Demow Rural Hospital has successfully recorded zero snakebite-related deaths for five consecutive years from 2021 to 2025, underscoring the effectiveness of its protocol-based treatment approach, skilled personnel, and community involvement in managing snakebite cases. Snakebites remain a significant public health issue in Assam, particularly among rural, economically disadvantaged populations, which typically necessitated referrals to tertiary care due to the lack of local capacity.
Initiated in 2018, the hospital developed its snakebite treatment services, transitioning from referring patients to managing cases directly. This was achieved through systematic training, enhanced clinical competence, and increased community engagement, resulting in the establishment of the “Demow Protocol”. This protocol prioritizes early reporting, 24-hour observation, timely anti-venom administration, uniform treatment regardless of socioeconomic status, and the identification of local venom syndromes.
From 2018 to 2025, the hospital treated a total of 3,560 snakebite cases, of which 511 involved venomous bites. The venomous profile included various species, with only one death occurring from a krait bite in 2020, displaying improved community trust leading to better reporting. Comparatively, Assam reported about 10,650 snakebite cases in 2024, with related deaths steadily decreasing.
Recognized at multiple levels, the Demow Model has been scientifically evaluated by the Indian Council of Medical Research (ICMR) and presented in various forums. The success of this model has prompted enhancements to snakebite treatment services across rural and district hospitals in Assam, validating that effective management of snakebite envenomation is achievable in resource-limited settings with structured care and community engagement.
