Isingiro, Uganda — Life‑saving antivenom medication is often too little, too late, especially for the rural residents most at risk. One evening, a family in Soroti district huddled outside their house when Augustine Opio suddenly screamed. Within minutes it was clear that the 61‑year‑old had been bitten by a snake. He moaned, his feet turned red and swollen, and he began vomiting and sweating profusely. His younger brother, Tonny Opio, rushed him to the nearest health centre, about 10 kilometres (6 miles) away. When they arrived, the staff could not help because the centre had no antivenom. By the time they reached a hospital, the venom had entered Augustine’s bloodstream and he could barely breathe. Doctors placed him on oxygen, but before they could administer the specific antivenom he died.
Across Uganda, snakebites are common. The Ministry of Health reports that from mid‑2020 to 2022 there was an increase in animal bites, including snakebites, and more deaths. “This increase is because humans are encroaching on snake habitats—by farming in swamps, clearing forests for agriculture,” explains John Opolot, the ministry’s assistant commissioner of veterinary health and zoonoses. In sub‑Saharan Africa, where data are widely under‑reported, the World Health Organization estimates up to one million snakebites each year, resulting in 7,000 to 20,000 deaths and many survivors left with amputations or permanent disabilities. In Uganda, 32 % of households surveyed by Makerere University reported at least one snakebite in the family, and a 2020 survey placed the incidence at 101 per 100,000 people for the previous year. Rural residents, particularly those engaged in agricultural work, are most vulnerable.
Despite the rise in snakebites, many Ugandan health officials lack training to manage the emergency, and only 4 % of public, mission and private health facilities stock antivenoms. Up to 20 % of Uganda’s snake species are venomous, according to Kampala‑based snake expert James Ntulume. Venomous bites are identified by two puncture wounds, while non‑venomous snakes leave multiple bite marks, says Dr Geoffrey Kasirye, medical superintendent of Mukono General Hospital. After his brother’s death, Tonny learned that Augustine had been bitten by a Jameson’s mamba, one of the most venomous snakes. The bite caused respiratory failure and paralysis of skeletal muscles—key features of green mamba envenomation. “The venom slurs speech, causes difficulty breathing, and death is inevitable if not treated promptly,” Kasirye notes.
In 2017 the World Health Organization added snakebite envenomation to its priority list of neglected tropical diseases. Uganda responded in 2018 with a national snakebite prevention and management strategy, but implementation has stalled due to an unstable and inadequate antivenom supply chain. Opolot attributes the high cost and unavailability of antivenoms to a lack of snake‑specific data for the country. Antivenoms cost between 100,000 and 150,000 Ugandan shillings (US $27–$40), whereas antimalarial drugs cost about 20,000 shillings (US $5). “The cost of antivenoms may equal the price of drugs treating 100 malaria patients. A special project is needed to ensure their availability,” he says. Some antivenoms are already in stock; the challenge is ensuring they reach those who need them. The ministry is developing a strategic plan to secure funding.
Cultural beliefs also hinder timely treatment. Many people think snakebites are caused by witchcraft or ancestral spirits, prompting them to seek help from traditional healers rather than hospitals. “People view it as a local disease best treated by traditional healers who existed long before modern medicine,” says Ali Nasasira, a herbalist with 25 years of experience. In Augustine’s case, his family tried to persuade him to use traditional remedies, offering green tobacco leaves to swallow, but he refused.
While proximity to hospitals and antivenom supply remain critical issues, there are preventive measures people can adopt. Richard Otiti of the government‑operated Uganda Wildlife Conservation Education Centre advises wearing proper footwear such as gum boots and exercising extra caution during high‑risk periods: the rainy season, after bush‑burning, the half‑hour before darkness, and the two hours after darkness.
Apophia Agiresaasi is a Global Press Journal reporter based in Kampala, Uganda.
Comments are closed for this story.