Demow Rural Hospital has successfully recorded zero snakebite-related deaths for five consecutive years (2021-2025), exemplifying effective healthcare management in rural settings. This achievement stems from the implementation of protocol-based treatment, extensive training of staff, and strong community involvement in addressing snakebite cases. Snakebites remain a significant public health issue in Assam, predominantly impacting rural and economically vulnerable groups. Traditionally, victims were sent to tertiary care centers due to fears regarding inadequate local resources. However, Demow Rural Hospital’s experience indicates that prompt and consistent management of snakebite envenomation can be effectively managed at peripheral healthcare institutions.
Since initiating snakebite treatment services in 2018, the hospital has transitioned from referring patients to higher facilities to developing its own treatment protocols. This shift was facilitated by systematic training and increased community participation, which led to the creation of the “Demow Protocol.” This guideline promotes early reporting through community education, ensuring 24-hour medical observation post-bite, timely anti-snake venom administration, equitable treatment access irrespective of economic status, and clear identification of local venomous species and their complications. As trust in local medical services increased, there was a notable rise in case reporting. Remarkably, while one death occurred in 2020, the hospital has seen no fatalities from 2021 to 2025, treating over 3,500 snakebite patients during this timeframe without a single death—an unprecedented record for a rural facility without advanced intensive care capabilities.
From 2018 to 2025, the hospital managed a total of 3,560 snakebite cases, with venomous bites comprising 14.33% (511 cases). The breakdown of venomous cases revealed 314 from pit vipers, 96 from monocled cobras, 82 from red-necked keelbacks, and 19 from kraits, with only one death in 2020 attributed to a krait bite. State-level data indicates Assam had around 10,650 snakebite cases in 2024 and approximately 11,250 in 2025, with snakebite fatalities continuously decreasing—from over 150 in 2022 to 27 in 2025. The success of the Demow Model has gained recognition at multiple levels, including evaluations from the Indian Council of Medical Research (ICMR) and presentations at governmental and international forums. Following the model’s success, snakebite treatment services have been bolstered across rural and district hospitals in Assam, highlighting the importance of primary and secondary healthcare in managing snakebite cases. Demow Rural Hospital’s accomplishments demonstrate that with a disciplined approach, trained healthcare personnel, and active community engagement, preventable deaths due to snakebites can be effectively eliminated even in rural environments with limited resources.