[ESWATINI] In the village of Siphocosini, Eswatini, Clement Tsabedze still remembers the moment that nearly took his life.
After being bitten by a black mamba—one of the most feared and venomous snakes in the world—Clement survived thanks to quick thinking and access to life-saving antivenom.
“I used to think that traditional medicine was the only way to treat snakebites, but I know better now,” Clement tells SciDev.Net.
“We are trying to teach [people] to go to a medical facility and not to waste valuable time when they are bitten,”
Thea Litschka-Koen, founder, Eswatini Antivenom Foundation
“Modern medicine saved my life, I was lucky.
“People in our communities need to know that they can trust Western medicine and seek help when they’re bitten.”
His experience represents a crucial turning point in Eswatini – formerly called Swaziland –where between 200 and 400 serious snakebite cases occur annually according to the World Health Organization (WHO). The WHO classifies snakebite poisoning as a neglected tropical disease.
The subtropical climate in Eswatini creates ideal conditions for dangerous species like the puff adder, Mozambique spitting cobra, and black mamba.
A snakebite victim’s leg. There were zero deaths recorded from snake bites last year in Eswatini. Copyright: Nokukhanya Musi
For centuries, the Swazi people have relied on traditional remedies to combat snakebites.
These practices range from wearing charms and amulets to ward off snakes, to brewing herbal concoctions believed to neutralise venom.
Despite their cultural significance, these local remedies often fail against potent snake venom, and mostly only delay access to effective medicines.
Changing perceptions
Thea Litschka-Koen, founder of the Eswatini Antivenom Foundation, has been leading efforts to promote the use of antivenom across the country.
“We are actively involved with going into remote rural communities to educate them and help change perceptions about snakes and the treatment of snakebites,” she told SciDev.Net.
Thea Litschka-Koen, of the Eswatini Antivenom Foundation, holding a snake. Copyright: Nokukhanya Musi
“We are trying to teach them to go to a medical facility and not to waste valuable time when they are bitten,” she said, adding that it would take time for everyone to accept this message.
One of the biggest hurdles for Litschka-Koen and her team is building trust among communities and working alongside traditional healers.
Zero lives lost
The 2023-2024 snakebite season was a milestone year for Eswatini. Not a single life was lost to snakebite.
This coincided with the introduction of EchiTAb-Plus-ICP, a new antivenom that works against multiple snake species found in Eswatini and across Southern Africa.
It is a polyvalent antivenom, which means it contains neutralising antibodies against more than one species of snake.
Philip Price, scientific director of antivenom company EchiTAb-Plus-ICP, tells SciDev.Net that the project began in 2017 when Litschka-Koen sought support from Costa Rica’s Clodomiro Picado Research Institute during an antivenom shortage in Eswatini.
Price told SciDev.Net that the institute’s expertise in antivenom production helped navigate the challenges of sourcing snake venom, needed to produce the antivenom, to produce a treatment effective against Eswatini’s cobra and mamba species.
Early-stage research showed the antivenom to be an effective alternative to the existing treatment, which was expensive and difficult to source.
“The successful application of the polyvalent antivenom during the recent snakebite season highlights its improved safety profile, reliable supply, and affordability compared to the previous product,” Price said.
Traditional healers
For the Eswatini Antivenom Foundation, however, convincing traditional healers to refer snakebite victims to medical facilities is a challenge.
Litschka-Koen observing a coiled snake. Copyright: Nokukhanya Musi
The foundation recognises the cultural importance of traditional medicine but emphasises the critical need for prompt medical intervention.
Makhanya Makhanya, president of the Witchdoctors Association and a traditional healer, acknowledges the need for cooperation: “We can learn from each other. Their ways are unique and so are ours.”
Makhanya, however, says that traditional healers face discrimination and skepticism from government institutions and the scientific community, creating additional barriers to cooperation.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.