By Sharon Atieno
A robust strategy to deal with snake bites is needed to reduce mortality rates and the chances of permanent disability in the oil and gas industry.
With at least 435,000 people in Africa suffering from snake bites annually, dealing with this problem effectively cannot just be about limiting the impact on working hours but must also be about saving lives. The safety threat presented by snakes is very real as is the impact on workforce morale and efficiency.
In Kenya, snakebite envenoming claims hundreds of lives every year and, like diseases such as malaria, is a part of everyday life. For the oil industry, the threat of snakebites in this area is probably one of the top three risks to workers.
To support its local strategy in dealing with snakebites, International Oil Company Tullow Oil has worked alongside Remote Medical International with the support of the Asclepius Snakebite Foundation to put a robust response strategy in place for its sites in Kenya.
This includes donations of medicines, and training of staff in local hospitals to systematically assess, diagnose, and treat patients with snake envenomation.
The definitive treatment capability that has been developed produces better patient outcomes for anyone who is bitten in the area, and reports are already indicating a reduction in snakebite deaths and disabilities and an increase in patients seeking treatment in the area since the program began.
The response strategy from Remote Medical International includes evaluation of the local threat, identification of species of concern, assessment of the relative risk to workers, and a clear risk reduction strategy.
The clinical implementation comprises assessment of which antivenom is most effective against the local venomous snakes of medical significance and the creation of advanced field treatment protocols, along with continual advisement and 24/7 consultation with medical and subject matter experts (SME) in the event of envenomation.
Andy Kimmell, Operations Director, Global Coordination and Security at Remote Medical International said: “A medical response team for an envenomation needs to be trained specifically for such an event but the overall management of snakes in the area requires cooperation through a multidisciplinary team. We work with experts in snakebites and antivenom and a senior SME is always available to oversee incidents. It is through a well thought out, robust and cohesive strategy, put together by experts in this area, that we are able to save lives and limbs.”
Prevention of snakebites is the first goal. The team works proactively with snake handlers, safety and security teams to try to remove the threat of snakebites from camps and work areas. Inevitably, however, this cannot be 100% assured and snakebites do occur. When this happens the circumstances are reviewed, and safeguarding procedures updated if appropriate.
Referring to an example by Kimell of a snakebite that occurred in a remote oil and gas camp in Kenya, Jordan Benjamin, Founder and Executive Director of The Asclepius Snakebite Foundation said: “ Every snakebite is a unique toxicological emergency that must be dealt with quickly and precisely in order to ensure the best possible outcome for the patient.”
“Every minute wasted after a bite occurs allows more time for the various venom components to attack their targets in the victim’s body, and there is a marked increase in mortality for every hour that passes until the right dose of the right antivenom is administered.”
He also noted that companies that rely on Medevacs as their primary response to a snakebite fail to realize that they are making the situation worse as it is far more effective, both in cost and in outcomes, to invest in a robust snakebite management plan with onsite antivenom treatment capabilities.
“Snakebite is an occupational hazard, and the psychological effect on others in the work area can also be significant. Robust systems need to be in place to both react to the immediate threat to life from the envenomation and deal with how and why the bite occurred, taking any actions necessary to reduce risk in the future,” Benjamin said.
Developments in antivenoms have helped to reduce mortality rates from snakebites in remote areas. Treatments were previously based on using antibodies from horse serum that also required constant refrigeration.
“Freeze dried serums that do not require refrigeration and have longer shelf life make treatment more accessible and more affordable, as well as providing improved safety with lower risks of an allergic reaction. With these antivenoms available, more work now needs to be done in terms of outreach and education to help remote communities deal with this threat,” he added.