Where can we buy snakes in India

Africa needs antiserumSnake, poison and death

"It was raging pain, as if I had dipped my arm in boiling water or oil. As if someone was grinding my bones." This is how a snakebite victim describes the hours after the bite. It's hard to believe that poison can cause such agony.

Most of them are hit while they are working in the field, for example planting or harvesting. Children are also often affected when they carelessly reach into holes in the ground. Antidotes are effective, but because those affected are mostly poor, the expensive antisera are rarely sold. The African middle class also ordered the cheaper preparations from India, although they work worse against the African snakes.

In 2014, the pharmaceutical company Sanofi stopped production of the most important combination drug Fav-Afrique. The last batches expired in 2016, doctors and hospital wards were left empty-handed. The crisis probably killed thousands of people. But it has also roused the institutions.

In 2017, the World Health Organization put snakebites on the list of neglected diseases. And finally, money also flowed into research.

Listening tip for the broadcast:

"A very large venomous snake in the savannahs of Africa is the puff adder."

Marc Oliver Rödel is the master of hundreds of snakes at the Museum für Naturkunde in Berlin

"Up to one and a half meters, extremely fat, very, very sluggish animals. Some of them are drawn extremely beautifully. Don't move an inch when you approach them. If you are bitten, it can have very negative effects, including death."

But this puff adder won't kill anyone anymore. For decades it has been bleached out in alcohol. Her triangular head still looks malevolent. The primal fear of the snake is deeply embedded in the human subconscious.

"Snake bites are one of the most neglected health crises in the world. Hundreds of thousands die and hundreds of thousands remain permanently disfigured or physically impaired," says Marco Alves of Doctors Without Borders.

Don't drop the stick until the snake is dead.

Excruciating pain after the bite

The snake keeper Paul Rowley:

"This was a bite that happened 15 years ago and it was only a baby, eight week old rattlesnake. And the level of pain, it was excruciating. It felt like my hand and my arm dunked into boiling oil or hot water and somebody grounded my bones together, really, really painful. You cannot believe that such a little snake with such a low yield of the venom could cause so much pain. "

"Fifteen years ago I was bitten by a baby rattlesnake. It was only eight weeks old. It was maddening pain, as if I'd dipped my arm in boiling water or oil. As if someone was grinding my bones. You can hardly do it believe that such a tiny snake can cause such pain. "

Use your enemy's hand to catch the snake.

The toxicologist Ulrich Kuch:

"Most people are bitten by snakes while they are working in the field, such as planting or harvesting. A real occupational disease."

Restless feet quickly step into a snake pit.

"Sometimes people are bitten when they sleep at night. In their hut on the floor, for example, is a relatively common, very typical scenario, for example in South Asia," continues Kuch.

Anyone who has been bitten by a snake is afraid of every worm.

"Children because they are extremely exposed through their behavior - and poisoning is particularly severe for them," says Kuch.

People die because medicine is often too expensive

Five million people are bitten by snakes every year. At least 100,000 men, women and children die in this way every year, and even more remain permanently disfigured and disabled. Nobody would have to die if they were taken care of in time. There are antidotes. But these are currently hard to come by in Africa.

"Snakebites hardly play a role on national or international health policy agendas. At the same time, it is a condition that primarily affects people in poor countries. That means that people often simply cannot afford medicine."

The market is failing, says Marco Alves from Doctors Without Borders. The need is huge, but nobody can pay. Because it doesn't pay off, the producers withdraw. Most recently, Sanofi stopped production of Fav-Afrique, the gold standard of antisera, effective against the ten most poisonous snake venoms south of the Sahara.

"For us it is the case that the existing crisis is basically getting worse now. There are still antidotes, but they are not effective against all types of snake venom. And their safety and effectiveness or effectiveness have so far only been proven in small studies or in a very limited geographic area. "

Not only Doctors Without Borders sounded the alarm. In 2017, at its annual meeting, the World Health Organization put snake bites back on the list of neglected tropical diseases. The crisis has unleashed strength and Jean Potet, also from Doctors Without Borders, hopes that they will not fizzle out.

The WHO is now in demand

"The WHO has now not an obligation, but a mandate to work on these diseases and to support member states to implement prevention, preventive activities, therapeutic interventions, capacity building. So it will soon hopefully translate into some concrete achievements."

"WHO must now support member states in tackling snake bite prevention and treatment and building the necessary resources. Hopefully this will bring concrete progress."

