Management of Snakebite and Research Management of Snakebite ...

Management of Snakebite and Research
102
Care of the severly envenomed patients
Owing to the NHP 1994-2001, new snakebite centrer opened peritoneal dialysis facilities–
3 in Magway Division, 2 in Sagaing division, 1 in Mawlamyine, 1 in Ayeyarwaddy and 1 in
Yangon Division. Critically ill-patients are best managed with minimum disturbance. Hence,
dialysis on site is best with regard to outcome not to mention the transport expenses and
social inconveniences involved. Also, under the National Health Plan 1994-2001, the
snakebite control project established Haemodialysis facilities for selected snakebite renal
failure patients (hypercatabolic patients with less bleeding tendencies), in the central
snakebite training center in Sanpya Hospital Thingangyun. This is associated with shorter
clinical course and duration of hospital stay (results to be published).
Training courses for basic health workers and doctors in the identification of poisonous
snakes, prevention of bites and management are conducted by the snakebite control project.
Life support training is being conducted by the cardiovascular disease project and is
important for neurotoxic envenoming before the patient reaches the health facility.
AIM AND OBJECTIVE OF THE SNAKEBITE
CONTROL PROJECT
To reduce the morbidity and mortality from snakebite:
Strategies
(1) Health education. Health education on prevention, training in care of
envenomed patients targeted at the lay public, personnel as appropriate using
all available methods of mass education. Targeting the lay public, basic health
workers, doctors and nurses, NGOs, religious groups, patients and attendants;
snakebite prevention and the use of protective footwear well accepted by the
lay public3 , through public education, better information regarding identification,
first aid and management throughout Myanmar especially focussing on the areas
of greatest incidence, the patients themselves as well as their relatives and friends.
(2) Production and distribution of health education material.
(3) Practical training in management and making peritoneal dialysis available in
township hospitals in endemic areas.
(4) Advocacy and coordination in obtaining material for the production of more
and better antivenom. Appropriate and adequate distribution of antivenom.
More freeze dried antivenom. The Ministry of Industry I produces the antivenom,
the dialysis fluids supplies of which are important in reducing the mortality
from snakebite. Therefore, inter-ministry cooperation and coordination are
essential.
(5) Mass media, training courses, Ministry of Information, Ministry of Education,
Agriculture, and Forest. Inclusion of snakebite in the curriculum of occupational
health, school health, and NGO training courses. Maternal and Child Welfare,
Red Cross and religious groups. etc.