How do you get someone who lives in India to care about people in Uganda?
That’s the challenge for journalists who try to tell stories about parts of the world that most of the press ignores. Correspondent Enock Wanderema is from Uganda and wants the world to know what happens there.
For a story about the widespread government corruption he focused on one woman, Aloikin Praise Opoloje. Wanderema tells us this story about Opoloje giving birth in a hospital that had been starved of resources because of government corruption. He writes:
…she watched the midwife try to manage multiple births at once. Opoloje could tell she was exhausted. “One of the women was in critical condition, but the surgeon who was supposed to operate was nowhere to be found,” Opoloje said. “We tried calling him, but he wasn’t picking up.”
Wanderema used what we call an anecdote to help bring the complicated story of government corruption to life. Anecdotes are little stories about something that happened to someone. People tell little stories about themselves all the time.
Bring the story to life.
In interviews savvy reporters will focus attention on these little stories and try to get as many details as they can. When did this happen? Where were you exactly? What time of day was it? Were there people around? What did it sound like?
A good reporter knows that the little details help make a story three-dimensional for readers or listeners. It helps place the reader there as it is happening. And if people feel like they are there, they will care.
High school student Helen Milito wrote about her experience spending a year studying in Italy with School Year Abroad. To show how different she felt and how much it took her out of her comfort zone she gave this story:
We were split into two teams scrimmaging against each other. The boys I play with are competitive so there was the usual light trash talking, jersey pulling and agile foot skills.
We were playing friendly rules with no corner kicks. My teammate, Gugu, was fouled in the makeshift goalie box and dramatically fell to the ground yelling for a penalty kick.
None of us expected the coach to listen to him, but surprisingly he gave it to our team on the condition that I take the kick. All the players lined up around the box as I prepared to shoot, choosing to aim for the bottom right corner.
Two things you should know: First this is in Italy and I’m an American teenager who speaks little Italian. Second, I’m the only girl on the team.
The coach blew the whistle. I confidently ran, kicking the ball with all my strength. It went soaring over the crossbar into the fence behind. I wanted to crawl into a hole and hide.
Note how she shows us visually what is happening through action: “there was light trash talking, jersey pulling and agile foot skills.” She includes the sound of the coach’s whistle. And she gives us emotion: “I confidently ran…”, “I wanted to crawl into a hole…”
Telling other people’s stories
Correspondent Leah Pattem felt compelled to report how people in Madrid were suffering from high rents. To do that, like Wanderema, she found one woman whose story she could tell.
Pattem wrote:
Now in her 80s, [Marjorie] Kanter is at the peak of her career, author of three books and an active member of Madrid’s writing community. “I don’t have many more years left, so I really want to enjoy being a successful writer for as long as I can,” she said.
However, Kanter is facing a major setback. In September, a registered letter demanded she vacate her home at the end of October. A Galician vulture fund had purchased her apartment and didn’t offer her a new higher-priced rental contract. She suspects that means they will convert her home into a tourist flat.
The thing is, people don’t offer up anecdotes without prompting. They don’t think reporters are interested in the little stories they tell their friends. And there is a general rule in interviewing that people won’t answer unasked questions. So to get the anecdote you need to tease it out of the person you interview question by question.
Here are some questions that are useful in teasing out a little story:
Can you remember the first time you did that?
Can you remember the scariest time?
Can you think of a time when that happened to you?
Drilling down
Ask questions to jog a person’s memory. They’ll say, “There was this one time that …”
All the time, write down what they say and pester them for details. Imagine that the person is your grandfather and you are five years old. You will keep interrupting him to ask for details he doesn’t think is important but is important to a five-year old: What were you wearing? Was it cold? What did it smell like? Were you scared? Were you hungry? How old were you? How tall were you?
The key is to drill down. When someone says something, ask for specifics. When did that happen exactly? Where was that? Who else was there? No detail is too small or insignificant because to recreate a scene and you need to paint a complete picture.
Anecdotes are great ways to start articles. They grab the attention of readers and get them interested enough to read on.
After all, who doesn’t want to hear a good story?
