The instructional programs ordained under the project encompasses a wide range of plans ranging from mass education of high risk communities on “How to Live with Snakes” to highly technical sessions on “Evidence Based Snake Bite Management”. The participatory techniques under Andragogy methods of adult learning are used for conducting at the site project programs include, lectures, live demonstrations, return demonstration, group discussions, brain storming sessions, experience sharing, and visual aids to ensure maximum impact of these instructional programs for optimum improvement of knowledge, attitude and practices of the participants. It is very difficult to sponge fully the decades old myths and disbeliefs among the local communities and clinical myths among the local doctors and paramedics by such short term instructional programs, however the special methods of participatory training and community shared brain storming sessions de-root such firm belief to an extent that these disbeliefs gradually vanishes in days due to a shaken credence out of these programs. These instructional programs are designed on the basis of a scientific communication and training need assessment among the target groups and are thoroughly field tested with the anticipated beneficiaries before actual implementation. The communication and training material is developed and validated according to the local needs and utmost diligence provided to avoid any ethical, cultural, religious, lingual, racial, gender or social bias. The print and electronic material is developed in local languages with most of the terminology expressed in locally understandable and acceptable medium. The core theme of project instructional programs for community education and mobilization is “Not to kill the snakes better move them” a newer concept in Pakistan and the region helping in maintaining the natural ecosystem and preventing environmental degradation about to vanish some of very beautiful non venomous snake specifies.
The instructional programs of project are ideal for:
- High risk communities in desert and arid zone of the province.
- Farmers, other Agriculture workers and Snake Charmers having highest risk of snake bite.
- Field Extension workers of Forest, Agriculture, Irrigation and other allied departments.
- Field Staff of Oil Exploring and Drilling Companies.
- Field Workers of NGOs and Community Organizations.
- Medics and Paramedics of Public and Private Sectors.
- Peripheral Health Workers especially of Primary Health Care Services, Lady Health Workers, Peripheral Nurses and other field staff.
- Field staff of border armed forces, Rangers, Night watchmen, and regular police.
The project is having ability to design and implement instructional programs in local languages for any group or community on demand basis.
The description of various instructional programs are expressed onward, however it is worth to mention that most of these programs are free for the provincial government health staff and lady health workers. Any interested NGO, international collaborating agency or institution may avail these programs on cost basis. For further details please contact Project Director.
Training Objectives:
- To provide basic knowledge about venomous and non-venomous local snakes and how to live with them.
- To acquaint with information about most updated and evidence based first aid measures for a snake bite case.
- To train the Medics and Paramedics on effective treatment/ management of Snake bite cases based on Pakistan’s National Protocol of Snake Bite Management.
- To acquaint the local communities in any field operation areas regarding prevention of snake bite and first aid measures for snake bite victims.
Most of the rural areas especially in desert or arid zone in Pakistan/ Sindh is having abundance of deadly venomous snakes both of elapid and viperine families. The communities and field staff invariably meets snakes of various types while performing their routine responsibilities. They are among the highest risk groups having snake bite problem round the year especially during moon soon. The risk is enormously soaring for the staff working in desert or marshy areas along the costal border where snakes are relatively high in number. The night watchmen and the agriculture workers working in the night are more vulnerable when nocturnal snakes perceive them a hindrance while hunting their pray. In the day time although proper footwear (if used) may keep them bit safe even than various manual works without taking much care about the snakes around them make them prone for a jiffy bite by a viper or cobra creeping beneath some articles of their routine work.
Unfortunately due to none or less efficient medical care system in such remote areas the medical core services of the border forces or of some NGOs or Oil Exploring Companies like OGDC are the only reliable source for local inhabitant for seeking any remedy for various medical problems including snake bite. Interestingly the number of civil snake bite patients treated by them is much more than their own staff. Moreover field staff of these organization are having a close interaction with the local communities and it is not unusual that the villagers find them the only well oriented personnel in the vicinity thus seek guidance for various plights of their life. It is therefore they bear potential to be an effectual vector for transferring information on snake bite prevention and it’s first aid to the area communities.
There is no built in system in Government or Non Government organization working in the rural areas of the country to provide evidence based scientific information regarding local snakes, preventive measures to avoid snake bite, appropriate first aid protocol to ensure victim safety and surely their medical services are devoid of any evidence based locally appropriate approach of snake bite management. The field staff of these organizations deserve such as part of their occupational safety for which these organizations are committed to provide. The usual sources of information of this pivotal subject are the snake charmers, local Wiseman, senior colleagues, and somehow their own experience mostly based on assumptions out of some indigenous stories, disbeliefs and myths prevailing in the area. It is therefore the first aid provided to various victims is indifferent and most of the time even life threatening. It is common perception among the subject matter specialists that “it is not the venom but the first aid which harms most of the snakebite victims in developing countries”. A victim bitten by a non venomous snake does survive but the arm or leg tourniquet irrationally tightened may cause permanent disability and loss of the limb due to stoppage of blood circulation. Ingestion of heavy doses of alum, neem, tobacco, or similar articles used for neutralizing snake venom sometimes become lethal even in patient is having no envenoming.
