The Creepy Times Issue 7 newsletter by Rahul Alvares

Hi Friends

My newsletter subscription list is growing. A few more people subscribe from time to time, but a major increase has been indirect – from people asking me if they can link Snakesite and Creepy Times to their mailing lists/groups and sites.

Creepy Times started as a small idea but is now getting more circulated and professional by the day! As a favor from you readers I would like to ask you to find more people/ groups/sites interested in receiving the Creepy Times or linking up to Rahulsnakesite.

I enjoy sending out this information so the more people there are to receive it the better! Forward Creepy Times to all your friends and relatives who might be interested.

Lately a lot of people have been asking me questions regarding snake bites, antivenins, First Aid incase etc. I have therefore included in this issue an article I wrote sometime ago ‘When a snake bites'. The article is rather long but that's because it is very comprehensive.

We also feature guest writer Nitin Naik with his contribution ‘Know your birds'.

Rahul

Phone numbers of snake-catchers in Goa!!!

Forest dept campal 2228772

Amol naik 2605672 9822158715 (savorda sanguem cancon cuncolim molem) GREEN CROSS

Venkatesh sansgiri 25509229822150355 margoa GREEN CROSS

Philip fernandes 2787300 9422062503 margoa

Oldrin pereira 9850450120 aldona

Sharad chari 2293193 Aldona

Prakash kassikar 2459322 bambolim GREEN CROSS

Swapnil phadte pilgaon bicholim 2363210

Hanumanth tambulkar dhodamarg maharashtra 952363256541 952363256627

Girish kelakar 2343826 (res) 2314435(off) ponda

Neil alvares 2402957 3116183 9823028688 nerul

Sainath shirodkar mapusa (forest dept) 2265772

Nitin savant 9822486098 2414278 porvorim GREEN CROSS

Aaron lobo 2412265 9822135019 porvorim

Amrut singh 2363803 9422062503 bicholim

Rama bagi 2382163 valpoi GREEN CROSS

Vivek parodkar 2369224 sankelem keri GREEN CROSS

Nirmal kulkarni 3107079keri surla

Sunil korajkar, 2253715 9822123042 mapusa GREEN CROSS

Aaron fernandes 9822176756 mapusa GREEN CROSS

Rahul alvares 2278740 parra (calangute, mapusa porvorim)

Sudan naik kuthali marmugoa 2550898

Know Your Bird by Nitin Kumar:

All of us have seen this little Fellow, or heard him many times when we sip our morning tea in our verandah. You sometimes see this tiny silhouette jumping amidst the bushes or garden trees with that cocked tail and making that bold sound towit…..towit …(in rapid version ) chuvee…chuvee.

That's your “Common Tailorbird”. In more twisted language Orthotomus sutorius

Chirpiness is what we can associate with this bird. Olive green above, rust red forecrown, buffy white underbody, long pointed tail, approximately 13cms, both sexes look alike except you see dark spot on throat sides in males

The Tale of the Antivenoms

On 8th April 2002 , Anil Kumar, a young snake handler from the Forest Department working at Bondla was bitten by a cobra. The snake bit him when he was transferring it to a cage. Kumar was rushed first to two private doctors who were supposed to have anti-snake venom (ASV). Both of them, however, refused to treat him. After having thus lost valuable time, his colleagues rushed him to the I.D. hospital in Ponda where he was apparently given a primary dose of ASV and then sent to GMC. On the way, however, he died. No one knows how exactly he died. Some say it was because of the poison. I spoke to a forest officer who says that according to the post mortem report there was no venom found in Kumars brain and he probably died of shock instead.

I am a snake handler and have been handling poisonous snakes for about 6 years. When I heard the news of Kumars death I was shocked because I didnt think that anyone ought to die of a snake bite in Goa , especially after going to a hospital where ASV was stocked. So I decided to investigate this incident and also research on how snake bite cases are handled in Goa , so that the public which is chronically in fear of snakes due to snake bites would have authentic information about what to do in an emergency and no life was unnecessarily lost.

