Snakes in the country kills three times more people than Malaria and the eSwatini Antivenom Foundation wonders why this problem is not given the same attention it deserves.

 Treatment and prevention of snakebites have long been neglected by the government and now rests on the shoulders of an independent Foundation struggling with resources for treatment, awareness campaigns and responding to emergencies.

My theory is that it is because snake bikes are not the problem of people in towns, the middle class or those who can generally afford. Snake bites are a problem for the poor and the wretched of this country. I talk of those who walk barefooted. Those who use a pit latrine. Those with mud houses and no electricity. No one talks about this because this is a problem of the poorest of the poor,” posits Thea “The snake lady” Litschka, one of the founders of the Anti Venom Foundation. The organisation has been in existence for 15 years with no funding from mainstream donor agencies and no subvention from the government.

As well as providing free antivenom, the foundation visits schools, communities, companies and hospitals to educate people on the correct first-aid and medical treatment of snake bites. The organisation also provides free emergency call-outs to people who need snakes removed from their property. As the country approaches summer this is the season of snake bites and the Foundation is concerned it could be overwhelmed and overstretched given the fact that it is run on zero budget.

All the snakes that the foundation catches and relocates are taken away from human habitation. Litschka complains that his foundation does not receive any government subvention, no support from international donor organization and definitely no donations from local businesses even though a typical Black Mamba bite can cost up to E10 000 for a single patient and this is just for mild and not severe cases.

A child who was bitten by a snake. The Foundation says a bulk of snake victims are children.

Support to the foundation would allow the organisation to purchase polyvalent antivenom which can be used to treat bites from the most regularly encountered species in eSwatini; the black mamba and Mozambican spitting cobra. Each vial of antivenom costs E2 000.

Antivenom is very expensive and unaffordable for the majority of people in eSwatini. The cost to treat one Mozambique spitting cobra victim is approximately E30 000 and a Black mamba bite E20 000. With a Black mamba bite, paralysis can occur within 45 minutes and in eSwatini there are limited hospitals with an ICU, that has life support equipment. The Foundation reports that they received 435 calls for assistance.

These victims were transported, admitted for observation and treated with antivenom where necessary at full cost of the Foundation. Litschka said they work with volunteers all over the country who are not paid and have to respond to emergency calls on public transport and sometimes use their private cars on bikes. “We service the entire country with no salary. Everything is done by volunteers.This has taken a toll because we have to respond to emergencies all over the country,” said Litschka in an interview.

The Foundation has established 15 emergency banks of antivenom which they supply free of charge to snakebite victims throughout the country within two hours The foundation recently released a statement where they reported that this year alone they recorded nine deaths from snake bites and two of those were adults and seven children.

This is a remarkable achievement, considering all government facilities had no antivenom. Delays in getting the victims to a medical facility lead to their lives tragically being lost. There were 26 serious neurotoxic envenomations (Black Mamba and Snouted Cobra). Thanks to the life support at TLC, many of these victims were saved because they could allow their bodies to recover whilst being ventilated,” the Foundation reported in a recent statement.

Puff adders and Mozambique spitting cobras were responsible for most bites that required Antivenom to save limbs. The snake responsible for most bites was the Stiletto snake! These bites are very painful and can lead to significant necrosis, but Antivenom is not indicated (it doesn't work).

435 snakebites in total. What’s a little unusual is the number of bites in winter this year. Number of bites per month:

September ‘22: 9

October ‘22: 27

November ‘22: 48

December ‘22: 60

January ’23: 90

February ‘23: 57

March ‘23: 62

April ‘23: 31

May ‘23: 20

June ‘23: 12

July ‘23: 5

August ‘23: 14