Milking time in Liverpool, at the Alistair Reid Venom Research Unit.

"So we're going to start a venom extraction from a puff adder ..."

In the laboratory there is a wooden box with a puff adder.

"This is one of Africa's most medically important venomous snakes, Bitis arietans, which has a really powerful strike. So you're ready to hook this out? Yes, open the lid."

"This is one of the medically most important venomous snakes from Africa. Ready to fish it out? Then open up."

The snake keeper Paul Rowley uses a metal hook to pick up the heavy snake and place it on a sleeping mat. She puffs warningly, but remains relatively calm. The snake is fixed with two rods. Rowley then grabs the puff adder with his hand behind the head while biologist Nick Casewell holds onto her body. They carefully carry the snake to a glass vessel that is covered with a plastic sheet.

The manufacture of the antidotes

"The snakes have a really powerful body and a lot of force when they bite you can see it well it has a really large head and they've got very large fangs for the size of the head as well. Paul is no bringing the head towards this venom milking dish and we will see whether it bites and gives us some venom. "

"This snake has a very muscular body and can bite really hard. Its head is big, just like its fangs. Paul is now pressing its head against the glass jar, we will see if it bites and gives us poison."

The mouth snaps open in a flash, the teeth fold forward and break through the membrane. The puff adder bites several times and injects its yellow, thick poison.

"We got plenty there. That is a good yield."

"We will then dry the venom and will get rid of all the water so that it becomes a powder and is probably towards half a gram venom from the single animal. And when it is dried in the state it is extremely stable so we can keep that stored in the fridge at 4 ° for a long period of time and send it to manufacturers to make antivenom. "

"We dry it into a powder. This one animal provides about half a gram of poison, which can then be stored in the refrigerator. We send it to companies that use it to manufacture antidotes."

Antidotes are still produced today as they were 100 years ago. The snake venom is injected into horses or sheep in small amounts. They then form antibodies that are purified and used as medication.

"And there are a number of problems with this. One: antivenom is typically only going to work against the snake species that the venom was used for immunization. And so if you are ask by a different snake your antivenom is not going to work. But they are also other problems: they are not particularly safe, a lot of people have adverse reactions to antivenoms, because you are effectively injecting a patient with lots of foreign proteins that are either from the horse or a sheep. And the other problem is cost. They are expensive. "

"There are some problems with that. First, the antiserum only works against the venom it was made with. If you've been bitten by another species of snake, it's no use. Besides, antisera aren't particularly safe. Many people tolerate them badly because we have to inject foreign proteins from horses or sheep. And the last problem is the costs. They are really very high. "

"The morning is far" - those bitten often die before the next day

One of the most dangerous snakes for the population in arid Africa are sand rattle otters, relatively small snakes, well under one meter, brownish with an actually distinctive pattern of spots, white spots on them. The sand-breed otter turns around and rubs the scales on the sides of its body against each other. And that makes a rattling noise. When you hear that, you should at least not bend over it, because the animals can actually hop up half a meter and bite. Unfortunately, they are also very aggressive.

Echis ocellatus is on the yellowed label in the Berlin Natural History Museum. In northern Nigeria it has its own name:

"The small humble snake we call carpet viper or in Haussa: the Gobidenisa. And why they call it Gobodenisa? Tomorrow is far. If one is bitten, you die before tomorrow. So one in five died. So if one is bitten by it one starts losing blood from all orifices through the eyes of the mouth in his urine in his stool under his skin. "

"We call this inconspicuous little snake in Haussa Gobidenisa, which means 'The morning is far'. One in five bitten dies before the next day. It bleeds from the eyes, from the mouth. Blood is in the urine, in the stool. Under of the skin.

Abdulrazaq Habib heads an important center for African venomous snake research at the Bayero University Clinic in Kano, Nigeria

"Snakebite probably kills more people and maims more people than many neglected tropical diseases in this world globally speaking. The Emir in Kaltungo visited and mentioned to reporters and journalists we have AIDS, have HIV, we have TB, we have malaria - but these are not our problems. Our problem here is snakebite. But all of these pale compared to snakebite. And yet no one is doing anything about snakebite. People are dying from snakebite. If you go to Kaltungo, if you go Taraba ... or Lagos , you go to Adamawa or Lamurde every household would have lost a member of snakebite in memory. But no one is paying heed to all of this. "

"Snakebites kill and maim more people than many other neglected tropical diseases. The Emir of Kaltungo has told journalists: we have AIDS, we have HIV, we have tuberculosis and malaria, but that's not our problem. Our problem is snake bites. Pale compared to that all these diseases. Go to Kaltungo, Taraba or Lagos: every family has lost someone to a snakebite, but nobody cares. "

Whole life can change after a snake bite

Two thousand bite victims appear in Nigeria's statistics every year. Two thousand more have to have an arm or a leg amputated. In addition, there are people who remain disfigured or who struggle with anxiety disorders throughout their lives.

