Dear Neil, I have been following the Snake bite discussion with interest.
Over several years in many countries I have taught that Traditional Healers are first on call and many now have mobile phones. A photo can send a picture to the nearest antivenom centre who in their interests may provide THPS with training and even with phones. Though not yet reliable it will become so as solar panels become more locally available. and a decision whether Antivenom is needed (regional variation in efectiveness is still a problem and purchasing antivenoms which will not work is is an unacceptable expense.) can be followed by delivery by contemporary robots (Drones). Modern science has established that treatment should delay venom spread through the lymphatic system by immobilisation and by avoiding a long bumpy journey, Howarth DM ,Southhee Ae, Whyte IM, Lymphatic flow rates and firstaid in simulated peripheral snake or spider envenomation Med J Aust 1994 161:695-700.
Reassurance is therapeutic since fear can kill. and the THP [Traditional Health Practitioner] is often best at this especially if the patient thinks witchcraft is the reason for being bitten. Avoiding scarification and tourniquets. This should be taught through Associations of THPS as I demonstrated years ago in Sierre Leone. Not only are they first on call but they are numerous. Antivenom centres should learn how best to use this rich facility. It should not be forgotten that footwear is protective.
HIFA profile: Terence Ryan, an Emeritus Fellow of Green /Templeton College Oxford, is a Dermatologist whose activities have a broad remit of global skin care. Since retirement from a full time consultant post in the NHS in 1997 and the title of Professor from both Oxford Universities he has been a member of all governing bodies of his profession (President International Society of Dermatology, Member of the International Committee of Dermatology, Chairman of The International Foundation of Dermatology). Currently he is Chairman of the International Society of Dermatology Task Force for Skin Care for All : Community Dermatology. He has travelled widely as an advisor to LEPRA and the St Francis Leprosy Guild. As an expert in the management of Lymphoedema he is an Adviser to the Global Alliance for the Elimination of Lymphatic Filaraiasis and to the Institute of Applied Dermatology Kasargod, Kerala which is Integrating Indian Systems of Medicine with Biomedicine especially in the management of 'elephantiasis' due to Lymphatic Filariasis or conditions requiring palliative care. He has negotiated a Humanitarian "Gift" of 'PUR' a technology to make washing and emollients globally available from Procter and Gamble. He has received Life time Achievement Awards from several International Organisations. He holds titles of professor at Jefferson Philadelphia, Beijing, Nanjing, Missouri and Limerick Universities and a doctorate at Martin Luther University Wittenberg /Halle. When in Oxford he is an Archivist of the history of Medicine at the home of Sir William Osler, 13 Norham Garden. userry282 AT aol.com