The natural fear of snakes together with least trustable medical facilities in the remote areas leads mostly to a complex situation where the people including the peripheral staff of public and private sector organizations kill the snakes at first sight without differentiating the venomous and non venomous snakes, thus adding at large in the vastly disturbed natural eco system. The importance of snakes in desert and arid zone is quite high because they usually eat the type of mice hazardous for various crops and stored grains. In most of these areas due to scanty rain the crop cultivation is usually once in a year hence the yielded grains are very precious for the inhabitants. The safe storage of these grains is immensely important to avoid any draught situation if consumed or wasted before the next crop. Indiscriminate killing of the snakes especially when 75% of them are non venomous is causing a human harming biological imbalance. Elsewhere in the globe snakes are considered farmers friendly and are preserved to maintain the local ecosystem. The project is counseling the same in Pakistan to preserve many species of snakes about to vanish in this part of the globe. It is necessary to teach the masses how to live with snakes rather without them. Likewise it is better to move the poisonous snakes away from human settlements rather to kill them.
Perceiving well the immense need of educating various high risk groups about this pivotal issue of public health, Neglected Tropical Diseases Society Sindh Health Organization (the only of it’s type in Pakistan) assists the project in providing information, education and communication (IEC) services to the organizations and masses especially those dwell deep in the remote areas of Sindh. It is firmly anticipated that at successful completion of such programs the participants are able to:
- Differentiate between venomous and non venomous local snakes.
- Live with snakes more comfortably, and sponge harmful myths and disbeliefs about snakes.
- Apply most appropriate method of first aid.
- Get educated about scientifically proven most modern knowledge about local snakes and their importance in maintaining the natural ecosystem.
- Move safely the venomous snakes away from human settlements.
- Treat and manage snake bite cases well according to our National Protocol on Snake Bite Management.
Instructional Programs:
The program includes three sets of instructions. One comprising general information for common masses and communities at risk, the second for field staff, paramedics and ancillary staff about evidence based first aid and skilful assistance to clinicians and third comprise of specific medical information for the medical practitioners and clinicians on How to Manage a Snakebite case.
A. The General Information, Education and training of community notables, social activists, NGO field staff in high risk areas. (Five Hours Duration)
| No | Program Content | Time |
| 1 | Introduction | 15 minutes |
| 2 | Leveling of Expectations | 15 minutes |
| 3 | Knowing the existing concepts, knowledge, attitude and practices about snakes and snake bite first aid (Group discussion) | 30 minutes |
| 4 | Introduction to various venomous and non venomous snakes in Sindh in the context of training locality. 10 minutes video and demo of live snakes both local venomous and non venomous snakes. | 30 minutes |
| 5 | How to live with snakes, and some safe methods to move poisonous snakes | 30. minutes |
| Plenary | 30 minutes | |
| 6 | How to develop safe snake capturing and moving gadgets from local resources. | 1.00 Hour |
| 7 | The first aid for snakebite case. What to do and what not to do. | 1.00 Hour |
| 8 | Return Demonstration | 30 minutes |
Course fee.
Pak. Rs. 50000/ Session
Group Size.
Maximum 50-60 participants.
Award at the end.
- Brochures on Venomous snakes of Sindh (Sindhi, Urdu, English which ever asked).
- Brochure on How to prevent snakebite. (Sindhi, Urdu, English which ever asked).
- Brochure on common disbeliefs about snakes. (Sindhi, Urdu, English which ever asked).
- Brochure on frequently asked questions about snakes. (Sindhi, Urdu, English which ever asked).
- Brochure on first aid for snake bite victim. What to do and what not to do. (Sindhi, Urdu, English which ever asked).
- One snake stick / village for safely moving the snakes.
B. The Skill Enhancement Training of Field Staff and Primary Health Field Workers (Five Hours Duration).
| No | Training Content | Time |
| 1 | Knowing the existing/ local concepts, knowledge, attitude and practices about snakes and snake bite first aid (Group discussion) | 1.0 Hour |
| 2 | Introduction to various venomous and non venomous snakes in Sindh with special focus on program area specific species. Video and Live demo of venomous and non venomous local snakes. | 1.0 Hour |
| 3 | How to live with snakes, and some safe methods to move poisonous snakes. Demo with lecture. | 1.0 Hour |
| 4 | The first aid for snake bites case. What to do and what not to do. Demo of first aid with lecture. | 1.0 Hour |
| 5 | How to receive and prepare a snakebite case | 30 |
| 5 | Plenary (Question & Answers) | 20 minutes |
| 6 | Certificate Award | 10 Minutes |
Course fee.