The 50 beds in the snakebite ward in the Kano hospital branch are always occupied. There are always children lying here who have reached into the wrong hole in the ground while playing. Most of the patients are farmers and fishermen who have been bitten while working the earth with their hands or pulling nets onto land. Or stepping on a line in the dark on the way home.

"We have seen a cycle of poverty from snakebite. I recall a patient who had just come to this particular room who has been bitten. Many years ago in the early 1970s by Puffadder. Until today he is still a beggar. He has come to this hospital, we have done surgeries on him because his bone has become infected. We have even used the microcredit scheme to give the money to sell yams but still he has gotten into this perpetual cycle of poverty and deprivation and the original trigger is actually snakebite . "

"A snakebite triggers a cycle of poverty. In this room I was treating a man who was bitten by a puff adder back in the 1970s. He's still begging. Here in the hospital, we operated on his bone infection. We got him one Microcredit arranged so that he can sell yams in the market. But the cycle of poverty and deprivation continues and the trigger was the snakebite. "

For Abdulrazaq Habib it is unbearable that poisonous snakes cause such suffering in his homeland, because there are effective antidotes - antisera or antivenins.

"We maintain a research facility in southern Gombe, we have shown that if we have a stock out, the antivenom finishes and is not replenished, we have seen deaths multiplying several fold over. However if you use the appropriate effective antivenom we had cases and I show some here for you within six hours you see the bleeding seizes stops. But with an effective antivenoms this is reduced to less than one in 50. "

"We have a research station in South Gombe. If the antidotes run out there, the death rate skyrockets. But if you inject the right antidote, bleeding stops within six hours and only one in 50 victims dies."

"These are very, very effective products."

"These are very, very effective ingredients."

There are just as many species of cobras in both the savannah and the rainforest. Some of the cobra species can not only inject their venom, but they also spray it, sometimes in a targeted manner, over several meters onto the eyes of a potential attacker. Not wearing glasses can lead to blindness. Completely different from vipers, cobras are actually rather shy animals, and as long as you don't behave in such a way that they feel cornered, they will always try to get away.

Snakes can dose the poison

Snakes do not produce poisons for defense, but for hunting, says toxicologist Ulrich Kuch from Goethe University Frankfurt am Main. When a snake attacks a bird in the branches or a mouse on the ground, one thing above all matters - the quick effect.

"If a mouse like this hops away after a snake bite, it usually falls over after a few hops and then has a circulatory collapse or another important symptom of poisoning, such as respiratory paralysis, for example, and can then be detected and found by the snake."

A snake achieves the rapid effect by injecting a whole poison cocktail. It takes a lot of energy to produce. Therefore, if she just wants to fight back, she doesn't always inject her entire supply of poison. So not everyone is in mortal danger after a snake bite.

"This is why these traditional healers generally have a relatively high success rate and therefore a certain good reputation among the population."

If a venomous snake is serious about it, neither herbs nor the black poison stone will help. The traditional incisions around the wound even make it easier for the toxins to penetrate and accelerate their effects.

How poison can kill humans

"Often, for example, the nervous system is damaged, ie symptoms of paralysis. Many snakebite patients then die because they can no longer move and therefore can no longer breathe. Many snake poisons destroy tissue, i.e. muscles, connective tissue. Quite a lot Snake poisons make a lot of holes in the blood vessels, so that insatiable bleeding occurs internally and externally. These are very devastating processes that then take place in the human body. "

For decades, Sanofi and, for example, the Behringwerke, produced elaborate antidotes against the destruction of the snake venom. Snakes were milked, the venom injected into horses or sheep, and antisera recovered from the animals' blood. Only a minority of the bite victims could afford the medication. Despite the huge demand, there were no profits. In 2014, Sanofi stopped production of Fav-Afrique, and in 2016 the last batches expired. In Nigeria, Abdulrazaq Habib was left empty-handed. He turned to his health minister and he actually released funds. Sand rattle otters and puff adders were caught in Nigeria and milked in Liverpool. Then two manufacturers in Wales and Costa Rica produced specific antisera for Nigeria.

