked at Bio-Ken Snake Farm in Kenya. Photograph: Bio-Ken Snake Farm
Back in Mombasa, Salome sits silently as the family discusses leaving the hospital. She is normally a chatterbox, her dad says. “Wait until we get home, everyone will get the long version,” he quips.
The hospital bill for Salome’s treatment was 97,194 Kenyan shillings (£721), a sum completely unaffordable for the family. Chiti was able to pay 25% of the fee, while the doctor and hospital agreed to waive the rest of the cost. The anti-venom was donated free of charge by the James Ashe Trust. Many others do not get the same support, and instead face crippling debt. Without settling the bill, Salome would not be permitted to leave the ward. Now she is about to return home.
“I’ve seen people who have died from snakebite,” reflects Chiti. “I thought I was going to lose her.”