Priyanka Kadam woke up at 6 a.m. on a cool February morning and reached for her phone out of habit. As she checked her notifications, one from the "Snakebite Interest Group" WhatsApp group caught her attention. Kadam, an admin of the group, is the President and Founder of the Snakebite Healing and Education Society, which addresses snakebite and snakebite-related issues in India.
She opened the app to find over a hundred messages detailing a life-or-death situation that had unfolded overnight.
At 2 a.m., a doctor in a rural primary healthcare center (PHC) had posted about a patient showing signs of a snakebite. Unsure of the diagnosis and with limited resources, he sought advice from the group. A young, keen doctor responded promptly, guiding the treatment that ultimately saved the patient's life.
“When we woke up, there were numerous messages in the group discussing what had transpired overnight,” said Kadam. “We felt immensely proud that one doctor's knowledge and willingness to help had made a significant difference.”
This incident underscores the power of the Snakebite Interest Group, a WhatsApp community formed in 2015 by Dr. Dayal Bandhu Majumdar. A veteran of the West Bengal health department, Dr. Majumdar founded the group to address the gaps in snakebite treatment he had encountered during his 30-year career.
In India, snakebites are a significant public health issue, with the World Health Organization estimating about 5 million bites annually, resulting in 81,000 to 138,000 deaths and up to 400,000 amputations and other disabilities. Despite this, India's undergraduate medical curriculum often lacks updated training on snakebite treatment, leaving many doctors ill-equipped to handle such cases.
The Beginning Of A WhatsApp Group
Dr. Majumdar, who has worked in healthcare for 30 years, vividly recalls the time in 2007 when he frequently encountered snakebite patients at the Habra State General Hospital in North 24 Parganas district. Many patients had to be referred to hospitals in Kolkata, and some didn’t even survive the journey.
Through research and advocacy, the doctor engaged policymakers and secured resources for training doctors. Recognising the potential of social media, he launched the WhatsApp group, now boasting over 450 members, including doctors and activists from 17 Indian states, Nepal, and Bangladesh.
The group operates as a real-time support network where experienced doctors assist their colleagues in diagnosing bites and recommending treatments.
An example of its impact occurred in 2015 when a woman visited the Dhaniakhali rural health center in Hooghly district, West Bengal, complaining of stomach aches. The attending doctor treated her stomachache that night. However, the next day, she continued to experience stomach aches.
Soon, she started experiencing numbness and difficulty articulating sentences. The doctors at the health center referred her to the Burdwan Medical College. Before she could be transferred, Dr. Sheikh Rajib, a doctor at the health center, noticed that she had drooping eyelids, a classic symptom of a poisonous snakebite.
To confirm his suspicion, he took a picture of her face and described the symptoms in the WhatsApp group.
A senior doctor in the group recognised the symptoms of a painless snakebite and immediately advised Dr. Rajib to start anti-venom treatment. The patient finally recovered.
India’s undergraduate medical curriculum is woefully inadequate in training doctors to treat snakebites.
“In medical textbooks, the treatment protocols for snakebites are not updated. Doctors who haven't encountered snakebites or received specific training on the topic will typically follow what they've learned in their textbooks, which are often outdated, sometimes even 20 or 30 years old,” said Gerry Martin, herpetologist and founder of The Liana Trust, an Environment and Wildlife NGO.
In rural areas where snakebites are common and resources are limited, young doctors often struggle to accurately diagnose and treat snakebites due to insufficient training and the absence of protocols. The WhatsApp group's efforts have played a significant role in saving many lives in such situations.
Beyond Borders
Dr. Md. Abul Faiz, a professor and president of the Toxicology Society of Bangladesh (TSB), is also a member of the Indian ‘Snakebite Interest Group’ on WhatsApp. Meanwhile, the "Snakebite Support Group" in Bangladesh, overseen by TSB members, operates 24/7 to support young doctors in remote areas, offering advice on species identification, treatment protocols, and managing antivenom reactions.
Through Faiz’s work and association with global entities like the World Health Organization (WHO), he has built a broad network of colleagues working on snakebites in India, Sri Lanka, Nepal, Thailand, and Myanmar.
Although not social media-savvy, Faiz joined this group to support healthcare professionals working in this area. Snakebite management is a neglected area globally, especially in South Asia, which bears the highest burden of snakebite.
“These professionals often work in small groups or alone and might benefit from support in various aspects such as identifying bites, categorizing them – whether they are venomous or non-venomous, determining if they need antivenom, and knowing what to do if they have antivenom reactions. This initiative is essential for better snakebite management,” he said.
The group has an understanding with the Directorate General of Health Services (DGHS) and an MoU with the DGHS, which officially permits them to provide reliable advice. The group members are well-known and trusted within the country's healthcare professional community.
Like the group in India, this group allows participants to post scenarios and problems, such as species identification or pain and other management, and seek necessary interventions.
This group has regularly held monthly clinical meetings for the past few years. Sessions last for one hour and feature presentations by young doctors. Following each presentation, healthcare professionals nationwide discuss it, with around 200 people attending each session.
“Through the group, senior clinicians and scientists promote best practices and empower young professionals and the community to take responsibility for providing appropriate care, adopt prevention practices, and seek prompt scientific treatment in small hospitals,” said Faiz.