Rs. 10000/ participant.
Group Size.
Maximum 25 participants, However minimum charges would be for 20 participants even if the number is less than 20.
Award at the end.
- Certificate of one day training program
- Brochures on Venomous snakes of Sindh (Sindhi, Urdu, English which ever asked).
- Brochure on How to live with snakes (Sindhi, Urdu, English which ever asked)
- Brochure on first aid for snake bite victim.
- Brochure on “How to receive and prepare Snakebite case”
C. Specific Training of Medical Officers on Snakebite Management (Six Hours Duration)
| No | Training Content | Time |
| 1 | Knowing the existing knowledge and practices of snake bite management (Group discussion) | 1.0 Hour |
| 2 | Multimedia presentation on evidence based most updated management of snake bite case at a Hospital/ Health Centre | 1.30 Hour |
| 3 | Introduction to National Protocol of snake bite management and how to use it. | 1.0 Hour |
| 4 | Introduction to various venomous snakes in the area and their clinical signs and symptoms. Lecture and live show | 1.30 Hour |
| 5 | Plenary (Question & Answers) | 30 minutes |
| 6 | Certificate Award | 30 minutes |
Course fee.
Rs. 50000/ participant.
Group Size.
Maximum 15 participants, However minimum charges would be for 10 participants even if the number is less than 10.
Award at the end.
- Certificate of one day training program
- Brochures on Venomous snakes of Sindh (Sindhi, Urdu, English which ever asked).
- Brochure on How to live with snakes (Sindhi, Urdu, English which ever asked)
- Brochure on first aid for snake bite victim.
- National protocol of Snake Bite Management.
D. Specific Training of Paramedics and other Ancillary Staff (Five Hours Duration)
| No | Training Content | Time |
| 1 | Knowing the existing knowledge and practices and role of paramedics in snake bite management(Group discussion) | 1.0 Hour |
| 2 | Multimedia presentation on evidence based most updated management of snake bite case at a primary health care unit level, and the role of paramedics in snake bite management. | 1.0 Hour |
| 3 | Demonstration on patient receiving, history taking and patient preparation for Medical intervention. | 1.0 Hour |
| 4 | Introduction to various venomous snakes in the area and their clinical signs and symptoms. Lecture and live show | 1.0 Hour |
| 5 | Plenary (Question & Answers) | 30 minutes |
| 6 | Certificate Award | 30 minutes |
Course fee.
Rs. 25000/ participant.
Group Size.
Maximum 20 participants, However minimum charges would be for 10 participants even if the number is less than 10.
Award at the end.
- Certificate of one day training program
- Brochures on Venomous snakes of Sindh (Sindhi, Urdu, English which ever asked).
- Brochure on How to live with snakes (Sindhi, Urdu, English which ever asked)
- Brochure on first aid for snake bite victim.
- Brochure on paramedical assistance in Snake Bite Management.
E. Mass awareness and Education program for communities.
Comprise of a film show of 1.00 Hour about venomous and non venomous snakes of Sindh, various facts about snakes, general practices encouraging snake bite, preventive measures to keep the snakes away, importance of snakes in natural ecosystem, how to move the snakes, various local first aid remedies and their possible harm for the patient, appropriate first aid methods. Afterward a one hour live demo about how to move the snakes and first aid of snake bite case. In the end no time bound plenary conducted to answer as many as questions put by the participants.
Cost / extension program
Rs. 50000/ Program
Group Size.
Maximum 100 participants, However minimum charges would be for 50 participants even if the number is less than 50.
Award at the end.
- Brochures on Venomous snakes of Sindh (Sindhi, Urdu, English which ever asked).
- Brochure on How to prevent snakebite. (Sindhi, Urdu, English which ever asked).
- Brochure on common disbeliefs about snakes. (Sindhi, Urdu, English which ever asked).
- Brochure on frequently asked questions about snakes. (Sindhi, Urdu, English which ever asked).
- Brochure on first aid for snake bite victim. What to do and what not to do. (Sindhi, Urdu, English which ever asked).
- One snake stick / village for safely moving the snakes.
Subject Matter Specialists
- Dr. Naeemul Haque Quraishi
- Dr. Mohammed Bux Bhurgri.
- Professor Dr. Jaimal Dhanani.
- Professor Dr. Allah Bux Ghanghro.
- Professor Dr. Abdullah Arejo.
- Dr. Saud Farooque (M.Phil)
- Mr. Zahoor Ahmed Khoso (M.Phil)