“Then they prayed, they did nothing else, they just prayed for the boy and he was well”: A qualitative investigation into the perceptions and behaviours surrounding snakebite and its management in rural communities of Kitui county, Kenya

Abstract

Introduction Human-snake interactions are common in tropical regions where subsistence-farming and livestock-herding activities predominate alongside proliferation of snakes. Local beliefs and perceptions about snakes and snakebites influence human behaviour. Understanding these beliefs and perceptions can inform the development of resources to drive behaviour change and to minimise the risk of injury to both humans and snakes. This qualitative study, conducted between May and July 2019, sought to explore the beliefs and perceptions regarding snakes and snakebites, and methods of prevention and management among members of the community in Kitui County, Kenya. Methods Semi-structured interviews were used to collect qualitative data from 23 participants, recruited using a stratified purposeful sampling strategy in four selected sub-counties of Kitui county. Interview data was anonymised and coded and a thematic analysis was conducted using NVivo 12. Results People from Kitui county mostly had negative perceptions about snakes. There was a generalised awareness of the need to prevent snakebite, predominantly through keeping snakes away from homes/compounds. However, implementation was limited by financial constraints. Participants also identified logistic and financial obstacles to early hospital presentation following a snakebite, and they expressed a strong preference of having their snakebites treated in a hospital over consulting traditional healers. There was a universal recognition of the benefit of early intervention with a specific appreciation of the utility of the black stone. Furthermore, the removal of a snake’s “teeth” was an expected treatment outcome for some community members, with the failure to do so perceived as causing poor wound healing or persistence of symptoms. Some religious groups held views which differed from most participants. Conclusion There is a need to explore and clarify common misconceptions about snakes and first aid treatment of snakebites, encourage learning about the true nature of snakes, and highlight beneficial uses of snakes. A change in the epistemological conception of community education material by enhancing the value and use of local forms of knowledge, and the employment of art techniques to transmit this knowledge, could improve community perception and methods of snakebite prevention. Patient expectations should be appropriately managed by discussing possible outcomes, incorporating follow-up visits and addressing long-term complications of snakebites.

Snakebite care through the first two waves of COVID-19 in West Bengal, India: a qualitative study

“…Our study provides a nuanced understanding, away from the dominant dichotomous framing (traditional belief systems versus modern medicine) ( Bawaskar et al, 2020 ; Bhaumik, 2013 ; Chakma et al, 2020 ; Menon et al, 2017 ) around choice of healthcare providers for snakebite. The multi-factorial nature of decision-making to choose healthcare provider for snakebite has also been previously reported in Cameroon and Kenya ( Chuat et al, 2021 ; Wood et al, 2022 ).…”

Venomous snakebites: Exploring social barriers and opportunities for the adoption of prevention measures

“…The adoption of unrecognized prevention measures included the spreading of readily accessible products in the home, such as turmeric or garlic water, salt, and cow dung, as well as potentially dangerous substances (e.g., kerosene), and the erection of fencing around the property. Many of these unrecognized measures differ from those recommended by the national government (Ministry of Health & Family Welfare Government of India, 2016), WHO (WHO, 2019), and notable nongovernment organizations (MCBT, 2022), heightening calls for further research to explore the snake‐deterrent efficacy of these approaches and negative ecological impacts of their potential implementation (Wood et al, 2022). Furthermore, it also identifies the importance of governing bodies' engagement and transparent communication with affected communities to mutually develop a coherent view of how to prevent snakebites (Wood et al, 2022).…”

“…Unknown is also the number of snakes killed by humans each year, which is long feared to far outweigh human fatalities (Whitaker & Shine, 2000). Across the tropics, snakes are regularly killed on sight by neighboring communities (Jadhav et al, 2018; Wood et al, 2022), which critically threatens their provision of ecosystem services in many tropical landscapes (Budnukaeku et al, 2021). A deeper understanding of these negative interactions is urgently required to develop solutions for snake conservation and promote sustainable coexistence with humans.…”

“…However, with snakebite mortality consistently high year on year, few studies have explored affected communities' willingness to adopt prevention measures to inform snakebite prevention efficacy (Malhotra et al, 2021). For example, physical discomfort and deep‐rooted cultural beliefs can reduce the adoption of protective clothing by at‐risk communities (Ayode et al, 2013; D'Août et al, 2009), and financial limitations limit the scalability of other purchased prevention products (Wood et al, 2022). To reduce snakebites and facilitate snake conservation, it is crucially important to understand the drivers of effective snakebite prevention.…”

Antivenom availability, delays and use in Australia

“…Similarly, patients also use unsafe first aid methods in preference to being transported to hospital. Fortunately, this appears to be changing in some countries, with more people attending hospital for snakebite, rather than traditional healers ( Silva et al, 2020 ; Wood et al, 2022 ). Finally, delays can occur because of patients' perceptions in regards to the severity of the bite, often leading to much longer delays ( Cristino et al, 2021 ; Schurer et al, 2022 ).…”