Attitudes, knowledge and practices of traditional snakebite healers in Nepal: implications for prevention and control of snakebite.

ABSTRACT

BACKGROUND: Traditional healers are a valuable source of information about community-level treatment of snakebite. Snakebite victims in Nepal depend on traditional healers for treatment, but their practices have not been well-documented. METHODS: This was a cross-sectional study of 50 traditional snakebite healers (TSHs) who were selected using a snowball sampling method representing eight districts and four provinces of Nepal. Data were collected using face-to-face-interviews and semi-structured questionnaires. RESULTS: About half of the respondents liked to gain knowledge on modern care for snakebite management and nearly all respondents (94%) wished to cooperate closely with the local healthcare system to support snakebite management. People's ingrained faith in traditional healing of snakebite (84%), unaffordable modern care of snakebite (60%) and wishes for early treatment of snakebites (44-48%) were the main causes of their dependency on TSHs. Rauvolfia serpentina, Piper nigrum, Momordica charantia and Tinospora cordifolia were commonly used plants in traditional treatment of snakebite. CONCLUSIONS: Easily accessible and affordable healthcare facilities provided by TSHs, public beliefs in traditional healing and inadequate knowledge of antivenom therapy caused dependency on TSHs. The introduction of snakebite treatment centres in snakebite-prone regions and educational interventions are essential to minimize this kind of dependency and associated deaths and disabilities.