Three questions to consider:
1. What is an anecdote? 2. How can anecdotes help you tell a complicated story? 3. Can you think of a little story you have told your friends or family about yourself?
If you’re worried about losing your benefits, you’re not alone. With new budget resolutions and lawsuits targeting SNAP, Medicaid, and student loan forgiveness, millions of Americans could be impacted.
HOUSTON — Jefferson Early Learning Center bears little resemblance to elementary schools many adults recall attending in their earliest years. The classrooms have child-sized boats and construction vehicles children can play on, and ceilings painted to resemble outer space. There are no desks — all space is devoted to learning through play. Windows are low to the ground so children can easily look outside. The gym floor is made of “pre-K friendly” layered vinyl, rather than hardwood, to cushion inevitable trips and falls. Hallways are lined with a corrugated plastic for wiggly fingers to touch as children transition to other locations.
Children love coming to the building, said teacher Cathy Delamore. “They feel like they own it.”
Alief Independent School District, which serves about 40,000 children in west Houston, is one of a growing number of districts across the country to pump money into creating a building that is tailor-made for pre-kindergarteners. Its new facility cost about $21 million and enrolls nearly 400 4- and 5-year-olds. By making the investment, school leaders are trying to avoid some of the pitfalls of placing young children in buildings designed for older students, including lost learning time when tiny feet have to meander down long hallways to bathrooms and cafeterias. Research suggests that when designed well, buildings can contribute to better outcomes for children. Creators of the Reggio Emilia approach to early learning, an educational philosophy that emphasizes child-led learning, even refer to the environment as the “third teacher” in a classroom.
A Gulf Coast themed classroom at Jefferson Early Learning Center. The themed classrooms reflect local careers and locations to help children connect what they learn with their local environment. Credit: Jackie Mader/The Hechinger ReportThe “Space City” classroom at Jefferson Early Learning Center is an homage to the local NASA space center. Credit: Jackie Mader/The Hechinger Report
Over the past few years, educators have grown aware of the benefits of a personalized pre-K environment, said Melissa Turnbaugh, a senior principal at the architecture firm PBK, which has designed more than 240 elementary schools nationwide, including Jefferson and several others in Texas. “There’s an openness and willingness to rethink these sites,” Turnbaugh said.
Related: Young children have unique needs and providing the right care can be a challenge. Our free early childhood education newsletter tracks the issues.
Nationally, districts of all sizes have embraced the trend over the past few years, including the Troy School District in Michigan and New York City Public Schools. In some cases, building a specialized facility helps a district with limited resources get “the biggest bang for their buck,” while meeting enrollment needs, said Turnbaugh. Some states and cities are also dedicating money to the efforts, including Illinois, Detroit and San Mateo, California.
That embrace is in part because of a growing recognition nationwide of the importance of play for young children, as well as reports that play time has been increasingly squeezed out of the early grades. States are also seeing record high enrollment in state-funded preschool programs. During the 2022-23 school year, investment in state-funded preschool reached an all-time high. Spending on the programs increased in 29 states, buoyed in part by Covid relief funds. Between 2022 and 2023, for example, Texas saw more than 21,000 additional 3- and 4-year-olds enroll. The state also slightly increased pre-K funding and, beginning in 2019, started requiring districts to offer full-day pre-K programs. The full-day programs have been rolling out in districts since 2020.
Scores of districts are “adding this new grade of 4-year-olds,” said Shelly Masur, vice president of advisory and state policy for the Low Income Investment Fund, which runs an initiative focused on creating and improving high-quality facilities for early learning programs. “They have to figure out where those kids are going to go.”
A facility built for their needs, like Jefferson, is exactly where young children should go, some experts say. The children seem to agree.
On a sunny fall morning, joyful screams could be heard as children chased each other up and down gentle hills on a large playground with natural-looking features meant to replicate the highlands and lowlands of Texas. Pre-K students in elementary schools don’t always have age-appropriate playgrounds, and structures are often designed for children who are older. But Jefferson has multiple large playgrounds and play courtyards, all designed for pre kindergarteners, featuring natural structures and textures, like logs and grass.