I myself have never been bitten by a poisonous snake though during my snake-handling training I allowed dozens of non-poisonous snakes to take a bite of my fingers, hands and wrists. One even bit me savagely on my nose! Bites from non-poisonous snakes, including the rat snake and the water snake, are quite painful, but they do not kill since there is no poison in them. But allowing oneself to be bitten by non-poisonous snakes takes away a great deal of the fear associated with snake bites.

A few friends of mine have been bitten, however, by deadly poisonous snakes. One of my friends, Aaron, once caught a Russels viper and was returning home with it on his motorcycle (holding it with both hands on the pillion while his friend Luke drove). At one place, Luke was forced to brake suddenly and Aaron lost his balance. The snake bit Luke on his back. A bite from a Russels viper will kill if not attended to with ASV.

Not knowing what to do, Aaron called me up because he knew that the office where my father works in Mapusa stores ASV for the safety of young people who rescue snakes. So the three of us on Aarons tiny motorcycle, with the Russels viper under our seat, rushed to Mapusa to retrieve the anti-dote. It was now about 12 in the night. With it, we rushed to the Mapusa Asilo. When we spoke to the doctors in charge, however, we found they were too nervous to handle the case, so we rushed to a private doctor in Porvorim, who directed us to the GMC. This is where Luke was finally treated, just as he was getting fuzzy from the poison. The running around looking for the ASV and doctors took us about 1 hour. Luke survived the ordeal because he remained cool.

Now I realise it must be as confusing for other people when they are bitten as it was for us that night. The more time you waste finding a doctor, the more dangerous it becomes for the snake-bite victim. On top of this, there are many snake charmers who offer untested and unreliable cures, wasting the victims time further, so that by the time he reaches the hospital it is invariably too late.

The only reliable cure for snake bite is anti-snake venom (ASV). ASV is made from the blood of horses that have been immunised to snake poison. This can sometimes create problems in some snake-bite victims who may have an allergy to horse serum. An allergic reaction to the administration of ASV can be very dangerous and can be more life-threatening than the bite itself. Therefore, doctors always carry out an allergy test prior to administration of ASV. For this reason, it is always best if ASV is administered by a doctor. If the person is found to have an allergic reaction to ASV, then anti-allergy drugs are first given to him or her after which ASV can be safely introduced.

So, much depends on two things: first, are there enough ASV doses stocked in Goas hospitals and Primary Health Centres? Second, are the doctors able and confident enough to administer it? Private doctors generally refuse to administer ASV because they feel that if the person dies in some way, they will be held responsible. On the other hand, if a private doctor has stocks of ASV, it would be against his professional duty if he did not administer it, especially when delay can be fatal for the snake-bite victim. The worst thing a medical doctor can do is to send the patient running around in circles.

I checked out the availability of ASV in Goas hospitals with the man at the top: Dr A.V. Salelkar, Director of Health and Services. Dr. Salelkar told me that ASV is always available at GMC, Mapusa Asilo and at the Hospicio, Margao. He said it is also available at all the primary health centres, all of which are located in rural areas. So I checked out this information. All the three major hospitals mentioned above do have ample stocks of ASV. This is the situation at the following PHCs (phone numbers are given alongside):

Valpoi PHC Had adequate ASV supplies. Ph. 374260

Bicholim PHC Had 5 vials. Ph. 362041

Sanquelim PHC Had 18 vials. Ph: 364258

Pernem PHC Had 67 vials. Ph. 291249

Siolim PHC No ASV stocked, due to proximity to Mapusa Asilo. Also, nursing staff not equipped to handle snake bites.

Aldona PHC Had adequate supplies but with limited expiry date. Ph: 293251

Candolim PHC 14 vials (expiry date: 2005) Ph: 276035

Betki PHC Had 20 vials. Ph: 287160

Ponda PHC Had 20 vials. Ph: 312115

Sanguem PHC Had 10 vials. Ph 604235

Curchorem PHC Had 20 vials. Ph 650566

Bali PHC Had 30 vials. Ph: 670216

Canacona PHC Had 32 vials. Ph 643339

Assolna PHC Details not available

All these PHCs are supposed to be able to deal with snake bites. I found, however, that in some cases, after a primary dose is administered, the snake bite victim is sent to the GMC. This happens often with those PHCs located close to the GMC. PHCs like those at Curchorem and Valpoi treat snake bites fully without referral to the GMC.

