After a long day doing household chores, Manjula Devi rolled out a mattress on the floor of her modest home in India's eastern state of Bihar and prepared to go to sleep.
However, minutes later she was woken by excruciating pain in her toe. Her screams awoke her husband and two children in their two-room mud-and-brick house in the village of Jalalabad. Turning on a light, the family were shocked to find a cobra, one of the world's most venomous snakes, slithering across the floor.
“We always sleep under a mosquito net because of the fear of snakes, but it still bit me,” Ms Devi, 30, told The National in early September from a hospital bed. She had deep blue marks on her toe.
She was lucky. The homemaker was taken to the area's Government Medical College, the only state-run centre treating snake bites in her district of Purnea, where she was given anti-venom.
Many others are not so fortunate. In India, about 50,000 people die every year from snake bites. An estimated three million to four million people are bitten by snakes every year in the country, with doctors and politicians saying the number is rising as serpents are displaced by climate change and come into contact with humans.
A few beds away in the ward, Jameela Khatoon, 70, shows another deep blue wound on her leg from a cobra she encountered near her home last month.
“It was still dark. I was walking home when I felt a sudden pain. When I lifted my sari, I saw a long snake hanging from my leg, its fangs still deep in my flesh,” Ms Khatoon said. “It was about an arm’s length … I ran home, crying for help.”
Her neighbours tied a rope around her leg to stop the venom from spreading through her body, before her son-in-law brought her to the hospital on his motorcycle. “Doctors said I am out of danger, but it is painful,” she told The National.
Dozens of snake bite patients are treated at the medical centre every day, with statistics showing an increase across the state on the banks of the Ganges amid lots of lush vegetation. It is a perfect sanctuary for snakes and other reptiles.
Rajiv Pratap Rudy, a Bharatiya Janata Party politician, told parliament in August that more than 10,000 deaths from snake bites were reported in Bihar in the past year and that climate change was partly to blame.
Globally, about 5.4 million people are bitten by snakes each year, the World Health Organisation said, with between 1.8 million and 2.7 million of those involving venomous snakes. There are about 130,000 deaths annually. Many more victims are forced to amputate body parts or are left with permanent disabilities. Doctors in Bihar say about 90 per cent of bites are caused by four serpents – the common krait, Indian cobra, Russell's viper and saw-scaled viper.
“We receive an average of 15 to 20 cases every day. Of them, five per cent are fatal. We have seen a sudden sharp rise in snake bite cases,” Dr Vinay Kumar Jha at the Purnea Hospital's Emergency and Toxicology Department told The National.
Climate change to blame
Several studies have found climate change is driving an increase in the number of snake bites by forcing the reptiles into greater contact with people. The Lancet Planetary Health journal in a March report suggested global warming would alter snake habitats, pushing them into populated areas and increasing the likelihood of encounters with humans.
“Climate change is expected to have profound effects on the distribution of venomous snake species, including reductions in biodiversity and changes in patterns of envenomation of humans and domestic animals,” it said.
Indian researchers reached similar findings in a paper issued in July. Future of snake bite risk in India: Consequences of climate change and the shifting habitats of the Big Four in the next 50 years, which has not yet been peer-reviewed, said the warming of the planet had diverse effects on global biodiversity, including shifting the geographic ranges of snakes.
Climate change and other man-made threats result in a loss of snake habitats and cause the reptiles to search for food near humans, Shantanu Kundu, an assistant professor at South Korea's Pukyong National University and one of the authors of the report, told The National.
Vishal Santra, a herpetologist and snake bite expert, said farmers in neighbouring West Bengal had been using more water for harvesting due to a lack of rain, causing snake habitats to flood and pushing the reptiles into proximity with locals.
“There is a shift in agricultural patterns and crops due to a shift in climate. Some years we don’t get rain at all, some years see a lot of rain,” Mr Santra said. “We have seen a shift in breeding patterns of some venomous snakes like cobras that are laying two clutches of eggs a year because females are coming to cycle again.”
Health care under pressure
Adding to the problem is a creaking healthcare system in many parts of rural India, meaning some victims struggle to get the help they need before it is too late. When schools in Purnea began their summer holidays in July, Gaurav Kumar, eight, visited his grandparents in Singhia. Four days into his stay, he was bitten by a snake while playing outside the house. His family took him to a traditional healer but he died.
“We didn’t have a car or a bike to take him to the hospital, which is 15km away. We first took him to a healer so his condition could be stabilised, before taking him to hospital, but he died on the way,” said his grandfather, Panchanand Mahaldar.
Dr Soumyadeep Bhaumik, an Indian doctor at the George Institute for Global Health in Sydney, told The National that the high number of fatalities in India was due to a lack of robust healthcare infrastructure.
“We are always focused a lot on anti-venom but it is not just that, it is the entire functional health system – doctors, good health facilities and facilities for people from villages to rapidly reach hospitals,” he said. “None of these are happening.”
