Here are just a few of our current projects.
Establishing dedicated Snakebite centers
Our core program involves the development of dedicated snakebite centers to serve as hubs for patient care, research, community engagement, and education for local providers. To accomplish this, we travel into the field to treat snakebite patients, bringing donations of high quality antivenom and critical medical supplies and establishing snakebite centers with local partners in areas with the highest burden of snakebites and the fewest amount of resources to address them. We live and work alongside local healthcare providers, conduct training in the best practices for snakebite management, and provide them with the supplies and medications needed to save lives when a bite occurs. Finally, we help develop these initial snakebite centers into snakebite centers of excellence that can serve as regional referral centers for serious envenomations, conduct their own community outreach in local villages, and provide training to physicians and nurses from around the country in how to better manage these complex patients. Ultimately, we can develop a snakebite chain of survival that reinforces positive actions and reduces the preventable death and disability that results from this neglected tropical disease.
Donating Critical medical supplies
Many rural clinics in Africa and elsewhere in the developing world lack the basic medical supplies required to effectively manage snakebite patients. We have established an ongoing relationship with Remote Medical International (RMI) to receive regular donations of medications, equipment, and supplies. We bring these critical supplies with us to supply our snakebite clinics with the tools needed to facilitate the assessment, diagnosis, treatment, and prolonged field care of these patients. Due to the extremely high need for these items we are always looking for additional partners who are interested in donating equipment, medication, or supplies. If you or your organization is interested in supporting this work, please reach out to us and start the conversation today. Every donation we receive has a huge impact on the outcome for these patients.
Investigating the high fatality rate of neurotoxic snakebites in Guinea
We are launching the first comprehensive study to investigate the high case fatality rate associated with neurotoxic snake envenomations by cobras and mambas in West Africa. Despite substantial advances in antivenom therapies, neurotoxic snakebites continue to present significant clinical challenges and remain the most poorly understood syndrome of snake envenomation. Concerningly, the case fatality rate (CFR) for neurotoxic snake envenomations in poorly equipped rural clinics is often 20% or more despite antivenom therapy. Death due to direct effects of the venom has been reported as early as 15–20 minutes after the bite, though it is more commonly seen in the first 2–24 hours.
In November of 2018 we will begin the first prospective study of neurotoxic snake envenomations in sub-Saharan Africa to identify some of the factors responsible for the high case fatality rate that has been observed in these patients and to identify novel strategies for improving the clinical management of these patients in the field. This will be accomplished through a comprehensive, interdisciplinary investigation into factors associated with the venom, the antivenom, the envenomation and, finally, the relationship between each of them relative to the overall clinical picture and the efficacy of antivenom therapy in a given patient. We will be treating patients, collecting snakes and venoms samples, and collecting clinical data to determine where current shortcomings exist and rapidly identify and implement strategies to address them. This is a very exciting project that will investigate many of the unanswered questions about snakebite.
Snakebite Medicine Training Materials for local medical Providers
We have produced a series of free clinical resources for medical professionals as part of an effort to train doctors, nurses, and other healthcare providers in the rural areas where 95% of snakebites occur in sub-Saharan Africa and the developing world. These include manuals, posters, classes, reference materials, educational videos and more. These resources are specifically designed to give medical personnel the tools they need to diagnose a snakebite and treat it with the appropriate amount of the correct antivenom without wasting time trying to determine the identity of the snake that bit the patient. Many of these items are available for download on our website and can be viewed on mobile devices or printed out and kept in the clinic to establish a series of protocols to guide non-experts in the management of these complex patients.
Improving Prehospital Care
Treatment delays diminish the chance of a positive outcome, and a 1% increase in mortality has been documented for every hour wasted from bite to arrival at definitive care (Habib and Abubakar, 2011). Efforts to improve the management of snakebites in the prehospital environment can have significant impacts on the outcome for these patients. We are developing and implementing a range of projects to address this critical step in the snakebite chain of survival. We train rural populations in how to provide basic snakebite first aid and supportive measures to help a patient survive long enough to receive antivenom treatment in a hospital. We are currently working on a novel approach by developing an incentive program for local motorcycle taxi drivers where they are provided vouchers to transport snakebite patients to the hospital, which should dramatically reduce the delay to treatment for many patients in the rural areas. We are also developing a program for training and funding a snakebite motorcycle ambulance corps that can provide EMS services and transport for these patients. Finally, we help local hospitals develop these programs so they can support this type of training themselves and strengthen the chain of survival in their own communities.
Snake Venom Research
We conduct cutting-edge biochemical research into the composition of various snake venoms to better understand the clinical effects of envenomation and improve antivenom treatment. This requires us to capture venomous snakes from various locations in Africa and collect venom samples for analysis. Only by traveling into the field to collect samples from wild snakes is it possible to accurately determine the venom of a group of snakes in a given area, and therefore to determine whether existing antivenoms will prove effective against these snakes.