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Expert shares why practical |
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Wednesday, 10 March 2010 |
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Snakebite is often described as a neglected disease. In fact, it would be more accurate to say it is a condition where the focus of experts has been seriously misplaced. The concentration of experts has remained on gaining research and project funding at meetings, often in very nice hotels and resorts a long way from the reality of rural snakebite victims. There has been no shortage of meetings to discuss what should be done but very little has been delivered.
Ian Simpson, snakebite adviser to the Pakistan Medical Research Council (PMRC), drew attention to the neglected issue of snakebite while talking to ‘The News’ here on Tuesday. Continuing the argument, Ian recalled a recent meeting, where an expert centrally concerned with many snakebite initiatives said, “I have spent the last 40 years being disappointed that people wouldn’t take snakebite seriously.’ Simpson described this as being “the crux of the matter.”
On March 4, 2010, the PMRC launched new guidelines for managing snakebite in Asia and Africa. This represents the first comprehensive protocol for managing snakebite and has vital data for doctors and health officials in Asia and Africa, the two key areas for snakebite mortality.
These guidelines follow on from Pakistan’s national protocol published in 2008. Simpson, who developed this protocol, spoke about the guidelines and the contribution Pakistan is making to worldwide snakebite management.
“While snakebite improvement remains focussed on topics other than the victims, progress will be limited. Pakistan and PMRC have concentrated on practical improvements and these have led to organizations such as the Pakistan Medical Association, and the National Programme for Family Planning and Primary Health Care endorsing the recent initiative. Organisations take snakebite seriously when they see genuine achievements and not mere plans and meetings,” Simpson expressed.
According to Simpson, the concentration on attempts to obtain funding for various snakebite initiatives also has other unfortunate consequences. When the objective becomes securing funds, low-cost practical solutions become inconvenient as they reduce the need for funding. “Recently published work by western experts has conspicuously excluded recommendations which give practical solutions such as utilizing the most effective production methods for anti snake venom (ASV). Whilst there are good studies that show that ASV can be produced which is effective, safe and sustainable, the problem of ASV supply in Africa or Asia has yet to be solved and available solutions ignored because a reduction of the problem clearly means less funding for experts!” Simpson pointed out.
Simpson said, “Some of these experts have been involved with snakebite for decades and in their own words delivered little and yet unlike most other forms of endeavour, where dismal failure triggers a change in management, they continue to drive efforts to ‘improve’ snakebite. They block good practical solutions that could benefit victims. Whilst doctors and victims are keen to reduce the problem of snakebite, what would all the many snakebite ‘experts’ do if snakebite were to be reduced? Maybe this accounts for the lack of success.”
Simpson concluded by saying, “Pakistan and particularly PMRC have focussed on the victims and sought to intervene practically with solutions that can aid doctors and administrators across two continents.”
The importance of the new protocol is that it will enable doctors to treat snakebite in the most basic settings. “We have recently seen an African snakebite victim flown back to the United States by a developed world expert in order to treat them, which may make nice headlines but costs hundreds of thousands of dollars, does nothing for local capability and wastes resources when the key objective is to help local doctors manage snakebite locally,” Simpson explained to lend further clarity to his viewpoint. |
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