Accurate figures on snakebite deaths and injuries are virtually non-existent, but
Cambodian snake experts fear the problem is worse than the country's landmine scourge.
The bamboo pit viper is found in dense rainforest and plantations.
A bite from the Malayan pit viper is an especially slow and unpleasant way to die.
And surviving one has its consequences. Gangrene can set in and the limb might have
to be amputated, damaging the victim's working life and causing social distress.
Nearly 85 percent of the population live and work in rural areas, making deadly snakebites
a reality of life in the countryside. Not only is bite prevalence growing, according
to one expert, but the country has virtually no resources to deal with the problem.
"In some areas more people are losing more legs to Malayan pit vipers than landmines,"
says Jenny Daltry, a leading expert on Southeast Asia's number one killer snake.
A herpetologist working in Cambodia with Flora and Fauna International, Daltry says
most bites occur in rubber plantations and rice paddies, where snakes reach high
density due to the abundance of rodents, birds and other small creatures.
"The current figures on snakebites are just the tip of the iceberg," she
says. "If we did have the numbers, I suspect people might find it a bit shocking."
What is shocking is the effect of a pit viper's bite.
"It's almost like [the venom] digests the flesh," she explains. "The
flesh literally begins rotting on the spot. It can really stink."
Because authorities rely only on statistics collected in hospitals, official figures
on snakebites in Cambodia are scarce. As few as one percent of people bitten seek
medical help from a registered clinic.
In southern Vietnam, authorities claim that snake bites are the third highest killer
of rural people after malaria and malnutrition; Vietnam shares the exact same venomous
snake species as Cambodia.
Nikolai Doroshenko runs one of only two snakebite treatment centers in the Kingdom
that uses anti-venom to treat bite victims.
"The biggest problem is children," he says. "Every day I get a call
and every day somebody comes in with their child who has a bite. Sadly, there are
some people who we cannot save."
From his observations and anecdotal research in Sihanoukville, Doroshenko estimates
around 800 people are bitten each year in Kampong Som province alone; more than half
die as a result of the bite or from ineffective treatment.
A single shot of anti-venom costs at least $10. For a severe bite a victim may need
as many as ten doses, making treatment too expensive for many rural people.
The other anti-venom clinic, in Kampong Cham, offers Chinese-made snakebite antidote
created from snake species not found in Cambodia. Daltry says it works, but only
in large quantities and with significant side effects.
As a result, many hospitals struggle to give adequate care.
Nineteen-year-old Sok Ra still believes that it was the hospital's fault he lost
his leg after a snakebite last year. Now a resident in a Phnom Penh prosthetics clinic,
he recalls being viciously bitten on both legs by what he called a "mountain
viper" while collecting frogs in a rice paddy near his home in Kampot province.
"I woke up around midnight, after hearing frogs starting to call. I took my
flashlight and went out into the rice field. I was walking along and the snake just
bit me - I didn't see it," Ra says.
"At first I felt okay. But soon I started to feel dizzy and was unable to see
anything. Then I fell unconscious."
After waking up, he crawled to a neighbor's house where a local healer attempted
to treat the bite using prayers and incense. Countless agonizing hours later, he
went to the hospital.
They amputated his left leg.
"Now I feel very sorry and unhappy," he says. "It's very difficult
to walk or to go anywhere like this."
Ra's story is all too common and adds to people's fear of hospitals.
"There is a rumor that if you go to a doctor, they will cut off your leg or
your arm," says Daltry. "Most people go to a magic man or they try to deal
with it in the village."
Local beliefs can also play a deadly role in the plight of snake bite victims, with
many people preferring to see a kru Khmer, or traditional healer, than a medical
Traditional treatments can often make minor snake bites deadly.
Some of the local remedies include rubbing the wound with a concoction of buffalo
dung, frogs blood and chewed-up herbs, or placing a 'magic snake stone' on the bite
to draw out the poison.
Many of these treatments can turn a nonlethal bite into an angry gangrenous infection.
"I have seen one treatment where the medicine man took the skin of the tree,
the bark," Doroshenko says. "[He] Sharpened it into a long spike and then
hammered it into the victim's leg."
Another common treatment, the tourniquet, involves tying off the blood supply to
the bitten limb with a piece of cloth for several weeks. Although the poison is stopped
from spreading around the rest of the body, the limb soon becomes shriveled and atrophied.
Doroshenko says the best possible solution would be to set up an anti-venom unit
in Cambodia using Cambodian snake populations.
"Praying seems to be the most popular treatment here," he says. "But
in the end, the only effective treatment is anti-venom."
Cambodia's four most venomous snakes
killer in Cambodia, Malayan pit vipers have long fangs, a bad temper and can launch
themselves through the air at potential threats. Found in rice paddies and rubber
plantations, their hemotoxic venom breaks down flesh. Death can be slow and agonizing,
but chances of survival are good with proper medical aid.
but deadly, the krait is mostly active at night in paddies and bamboo groves. It
is also known to seek shelter in human settlements, hiding in beds, boots and tents.
Their small head and reluctance to bite make a fatal bite unlikely unless stepped
on. A krait's powerful neurotoxic venom causes little pain or swelling but can result
in rapid respiratory failure.
highly camouflaged family of snakes is responsible for many bites but not all are
deadly. The green tree pit viper is especially hazardous to bamboo and rubber plantation
workers, with most deadly bites occurring around the face or neck. The hemotoxic
bite causes immediate pain, swelling, bleeding and tissue damage.
largest, fastest and most toxic of the world's venomous snakes, baby cobras possess
a deadly bite from the moment they hatch. The poison attacks the nervous system,
causing immediate dizziness and muscle weakness followed by coma and eventual respiratory
failure. Without medical aid, death is a certainty for victims.