A 60-year-old tribal from Manibeli village in Nandurbar, on the northern border of Maharashtra, succumbed to a snake bite on Tuesday night after the family found the closest sub-centre shut and a primary health centre inaccessible. A boat ambulance, meant to provide emergency medical care for villagers in the remote tribal area, was delayed by two hours.
By the time Jamunabai Vasawe was administered anti-snake venom (ASV), her condition had worsened. She was declared dead in a government hospital in Garudeshwar, Gujarat, around 11 pm.
It is the second death from snake-bite in Nandurbar in a week. On June 28, Ravish Vasawe (14) died in Gaman Ashramshala where he studied in Class VII. According to local people, the closest primary health centre in Gaman had no nurse or paramedic staff. Ashramshala teachers took Ravish in a private vehicle to Molgi, 22 km away, but he died on the way.
In the latest case, a preliminary inquiry by district health officials shows that the boat ambulance, which offers medical aid to nine villages along the Narmada river between Gujarat and Maharashtra, was parked at Kevadiya village for diesel, instead of being stationed at its usual post in Manibeli.
According to villagers, on Tuesday evening, Vasawe was in her cattle shed when a snake bit her at 6 pm. Villagers in Manibeli, a few kilometres away from Sardar Sarovar dam, started calling for the boat ambulance but could not access mobile connectivity for half-an-hour.
When they could finally call, it took another hour- and-half for the boat to reach. “There was bleeding and she was in a lot of pain,” said relative Dinesh Vasawe. The closest primary health centre, in Jangthi village, was an hour-and-a-half away if they trekked through hills.
“The sub-centre has remained shut since its construction in 2011. No nurse visits us. Until a few months ago, a godman was living in the sub-centre’s structure until district officials asked him to leave,” said Manibeli’s Sarpanch Narayan Chima Tadvi.
Even as Maharashtra has proposed to convert 1,270 sub-centres to health and wellness centres under the Ayushman Bharat programme, Nandurbar’s 20 sub-centres do not even have permanent structures. The tribal district has 290 sub-centres, and tribals claim that even basic services are lacking. With no road access, the district makes use of three boat ambulances to provide health services to 33 villages. Locals, however, said poor mobile network makes it difficult to contact them.
Union Health Ministry data says Maharashtra recorded highest number of snake bite cases in India with 38,917 cases in 2017-18, of which the most were in rural regions, at 29,912. West Bengal was second with 34,213 cases. This year since April, 4,119 snake bite cases have been recorded with 3,229 in rural areas of the state.
Dr Himmatrao Bawaskar, snake and scorpion bite expert, said fatality in snake bites is due to delay in treatment. He is conducting training for medical officers in tribal regions on the correct method of administering ASV.
Dr Nitin Bodke, district health officer, Nandurbar, said: “Manibeli sub-centre’s auxiliary nurse midwife was transferred to Dhule in June. Additional charge has been given to another ANM.”