A playground at Jefferson Early Learning Center. Credit: Jackie Mader/ The Hechinger Report
In Alief, where more than 83 percent of children qualify as economically disadvantaged, more than 20 percentage points higher than the state average, residents voted in 2015 to approve a property tax increase to help pay for full-day pre-K programs in the district. After touring the Mansfield Independent School District’s early learning facility, Alief’s district leaders decided they wanted to invest in an early learning building with immersive, themed classrooms, instead of simply adding on or repurposing classrooms in elementary schools around the district. Jefferson opened in 2022 as one of two new early learning facilities in the district. About 6 miles away, the second, Maria Del Carmen Martinez Early Learning Center, which has a similar design, serves around 400 students.
A growing body of research shows that not all pre-K classrooms, or the facilities they’re housed in, are appropriate for young kids. Early learning settings in particular should have a warm, homelike environment with ample natural light, research shows. There should be spacious classrooms that allow children to move their bodies and play in a variety of spaces around the room. Facilities should have playgrounds that are appropriate for the littlest learners, and provide ample opportunities to experience and explore nature.
There are also practical details to keep in mind for preschoolers, like having bathrooms adjacent to classrooms, child-sized furniture, tiny toilets, and sinks low to the ground so children can practice routines like hand washing independently. “When we make things more accessible to them, they start to learn the independence that we need them to develop over time,” said Masur. This type of setting isn’t always present in elementary schools, which are built to accommodate a much wider age range of children and are typically designed for instruction rather than play.
Facilities can have a surprisingly large impact on the experiences of teachers and young children. A study of a preschool program in West Hartford, Connecticut, for example, found the amount of children’s time spent interacting with an adult caregiver increased from 3 percent to 22 percent after the program moved from a crowded basement room to a larger classroom with bathrooms, sinks, storage space and phones inside the classroom. Although all other factors remained the same, the teachers reported their students had fewer tantrums, something they attributed to having a larger, brighter and more organized space.
A facility can even affect how satisfied early educators are with their jobs. Delamore, the Jefferson teacher, who has worked in the district for 18 years, said the bright, spacious rooms and hallways help keep her from feeling “confined” during the day. While aimed at 4-year-olds, the building’s “calming atmosphere” helps her enjoy being at work, she said.
A student builds with blocks in a classroom at Jefferson Early Learning Center. The facility was built with 4- and 5-year-olds in mind and unlike elementary schools, revolves mostly around play.
Certain aspects make more sense for children at this age, she added, like the spiral shape of the building, which makes it easier to keep students together as they transition. Students eat family-style meals around circular tables, creating a sense of community, Delamore said, a contrast to the long, rectangular tables often seen in elementary school cafeterias.
Buildings that are not designed to meet childrens’ needs, or that are cramped and outdated, can impede development and learning, experts say.
One of the most recent examples of this comes from a 2016 study of Tennessee’s public preschool classrooms, which are mostly housed in existing elementary schools. That study, conducted by researchers at Vanderbilt University, found 25 percent of each school day was lost transitioning children to another activity, including walking to bathrooms and lining up to go to lunch.
When designing Jefferson, Turnbaugh and her team tried to “think of the campus through the eyes of a 4-year-old.” Delamore, at Jefferson, said the intricately-designed classrooms motivate students to go deeper in their play. On a recent morning in the “veterinary” classroom, a dozen 4- and 5-year-olds busied themselves around the room, immersed in play or small group work with a teacher. Children drew pictures of animals, read books and played animal-themed card games beneath large, colorful pictures of dogs and cats painted on the walls.
On one side of the room, 4-year-old Jaycyon had donned a white lab coat and was inspecting a fluffy gray and white toy cat lying on the counter in front of him. The cat was hurt, Jaycyon announced, likely from a sharp corner of the cage he was kept in.
“I have to give him a shot,” he said bravely. Jaycyon dipped a clear, plastic syringe into an orange medication bottle and confidently injected invisible medication into the cat.