"We have tried these antivenoms and have shown they have been useful in the world's largest clinical trial on any antivenom, recruiting 400 victims of snake bites we showed that these two products are really, really very effective."

"We tried these antisera. It was the largest clinical study in the world with more than 400 snake bite victims, and we were able to show that these products are really, very effective."

Abdulrazaq Habib is audibly proud.It is not the only important study his team published in Kano that has received international attention.

Every hour counts

"We have shown that those who have delay in coming to the hospital following snakebite they tend to die faster. We have in fact estimated for every one hour delay from snakebite to getting an antivenom, there is 1 per cent increment likelihood of dying from snakebite in southern Gombe. "

"In one study, we found that people who take longer to hospital die faster. Every hour of delay before the antidote is used increases the risk of death by about one percent."

The anchoring of medical care in the area is ultimately decisive, emphasizes Abdulrazaq Habib. From his hospital he looks after a number of smaller facilities and supplies them with antisera. It cannot be taken for granted that these are available. Another study from Kano was decisive for the political debate in Nigeria and showed that antidotes are not only effective, but also cost-effective compared to other drugs. It is worth the government to subsidize. Countries like Nigeria or Burkina Faso act accordingly and buy antisera for their populations.

"The black mamba can grow to be over three meters long, extremely elegant. Most poisonous snakes bite your hands or feet, mambas usually target your head and body. Mambas are the horror snakes par excellence if you listen to Africans. Most of them become but have never actually seen a mamba. These are extremely shy snakes that try to run away as soon as a person is around. "

Green and black mambas, puffers, rattlesnakes ...

Over 250 venomous snakes of more than 50 species are kept at the Alistair Reid Venom Research Unit at Liverpool University.

Earth vipers, sand rattle otters, kraits ...

Most of them in well-sealed plastic boxes on some newspaper with a small wooden box as a hiding place. The snakes do not need any more as long as there are regular dead mice.

Boomslang, cobras, spitting cobras ...

Tailoring new active ingredients

The air holes in the boxes are marked in red. A warning: do not touch here, a poison tooth could pierce through. And the room with the spitting cobras can only be entered with protective goggles. Most of the snakes hide in their houses. Only a mamba lets the head and front part slide seemingly weightless through the air. All snakes in Liverpool are milked regularly. Part of the poison is used to produce antidotes. Nick Casewell is doing research with the other, because today's antidotes work, but far from optimal. This is especially true for combination products that are supposed to help with bites of different types.

"The more venoms you use to immunize an animal the more dilute your product is, because you are of calls only ask by one venomous snake. So if you use ten different venoms to immunize only ten per cent of the antivenom is going to be specific to set snakes and bit you. And that's why you have to increase the doses of antivenom tenfold to save a patient's life and increased cost tenfold to save a patient's life.

"The more poisons you use to immunize the horses or sheep, the more dilute the end product. If you make an antidote against ten snakes, only a tenth of it will work against the one snake that bit the patient. You have to So increase the dose tenfold to save him - and that is ten times as expensive. "

Nick Casewell therefore wants to break new ground and tailor active ingredients against individual components of the snake venom.

"So in the example of snakes that cause coagulopathy non-clotting blood in patients there usually only two major types of toxins that are responsible for this procoagulant effect, even though the snakes themselves may have diverged tens of millions of years ago. And that, those shared toxins that are structurally similar can be taken advantage of in terms of how we make antibodies. "

"Many snakes block blood clotting. Even if the snake species diverged millions of years ago, only two groups of toxins are responsible for this. These toxins are similar in structure, which we can use to produce antibodies."

Develop effective active ingredients with decoded genetic material

Nick Casewell calls this approach Antivenomix. He studies the genetic makeup of the many species kept in Liverpool, examines which genes are active in the poison glands, separates the toxins and compares their effects. Of the two dozen toxins in a species of snake, only a few are usually really dangerous. And they often resemble the poisons of other snakes. Nick Casewell uses them to specifically produce monoclonal antibodies that neutralize these toxins. They are no longer produced in horses or sheep, but in cell cultures.

"We think that we can use this approach to make an antivenom more cross-effective, so to work against more snake species, and it also should make it much safer, because of the lower doses of antivenoms a patient would need. We are in a situation where we have this technology to potentially develop an antivenom that is more effective than that that exists today. And we aim to make it at least as affordable as existing products in the long run. "

"We hope that such a drug will help against many more species of snakes. It should also be better tolerated because the dosage is lower. We have the technology to develop much more effective antidotes that are no more expensive than today's antisera in the long term become."

