Demow: In a landmark public health achievement, Demow Rural Hospital in Assam has recorded zero snakebite-related deaths for five consecutive years from 2021 to 2025, a rare feat for a rural healthcare facility functioning without intensive care infrastructure. Snakebite remains a major public health challenge in Assam, particularly affecting rural and economically vulnerable populations. However, Demow’s experience has demonstrated that timely, protocol-based treatment at the rural level can significantly reduce mortality, challenging the traditional dependence on referrals to tertiary hospitals.
Snakebite treatment services were introduced at Demow in 2018. Prior to this, most cases were referred elsewhere due to limited local capacity. Through systematic training, regular case reviews and strong community engagement, the hospital developed a standardised treatment guideline known as the “Demow Protocol.” The protocol focuses on early reporting through community participation, mandatory 24-hour observation after a bite, prompt administration of anti-snake venom based on clinical indication, uniform treatment irrespective of socioeconomic status, and syndrome-based management tailored to Assam’s snake species.
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Between 2018 and 2025, Demow Rural Hospital managed 3,560 snakebite cases, with reporting increasing steadily as public trust grew. Of these, 511 cases were venomous. Except for a single krait-related death in 2020, no fatalities have been reported since 2021. Explaining the significance of the achievement, programme lead Surajit Giri said snakebite deaths are largely preventable if patients reach hospitals early and treatment protocols are followed strictly. He credited healthcare workers and community cooperation for the success. The Demow model has drawn attention at state, national and international levels, with several hospitals in Assam replicating its approach. For a state with one of India’s highest snakebite burdens, Demow now stands as a scalable, life-saving rural healthcare model.