At the end of three weeks, Jaycyon and his classmates will transition to a new classroom, such as “Tinker Town,” where they will learn about construction, or “Space City,” an homage to the nearby NASA space center.
On a daily basis, students have access to one of several outdoor spaces called a “back porch,” where families can also come and eat lunch together. These spaces also act as surrogate back yards for students, many of whom don’t have yards at home or access to parks. Students also have access to a sensory room with toys and soft mats, where they can take a break when they are overstimulated and practice skills to calm down.
Jefferson sits on nearly 20 acres of land, accessible via trails for students to explore with their teachers. (Alief returned the surrounding land back to its natural prairie state to help with climate-change related flooding.)
The educators at Alief say the district’s investment in a facility that encourages play-based learning has paid off. “What I see as a major difference is the children’s self-regulation, but also their confidence,” said the school’s principal, Kim Hammer, now in her 16th year leading an early childhood center. “A traditional pre-K setting is more teacher led and teacher directed,” she said. “Here it’s more teacher facilitated, so you see more of the children taking more initiative,” she added. “Children have autonomy, and children have much more choice.”
Two students play in a veterinary-themed classroom at Jefferson Early Learning Center. Each classroom is designed with a specific theme to encourage deeper play. Credit: Jackie Mader/ The Hechinger Report
There is evidence that the new facility may be helping children progress. During the 2023-24 school year, 49 percent of students came in meeting vocabulary benchmarks. By the end of the year, 73 percent were at that level, Hammer said, a higher rate than previous years when the district’s pre-K programs were in traditional elementary schools. School officials say the themed classrooms help enhance children’s language skills, as children learn the vocabulary specific to that room. Attendance rates are high and holding steady, something that is uncommon in pre-K.
Despite the success and benefits of programs like Jefferson’s, educators agree there are challenges. A pre-K only facility adds an extra transition for students who, in traditional programs, might otherwise attend pre-K at their home elementary school.
Without more funding, revamped pre-K facilities are unlikely to spread fast. Many districts lack the money, partly because state and federal funding for pre-K is often less than for other grades. In Texas, for example, although the state now requires districts to offer full day pre-K, it only provides funding for half a day of pre-K. Alief has to cover the rest from local funds.
Although sustaining the building will be financially challenging in the long run, educators are determined to find a way to make it work for the benefit of the kids.
Back at the veterinary center on that fall morning, Jaycyon finally had a breakthrough. He had discovered something alarming about his patient, or “kitty,” as he had been named by the pre-kindergarteners, that would direct his next veterinary tactics.
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As we head towards the federal election, both sides of politics are making a point of criticising universities and questioning their role in the community.
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While consequential for all of higher education, pending and potential moves by the Trump administration that implicate funding could especially affect what has become an increasingly dominant aspect of multiple universities in terms of budgets and focus—academic medical centers (AMCs). AMCs are major funding recipients from the National Institutes of Health, the National Science Foundation and other federal agencies. AMCs and their health enterprises also are deeply connected to patient care programs like Medicare and Medicaid.
Media outlets covered the “confusion and chaos” that beset university presidents, medical center vice presidents, deans and researchers after the initial federal funding freeze. Now that the freeze has been temporarily rescinded, leaders of academic medical centers should move beyond confusion and chaos to focus on public presentations that emphasize their competence, compliance and cooperation with federal reviews. Now is an opportune time to pick up on President Trump’s recent emphasis on “merit” as the key to gaining federal support. University academic medical centers are well positioned to demonstrate and document their case.
To showcase “merit,” for example, a university academic medical center could cite ratings and commentaries about its successful NIH grant proposals, illustrating the talent and competitive advantages of its principal investigators and research teams. And they should emphasize that the NIH-funded research projects are not isolated: They are inseparable from a cooperative network within university health centers and hospitals. Evaluating these complex applied research alliances helps answer external questions about efficiency, effectiveness and significance of projects. The same kinds of questions are continually monitored in analysis of existing and new university degree programs for the education of medical doctors, nurses, physician assistants, pharmacists, medical technicians and health-care administrators. In addition to evaluating the training and preparation of researchers and health-care practitioners, an AMC pays systematic attention to accountability and responsibility for patient care and treatment as part of its daily and annual operations. These stories need to be told.