In the long run, because a single monoclonal antibody cannot block all of the components of a complex snake venom. Nick Casewell is working to find the right combination. And it has to show in extensive clinical studies that it keeps what it promises. Meanwhile, the Liverpool laboratory and others around the world are pursuing other strategies. For example, to expand the spectrum of activity of established antisera through the targeted addition of antibodies. Or stop tissue breakdown more quickly with new drugs.

"I think what is very nice at the moment in antivenom research is that there's a small number of people, but there's a lot of different approaches. And I think we should be able to make really large gains in terms of improving therapies over the next decade over because of that. "

The researcher's optimism

"What is good about antidote research right now is that there may be few researchers, but they are pursuing a variety of approaches. I believe we will make great strides in the next ten years."

"There are different types of Kraits. Some of them are very banded. In the literature it is always described that they are extremely lazy and lazy during the day, and extremely aggressive and bite-loving at night. And these are snakes that you should keep your hands off of A very famous American colleague also died of a bite while traveling in Southeast Asia. "

"Kraits are also responsible for many deaths in Nepal. For a project, smears are taken from the bite wound in small health centers and sent to the Goethe University in Frankfurt."

"Well, this is where the DNA that we have from the snakebites from Nepal is extracted, and we store it here in this refrigerator. Here you can see the cotton swabs that have just arrived from Nepal and are being stored here for the time being. They will then be just taken out for extraction. And then part of the cotton wool is cut off, and then the extraction begins in the laboratory. "

Patrick Höde has already examined over 700 samples of bite wounds for his doctoral thesis. Hundreds more are still in the fridge. First of all, he isolates traces of genetic material from all of them.

"This is now our DNA pellet. Quasi the extracted DNA in a concentrated form. Which we then take up in a liquid and then process further with the PCR, by then duplicating it and then using sequencing to determine which snake the patient is has bitten. "

In Nepal, the lifesaver comes by moped

Or not, because often no snake DNA can be detected, says Ulrich Kuch, who organized the collaboration with the doctors and nurses from Nepal:

"By analyzing DNA traces of the snakes at the bite site, we found out some amazing things. On the one hand, we found out which non-poisonous snakes are involved in the bites. We had very, very little information about them before. That is but also important because they make up a large part of snake bites. And we were able to rediscover numerous snake species that were already known zoologically, but which had never been documented before as the cause of snake bite poisoning and deaths after snake bites. "

Lengthy DNA tests are unsuitable for everyday clinical practice. Often the animal that has been beaten to death is brought to the infirmary, but often not. Tests that show which antiserum is the right one within half an hour would be helpful here. Ulrich Kuch's group has developed detection methods that work in a similar way to the well-known pregnancy test.

"The rapid immune tests that we are currently clinically validating are, on the one hand, a test that detects the venom of the chain viper, and in the other test, we can detect cobra and krait toxins separately at the same time. That is, we get there depending on which snake bitten and injected poison, a different color reaction on the test, for either cobra poison or krait poison. "

Clinical studies are currently underway in Nepal and Myanmar. If all goes well, the tests will be available for the whole region from Pakistan to Southeast Asia within the next two years.

Economical and inexpensive antidotes

"An important group of poisonous snakes that most people don't take into account are terrestrial vipers. These animals actually look completely harmless at first, mostly black, without any great drawings. Life almost always underground. That means you come relatively seldom in contact with them. However, if you work in the fields, or if you walk around with flip-flops in heavy rainfall, you can step on the animals, and they usually bite you immediately. "

The World Health Organization's decision to finally put snakebites high on the agenda seems to be providing a long-lost momentum. Nick Casewell saw calls for funds specifically for snake bite research in Liverpool for the first time in his career. A highly motivated group of scientists in industrialized countries but also in Africa and Asia is getting to work with it. It will take some time until new antisera are available, so proven strategies must be implemented at the same time.

"There is no reason to wait to treat patients. We have the necessary treatments for snakebite poisoning today. They can be made available economically and cheaply, and they can also be used in the really remote, rural areas of Asia and Sub-Saharan Africa. You just have to do it. "

Nepal made a big step forward with motorcycle ambulances, reports Ulrich Kuch. Ordinary moped drivers have been trained to drive snakebite victims quickly to the nearest health station.

