A hospital snakebite unit that saves hundreds of lives each year in Papua New Guinea, thanks to Australian funding, is in peril, sparking fears locals will return to treating deadly bites with witchcraft. More than 1000 Papua New Guineans are estimated to die from snake bites each year — one of the world’s highest death rates — compared with, at most, two or three people in Australia. The toll has fallen since the snakebite unit in Port Moresby General Hospital began treating victims, and many more benefit as the unit educates the community about the dangers of treatments such as sorcery, tourniquets or razor cuts. The project, run by Melbourne University and the University of PNG’s Medical School, has conducted pioneering, world-class research to drive down the cost of antivenene from a prohibitive $2700 to $200, but the unit’s lifesaving work — it was caring for 86 patients over the weekend — is in peril because of a $350,000 funding gap. Unit director David Williams told The Australian Melbourne University had funded much of the work for a decade via the Australian Venom Research Unit, but a funding gap of about a year had appeared because of administrative delays; the unit was seeking corporate or government support. Clinical trials to treat bites from the 2m Papuan taipan, which accounts for 92 per cent of the deaths in the southern part of PNG, have yet to be completed. If, as anticipated, the trials succeed, doses of the antivenene will be bought by the PNG Health Department and distributed broadly to every health centre in the region where it can be stored for three months at room temperature. Dr Williams said “the aim is for this program to become sustainably run by our PNG collaborators”, supplying the serum needed to produce the antivenene, treating patients and running community education and training programs. He said about 400 people were being saved by the specialist unit every year after being bitten by deadly snakes. About 200 people died annually in health centres around the country because they lacked antivenene, or because the victims arrived too late. Dr Williams said many others died before they could reach a centre — or did not even make the attempt. The Papuan taipan venom destroys nerve endings. Without antivenene within four hours, victims start to find breathing difficult, and require ventilators — with other complications such as kidney failure also then threatening. If they were treated immediately by antivenene that, at the new price, would be widely available, patients could be sent home the next day, Dr Williams said. The snakebite unit tests the effect of the antivenene on patients and checks their recovery; it keeps Papuan taipans in tanks and milks their venom; and it operates a special snakebite ambulance equipped with serums and a ventilator, and can rush with a doctor and nurse to treat victims along the road network reachable from Port Moresby. The ambulance alone saved about 60 people a year, Dr Williams said. The snake venom is sent by the PNG unit to a medical centre in Costa Rica that specialises in producing antivenene at modest cost for developing countries’ health services. Dr Williams said education was crucial. The best answer to the widespread belief that witchcraft commanded snakes to bite victims — discouraging them from seeking medical help — was to cure more people, he said. “Every year we’ve been operating we’ve been seeing 50 per cent more patients because word has gone out that they can be cured,” he said. Many tell extraordinary stories of their efforts to reach the snakebite unit, including a man who carried his bitten young daughter on his back for kilometres through the jungle, then paddled a canoe down a river and finally brought her in by hitching a ride on a truck. Source: The Australian
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