Painful snake bites, an occupational hazard for women tea workers

Pahi Bhumij trembles when he remembers that day, and says he is thankful to have escaped death.

On May 5, as part of his program, Bhumji went to work in a tea garden near his village in Assam’s Sivasagar district. The 16-year-old was employed as a part-time tea picker. In the afternoon, as he was picking tea leaves, he felt pain in his ankle, and noticed a monocled cobra.Yes kaouthia) to slide on the grass below the tea plants. Bhumji was bitten by a snake.

He was taken home and later in the evening was transferred to Demow Model Hospital, a government health center in Sivasagar district.

“He was unconscious, and there was no visible carotid pulsation with slow breathing,” said Surajit Giri, an anesthesiologist at the hospital. “We are hampered by the lack of an ICU [Intensive Care Unit] place, but we still wanted to give credit. The ammo bag came in handy in the end. “

A bag valve, also called a bag valve mask (BVM), is a hand-held device used to deliver fresh air to a patient with inadequate or ineffective breathing. It was used to revive Bhumji’s lungs, as the required dose of antivenin injections was administered. After a few minutes, his heart rate returned to normal and he was conscious. The antivenin successfully neutralizes the cobra’s venom within a few hours. Bhumji was released the next day. “I don’t want to remember that horrible day, but I’m thankful to be alive,” he told Mongabay-India.

The Assam tea industry has 4.17 lakh female workers and most of them work as tea sorters. Evidence suggests that a large number of women tea workers in Assam are bitten by snakes every year. And not many of them survive when bitten by a cobra, due to the lack of timely access to antivenin.

The World Health Organization (WHO) designated snakebite as a Neglected Tropical Disease (NTD) in 2017 and launched a global initiative by 2022 to halve death and disability from snakebite by 2030. The WHO estimates that 81,000 to 138,000 people die from snake bites each year. around the world and about three times that number survive but are left with amputations and permanent disabilities. India is one of the countries most affected by snakebites and accounts for almost half of the world’s annual deaths.

Women tea workers are at risk of snake bites

The matter of snakebites in the tea plantations of Assam receives a mention in George M. Barker’s Life of a Tea Planter in Assam (1884), one of the first sustained accounts of life in the Assam tea industry in its early days.

I Narrative of Sramshakti, published in 1988, described snakebite as an occupational hazard for tea plantation workers. Recently, in 2021, a study conducted by the Assam Agricultural University also listed venomous snake bites as one of the occupational hazards for tea workers, especially women tea harvesters.

In the fields, there is a traditionally gendered division of labour. Generally, women do the work of harvesting tea to prepare it. Men work mainly in factories and other mechanical and manual labor.

As a result, women who work in tea plantations are more susceptible to fatal snake bites than their male counterparts.

“Tea bushes are planted close together to make harvesting easier,” says Bhumji. “This means that when we enter the middle of the field, our feet are completely hidden from view. And we have no time to take any notice of anything less. We have to pick a certain amount of tea leaves each day.”

What complicates the matter is that some venomous snakes found in this area, such as many species of green snakes, can hide in green tea leaves.

Giri told Mongabay-India that most of the snakebite patients at the hospital are from rural areas and work in farms or tea plantations where human contact with snakes is common.

Lack of knowledge and remoteness of tea estates

The tea gardens of Assam are home to many rich snakes including the king cobra (Ophiophago hana), one pipe (Yes kaouthia), banded krait (Bungarus is bound), black krait ((Bungarus Niger) and many types of green grass found in the area. Every summer, in these tea plantations, there is a spike in the incidence of snakebites and snakebite-related deaths, sometimes leading to retaliatory snakebites.

Prabhat Das Panika, a social activist from the Baksa district of Assam, said that awareness about snakes and snake treatment and access to antivenin clinics have improved over the years in Assam. “Big company farms have antivenin treatment facilities these days.”

However, this is not the case for the medium-sized and small-scale tea plantations located in remote parts of Assam. Evidence and history show that there is still a significant lack of snakebite control in these tea plantations.

Angshuman Sarma is a PhD in Labor Studies from Jawaharlal Nehru University and specializes in the tea plantations of Assam. Sarma said “all tea garden health centers should have snake treatment facilities, but most tea gardens still do not have access to antivenin.”

Giri argues that the gap is both in terms of timely and adequate access to antivenin treatment and awareness about snakes and snake care. As a result, many people still turn to other medicine—the local doctors.”

Giri has written a book in Assamese language to make people aware of snakes and snakes. “More information about venomous snakes can greatly reduce conflicts between snakes and people,” he said. “This is very important in places like Assam because early access to antivenin is still far away for the rural population of the state.” He added that there is no antivenin to treat bites from certain species of snakes that live in the region such as the red-necked keelback (Rhabdophis was hunting down) and many green meadows.

Moreover, tea plantations are located in remote areas away from human settlements. Most farms are not well connected to nearby urban centers, with poor roads or dirt roads that take hours to reach. This leads to delays in the arrival of snakebite patients to health care facilities equipped with antivenin treatment, which greatly reduces the survival rate of patients.

“The need of the hour is to make antivenin available within 20 kilometers of any place so that a patient bitten by a snake can receive proper treatment within one hour of the bite,” Giri said.

The need for local antivenin

India manufactures the only polyvalent antivenin that effectively neutralizes the venom from the ‘Big Four’ of Indian snakes – the spotted viper (ok sp.), crate (bungarus sp.), Russell’s theorem (Daboia Russell), a sharp line (Echis carinatus sp.) – jointly responsible for the death of a large number in many parts of India.

In northeastern India, where Assam is located, only two of the four Big Four species are found: the cobra and the krait. Even in these two small species, the efficacy of Indian antivenin is low.

Northeast India is home to other venomous snakes such as several species of green snakes, the red-necked keelback and the king cobra. While pit beetle bites are common in tea plantations and farms in northeastern India, Indian antivenin is found to be ineffective against beetle bites. The red-necked keelback, a common species in the region that was thought to be non-venomous, is now known as a venomous back snake. There is little research and no antivenin for the treatment of bites in this species.

“Therefore, what we urgently need is research on venomous snakes endemic to northeastern India and work on the potential development of site-specific, potent antivenins,” added Giri.

Read more: Radio telemetry reveals new ways to study snakes

Advertisement image: Tea garden workers. Photo by CC BY-NC-SA 3.0 IGO © UNESCO-UNEVOC/Amitava Chandra.