•In 2017, the World Health Organisation (WHO) listed snakebite as a neglected tropical disease.
•Fatuma Juma, 18, a resident of Lamu, was attacked by a python and says her biggest challenge is accessing medical services.
The puff adder pictured in Nairobi national park, is among the deadliest snakes in Africa
The puff adder pictured in Nairobi national park, is among the deadliest snakes in Africa
Image: COURTESY
James Wandati was standing outside his homestead in Kapkoiwo village, Baringo county, when he felt a sharp sting on his right foot.
Wincing in pain, he jumped up and managed to catch a glimpse of the puff adder, a long and heavy snake that relies on its camouflage, as it disappeared.
Puff Adder is a poisonous snake. Its venom is potently cytotoxic, causing severe pain, swelling, blistering and in many cases severe tissue damage.
If not treated appropriately, a puff adder bite can be fatal. 
"There was an old cloth on the fence nearby, so I took it and tore a strip to tie my foot. I then called a boda boda to take me to Kabartonjo Hospital," Wandati said.
It took him three hours to get to the hospital; he was treated and discharged after three days.
MINIMISE MOVEMENT
Snake expert at the National Museums of Kenya, Hesborn Nyambati, said if someone is bitten, the first step is to minimise motion - and therefore, warned against running.
But poor infrastructure areas like Kapkoiwo mean the only way to travel quickly is by motorbike, on a bumpy road.
Fatuma Juma, 18, a resident in Manda Island, Lamu, who is nursing a python attack, says her biggest challenge is accessing medical services.
She said that those bitten by snakes have to cross over to King Fahad Hospital on Lamu Island, many kilometres away for treatment.
“The distance between Manda and Lamu island is very long. By the time many arrive there, the venom is already beyond control and people just die like that,” Fatuma said.
Boomslang snake ,the most venomous found in arid areas
Boomslang snake ,the most venomous found in arid areas
Image: COURTESY
Puff adders, black spitting cobras, black mambas and the boomslang have been reported to be behind a majority of the snake bites in Kenya.
Baringo county Kenya Wildlife Service deputy warden David Cheruiyot in an interview with the Daily Nation, said that in 2017, more than four deaths and 13 injuries were reported, while in 2018, four deaths and 55 snakebite injuries were reported.
“The situation is worse during the dry spell, with snakes straying into homesteads in search of water. We have been advising people to put water outside their homes to reduce the chances of being bitten,”  Cheruiyot said.
ADMISSIONS ARE HIGH
Snake Bite Rescue Rehabilitation and Research Centre Kenya estimates that 300-500 people are admitted every month due to snake bites across the country. But many end up dying or losing their limbs because they cannot access treatment.
It is estimated that between 15 and 25 people lose their lives every day to snake bites while more than 100 others have their limbs amputated, causing them permanent disability.
Cases of snake bites typically increase at the beginning of the rainy season, when the reptiles come out of their shelter to hunt and breed.
The snake bite menace is prevalent in dry and arid areas like Baringo, Kitui, Kilifi, Wajir, Garissa, Machakos, Marsabit, Isiolo, Makindu, Mwingi, and Taveta as the snakes slither into homesteads to seek water and shelter.
Wandati and Fatuma were the lucky ones, managing to make it from a rural area to a hospital. Many others are less fortunate and succumb in the countryside.
What are the barriers to solving the snakebite problem? The Star spoke to authorities to find out.
ABSENCE OF ANTI VENOM
Kenya lacks correct anti-venom drugs at a time when snakebites are a leading cause of deaths from human-animal conflicts.
A source at the Kenya pharmacy board told the Star that Kenya does not manufacture anti-venom drugs even as 25 people die every day from venomous snakebites.
The little venom produced in the country is exported to South Africa for the manufacture of anti-venom drugs.
The Star has established that South African drugs are not sold in Kenya because they are yet to be registered.
But what is more worrying is the fact that victims of snakebites have to rely on anti-venom drugs imported mostly from India, and which have been found to be ineffective.
Communities believe he black stone neutralises the fatal effects of a snake bite by soaking up the poison at the entry point.
Communities believe he black stone neutralises the fatal effects of a snake bite by soaking up the poison at the entry point.
Image: COURTESY
BLACK STONE
Some communities believe in seeking treatment from traditional healers.
Musyoka Mutisya, a traditional healer, travels around Makueni county treating victims, most of whom were bitten by a puff adder. 
"I use a black stone which I place on the area of the bite. The black stone attaches to the area and sucks out the poison. My grandfather taught me how to do it. I have now treated hundreds of victims," he claimed.
He said the black stone neutralises the fatal effects of a snake bite by soaking up the poison at the entry point.
He places the stone on the skin and a small cut is made on the bitten area until blood oozes out.
The stone then absorbs the poison through capillary action reducing the fatality of a snake bite.
While there is no scientific research to support the idea that traditional methods work, residents believe that "healers" assure patients psychologically and therefore, address the panic.
"However, the [general] level of awareness is very low. Not many people know what to do and therefore, many succumb to the bites," a resident said.
NO TRAINING
Kapkoiwo residents said they had not yet received training on how to deal with the snakes. 
For Karen Chepchieng, a resident of Karas village, some practical help would be useful.
She said she regularly finds snakes in her home and has managed to kill most of them.
"I am not afraid of finding it," she said. "What I am afraid of, is not finding it. Then it could end up biting me or my children."
GOING FORWARD
Effective anti-venom is one part of solving the snake bite puzzle, but many other challenges remain.
More work needs to be done to identify the communities most at risk and to ensure a sustainable flow of affordable medicine is sent there.
Meanwhile, training more clinicians and healthcare workers on how to effectively treat snakebite victims would reduce the number of deaths.
Finally, educating local communities about snake bites would help lower the risk of being bitten, and mean appropriate action is more likely to be taken after a bite.