According to Faiz, WhatsApp is beneficial because it allows for transferring photos and videos, enabling real-time observation of patients.
“Despite occasional connectivity issues, it is valuable as it enables people to connect with us even from remote areas,” he said.
A WhatsApp Chatbot
Animal welfare organizations like The Liana Trust and Humane Society International (HSI) India are also leveraging technology to address snakebites. They have collaborated with The Liana Trust to develop a WhatsApp chatbot providing information on snakebite prevention and first aid. This pilot project in Mysore aims to improve healthcare access and will expand based on community feedback.
“We aim to create a district-scale model for tackling the problem. We currently work in the Mysore district, focusing on various aspects directly or through collaborations,” said Martin.
“We are working to improve our understanding of the ecology and behavior of snakes within agricultural landscapes independently. We collaborate with Humane Society International India for our outreach and awareness efforts, as well as understanding the socio-economic and psychological impacts of snake bites and contributing to mitigation efforts,” he added.
Sumanth Bindumadhav, Director for Wildlife Protection at Humane Society International (HSI), India, said that treatment improvements and policy changes are needed, but prevention is the best approach.
Considering the organisation's size and the limited workforce, it became difficult for the team to cover all areas simultaneously. So, they started brainstorming about the most effective ways of reaching people.
“We had an idea: what if we could provide information on preventing snakebites and what to do in case of a snakebite, available in both Kannada and English, directly on a person's phone? This way, they would have it available whenever they choose to access it,” he said.
HSI conducted a survey in the Mysore district and found that WhatsApp is one of the most used digital apps. They had been working with The Liana Trust on capacity building and with the health department, which led them to consider creating a chatbot collaboratively.
“It would be interactive, and people would select the information they need and receive only that without overwhelming their memories,” said Bindumadhav.
Both organisations collaborated with Tech4Dev to develop the chatbot, customize it, and create the content. Liana Trust's specific role included assisting the HSI team in delivering content to the people, testing the chatbot in small focus groups within the community, and ensuring that people receive personalized information.
The WhatsApp chatbot is being piloted in Mysore to test its feasibility and because the organisation’s work on human-snake conflict is primarily concentrated in the Mysore district. The project will be gradually scaled up to other places depending on the feedback and uptake from people and communities.
The automated chatbot can be accessed via a QR code or by messaging "Hi" to +91 9154190472. After selecting the language between Kannada and English, the user will be asked for permission to access their location. Following this, they will be presented with options for more information.
For now, people will receive four layers of information—information on snakes in their vicinity, including myths surrounding snakes, how to avoid snakebites and first aid for snakebites. Once these facilities are in place in the health department, more information on the nearest hospital that treats snakebites and ambulance services will eventually be added.
"We are working with the department to improve the healthcare infrastructure. We aim to ensure that when we direct people to a hospital, they can receive necessary treatment without being referred elsewhere. It would undermine the bot's effectiveness and reflect negatively on us if we suggested a place that couldn't provide adequate care," explained Bindumadhav.
To prevent this, HSI and The Liana Trust aim to enhance the local healthcare capacity first and then incorporate that information into the bot.
Technology Bites
However, the rapid adoption of digital tools raises ethical and privacy concerns. HSI and The Liana Trust said that they prioritise data security, using encrypted platforms and multi-factor authentication.
“People who get in touch with us share their phone numbers and, in some cases, their location from where they are reaching out. It's important for these conversations to remain secure,” said Bindumadhav.
All the data is stored on Google Cloud Storage, which has its own ways to keep it safe on its servers, including different backup plans. They also use multi-factor authentication for all the data accessed on the back end. This means that even if there is a security breach, unauthorized people won't be able to access the data of those who have contacted them.
Dr. Faiz stressed on the importance of consent and privacy, cautioning against premature diagnosis and the potential negative perceptions of doctors using WhatsApp during consultations.
“If a person is attended to very early, and there are no clinical signs of venomous toxicity, someone may give the wrong advice that the bite is non-venomous. The standard rule is to admit patients for 24 hours and observe them meticulously. Unless you observe for 24 hours, you cannot confidently say that the bite is non-venomous,” he said.
Faiz also pointed out that there has not been much dialogue on providing support and medical care while following social media etiquette, medical ethics, and informed consent.
“This is a two-way process. The community needs to be involved, and healthcare professionals should behave responsibly, treating patients as human beings rather than mere subjects. We must always be supportive and empathetic to fellow human beings who are in crisis or facing problems and ensure we do not exploit them in any way,” he added.
Despite these challenges, the impact of these digital initiatives is undeniable.
Through her network and collaboration, Priyanka Kadam has added experts and doctors from 16 Indian states to the Snakebite Interest Group.
Martin suggested that the government should be proactive in using technology to prevent snakebites, as communities tend to heed communications from government departments, especially the health and agricultural departments and the panchayats.
Meanwhile, Dr. Majumdar, working with the West Bengal health department, has trained over 8,000 doctors in snakebite care and developed a treatment protocol that has been distributed to all health centers.
Efforts are now underway to update the undergraduate medical curriculum.
