Gyaneswari - A true survivor of Krait bite

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My mobile phone woke me up very early  on Sunday the 6th of July 2014. It was Dr Sr Sijji on the other side. Sr Sijji is a qualified MBBS doctor from Pithora, Chhattisgarh.  She is a nun and belongs to the Order of St. Francis. The missionary nuns run a school and a healthcare centre in Pithora. The nearest government hospital is 100kms away in Raipur. The healthcare centre has very basic facilities and yet it is well known in the area for treatment of snake bite cases. The healthcare centre had admitted a   25 year old patient named Gyaneswari at 1:30 a.m. with Krait bite envenomation.

Gyaneshwari was a widow with two children aged four and two years. She belonged to Jhalap, a village under Police Station Patewa. The village was seventeen kms away from the missionary health care centre.   She was brought to the centre by her father.

Gyaneshwari’s vital signs  were plummeting  rapidly and by early  morning, she was showing severe snake bite related trauma and was in urgent need of immediate artificial respiratory assistance.The missionary healthcare has just one Ambu bag -  an equipment used to provide manual respiratory assistance in case of respiratory failures.

Some background information to understand the case: The Common Krait’s venom mostly consists of powerful neurotoxins which induce muscle paralysis.One of the most common signs of a Krait bite envenomation is the onset of ptosis (drooping of the eyelids) coupled with general respiratory failure.

Gynaeshwari was in a similar state and the sisters were trying to provide respiratory support by using the manually operated Ambu Bag.  At the first onset of dawn, the Sisters called to take the help of Team Indian Snakes to seek assistance from an expert snakebite doctor. Dr V V Pillay from Kerala was approached who very kindly advised the next course of action to Dr Sr Sijji on the phone.

The sisters waited another two hours while continuously providing artificial respiratory assistance along with ASV (Anti Snake Venom). Her condition was now static.  Neither any improvement    nor any deterioration in her condition could be observed. Dr Pillay roped in Dr Himmat Bawaskar who has a vast experience of treating such cases in the rural areas of Maharashtra. Dr Himmat Bawaskar provided further guidance and advice regarding supportive drugs to ease the paralysis of the muscles.  Gyaneshwari started responding to the treatment very slowly but steadily. She was able to come out of her ordeal in the next 24 hours.

we kept a steady vigil on the case to ensure things didn’t get out of hand.  A total of 15 vials of ASV were administered to the patient along with other supportive drugs to reduce chances of allergic reactions due to the ASV etc.

The other side to this story is the snake itself. It was captured by the family members and brought to the hospital. Team Indian Snakes immediately confirmed it was an average sized adult Krait. The snake was kept in a plastic jar with air holes.

On inquiring what the family members intended to do with the snake, Dr Sr Sijji mentioned that  they were  waiting for Gyaneshwari to  recover  and once there was an improvement in her condition, they would release the snake unharmed in the woods a few kilometers away.  Team Indian Snakes advised Dr Sr Sijji to pour some water and keep the jar covered to ensure that the snake   did not suffer stress. The following day both the patient and the snake found new freedom.  Gyaneshwari was discharged on 8th July 2014 and the snake was released shortly thereafter.

Writen by :Priyanka Kadam , Volunteer Indiansnakes.org