Snake bite cases are often referred to the GMC because it is the only hospital with a ventilator. This is very much essential when it comes to neurotoxic poisoning caused by cobra and krait bites. The venom paralyses the respiratory centres. In order to prevent respiratory failure, a ventilator is needed.

I spoke to the GMCs doctors. The GMC has been treating snake bite cases for a very long time Dr. Natekar of the Medicine Dept. told me. All the doctors at the hospital have experience in dealing with snake bite cases, he says.

One of my friends from Green Cross, Nirmal Kulkarni, was also bitten by poisonous snakes and he agrees that GMC is the best place to deal with snake bites. Nirmal Kulkarni says that he got bitten in Ponda but the doctors at the hospital there were not confident about handling his case, so he was moved to the GMC. This seems to be happening all the time.

Goas other snake-catcher, Harvey DSouza, was bitten by a krait, a fairly deadly snake. He was treated successfully at GMC.

It appears that people still do not know what they should do in the case of a snake bite. Here are crucial dos and donts in case you or someone else is bitten by a poisonous snake:

(1) First aid: Keep the patient calm and reassured that he or she is going to get medical aid and that it is available. Snake bite victims can sometimes die of shock and not from the poison.

(2) Immediately apply a pressure immobilization bandage (see picture) to limb. Pressure should be as you would apply to a sprained ankle or knee. Elastic bandages work well. This slows lymphatic spread of the venom.

(3) Do not use a tourniquet or ice. Most tourniquets are tied so tight that they prevent circulation of the blood in the bitten limb and cause tissue damage and necrosis, and many a times the consequence is the limb has to be amputated. Do not give alcohol, food or aspirin to the patient. Paracetimol is safe if needed for pain.

(4) Do not cut the wound or try to suck out the poison. This may result in infection and blood loss and is of very little use.

(5) Rush to the nearest PHC. Here a clotting test will be done together with an anti-allergy test. If the blood doesnt clot, and no other reactions ensue, a primary dose of anti-venom is immediately administered.

(6) Do not go to any private doctors. They may refuse to treat the case because they are either frightened or are not confident of administering the antidote and thus will simply waste precious time.

Earlier, since there were different antidotes for different poisonous snakes, people would try and kill the snake and bring it along with them for identification to the doctor. Killing the snake is not necessary today. First of all, the anti-dote is polyvalent, that is one antidote is effective against all poisonous snake bites. Secondly, even if one has been bitten by a poisonous snake, it could very well be a dry bite, that is, little or no venom has been injected by the snake through the bite. So the only way you know you require the antidote is by having the clotting test done. The clotting test enables the doctor to establish that there is venom in the blood. Please therefore do not kill any snake for the purpose of identification.

There are only 4 serious poisonous snakes in Goa : the cobra, the krait, the Russels viper and the saw scaled viper.

Snake venom from these four snakes is of 2 different kinds:

(1) Neurotoxic (from cobras and kraits) This venom causes damage to nerves. The symptoms, as the poison takes effect: the eyes become drowsy, saliva drools from the mouth, the lower jaw falls and breathing becomes increasingly difficult. Severe abdominal pains may develop in the case of krait bites. A ventilator may be required in cases of severe bites.

(2) Haemotoxic: (from Russelss vipers and saw scaled vipers)

The poison affects the blood. The symptoms, as the poison takes effect: bleeding from the gums, wounds and other orifices of the body. Swelling may occur. Severe pain is also felt at the site of the bite.

Always remember that snake bites give you plenty of time to get to a hospital. And that anti-snake venom can always save your life. Now you should also be assured that Goas hospitals and PHCs have enough stocks of the anti-dote.