"And that was a very, very successful project that colleagues from Geneva carried out together with our partners in Nepal, and with which the mortality rate after snake bites, especially cobra bites in Nepal, could be reduced from 10.5 percent to 0.5 percent . "

The example shows that it is crucial to approach the snakebite issue broadly. It starts with the local population. The people in Africa and Asia need to learn that help is available and that they can protect themselves, with shoes, gloves or at night with flashlights on the way home. Enlightenment is just the beginning. New priorities are also necessary in politics. In many African countries there is a lack of the basic requirements, health stations, qualified nurses and doctors.

"It's usually about poor people in often remote areas of developing countries who have little contact with their capitals, no contact at all with their health ministries. This is a problem that nobody wants to touch."

Research institutes and companies for all of Africa

But there are positive examples. Nigeria is one of them, including Burkina Faso. In South Africa there are even snake farms and a local production of antisera that are affordable for the residents. However, they are sold at a high price to other countries. It would therefore be important to set up appropriate research institutes and companies in all regions of Africa. Marco Alves from Doctors Without Borders refers to the example of Latin America.

"In Latin America there is more attention to the topic. The health ministries are aware of the situation and there is greater coverage with health insurances that pay for or at least subsidize antidotes, so make them accessible to the people. That is, the demand for The product is also paid for, which means, in terms of the market, that the industry has a much greater interest in providing products. "

In Africa there was no such functioning market for a long time. Governments paid particular attention to the costs and ordered antisera from India, which have no effect in Africa. This is one of the reasons why the production of Fav-Afrique no longer paid off for Sanofi. But slowly something is starting to change. In India, for example, antisera are now being produced specifically for Africa. This is progress, but not the breakthrough that Nigerian snake venom researcher Abdulrazaq Habib is hoping for.

"Antivenom is still a major problem. In Gombe state at some point the governor has two task chairman of local governments to give money. Similarly the federal government doesn't have a dedicated budget for an amount to procure antivenom. As I said, antivenom is the hallmark of care and management of snakebite victims throughout the country. We don't have a dedicated account. "

"Antidotes are still a big problem. Here in Gombe we have to keep asking the local administration for money. And the central government does not have a fixed budget for the production of antisera. These drugs are the linchpin of therapy for snakebite victims. And there is still no fixed budget. "

WHO and international donors have a duty

The World Health Organization and international donors could also do more, says Julien Potet of Doctors Without Borders.

"Most importantly for country like Germany: It may be possible to start in existing programs supported by the government of Germany in Africa and Asia and so on to start incorporating some basic integrations and basic health services on snakebite."

"A country like Germany could immediately start expanding existing health programs in Africa or Asia to include snake bites."

In Liverpool, the puff adder injected its poison into the glass bowl.

"So we're now just repeating the process in the reverse. We are putting the snake on the ground. Paul still has it behind its head and we are just pin the snake so that we can safely release it and put it back into its cage. "

"We are now doing everything backwards. First we put it on the floor. Paul still holds it behind his head. Now we take the stick and fix it. We can now safely let go of it and put it in the cage."

"Taking my pin away now."

"Let's put it back into its box."

The puff adder squirms, strives away, puffing threateningly, it just doesn't want to go into the small flap of the transport cage. In the end, Nick Casewell fetches a large garbage can, into which Paul Rowley maneuvers the puff adder.

"One thing with these snakes is that they are always unpredictable. So every time we do this process it's a different experience and sometimes there are extremely placid and other times they can be quite aggressive. You just have to be very careful."

"Snakes are unpredictable. The milking is different every time. Sometimes they are very calm and then again aggressive. You just have to be careful."

The puff adder is put in its glass box in the garbage can. She's still puffing, but already looks a lot calmer. She will soon have a dead mouse and then she will have four weeks of rest before she has to deliver poison again. Poison for research, but above all poison for the production of antisera. If the global community uses the current momentum, it could be possible to defuse the coexistence of humans with the poisonous snakes.

"Even here in Kano we lost a security man at the University last rainy season from snakebite he was bitten and died within the day. These things happen but people think it's a minor thing, we have to train healthcare workers, enlighten the government on its importance, enlighten the international community a lot of needs to be done for snakebite. "

"Even here in Kano one of our guards was bitten during the last rainy season. He died the same day. Many think it's a small thing. That's why we need to educate people further. The people in the clinic, our government, the international community. Much remains to be done on the snakebites.