There are other sources that can be used to document AMC merit and performance. One can look at accreditation reports, specialized degree program reviews and financial balance sheets for the mosaic of health services and programs that are housed under the umbrella of an academic medical center. Institutional data can show that an academic medical center that aligns colleges of medicine and health care with such disciplines as biochemistry, physiology, bioengineering and statistics has evolved into a dynamic institution in which practice and advanced research are intertwined with providing professional services within a community.
A few summary statistics indicate this presence. The top 20 university AMCs each brought in more than $400 million in NIH research grants in fiscal year 2023. Within this group, Johns Hopkins University is first, with $843 million, followed by the University of California, San Francisco, with $789 million, and in third place, the University of Pennsylvania with $703 million. These are the peak of a cluster of 220 university medical centers in which academic programs such as the college of medicine partner with university medical foundations.
The fusion represents a new academic model in which the medical and health programs typically constitute about 60 percent or more of the total university budget. At universities with this structure, the AMC typically is home to a majority of the university faculty positions and student enrollments. The AMC also becomes a major economic force and employer in metropolitan areas and regional communities.
The academic health and medical complexes are economic engines. They often are the largest employer in the metropolitan area or even in the state, such as is the case for the University of Alabama at Birmingham and its health system. Universities in this category are the major provider of health services to large constituencies of patients. This academic health organization includes partnerships with Medicare, Medicaid and private insurance companies. Federal grants for research and service to the university often stimulate state financial support in terms of program grants and capital funding from state legislatures and governors and major gifts from foundations and private donors.
The message for “merit” is that these universities represent a new type of American organization—what might be termed the academic health business model. An abundance of quantitative and qualitative data makes external evaluation and detailed analysis of accountability possible. Sound policy evaluation from several constituencies—the executive branch, Congress, federal and state agencies, university leaders, and patient advocacy groups—calls for thoughtful, informed analysis to review and perhaps renew what has evolved as a distinctive academic enterprise.
A lively dialogue about the promises and benefits of AMCs that includes consideration of recent executive actions and potential future decisions, such as funding levels for Medicaid, is timely. The events of the last two weeks provide a much-needed moment for academic constituencies to reflect on what the expansion of AMCs means for individual research universities and higher education broadly in the future. If a funding freeze causes a chill for AMCs and their health enterprises, does the rest of the campus catch a cold, or even worse?
Recent presidential actions from Washington, D.C., have highlighted how much the budgets and identities of some research universities are more and more defined by their AMCs. In addition to helping AMCs continue to sustain and enhance their vital missions, all higher education groups need to contemplate the implications for universities whose mission and purposes are increasingly characterized and shaped by their academic medical centers.
John R. Thelin is University Research Professor Emeritus at the University of Kentucky. He is the author of several books on the history of higher education.
Neal H. Hutchens is a professor in the Department of Educational Policy Studies and Evaluation at the University of Kentucky. His research focuses on the intersection of higher education law, policy and practice.
A new year is underway, but many colleges are still reeling from the fiscal challenges of 2024.
With yawning budget gaps and bleak financial projections at some campuses, administrators are cutting jobs, academic programs and athletics options to plug holes and stabilize their finances.
Here’s a look at cuts announced in January.
Sonoma State University
Facing a budget deficit estimated at nearly $24 million, the California State University campus is enacting deep cuts that will include dismissing dozens of faculty members, eliminating multiple programs and dropping athletics, according to an announcement from interim president Emily F. Cutrer.
“The University has had a budget deficit for several years. It is attributable to a variety of factors—cost of personnel, annual price increases for supplies and utilities, inflation—but the main reason is enrollment,” Cutrer wrote in an announcement last month.
She added that Sonoma State’s enrollment has dropped by 38 percent since 2015.
On the personnel side, 46 faculty members, including tenured as well as adjunct professors, will not have their contracts renewed for the next academic year. An unspecified number of lecturers will also receive notices that “no work will be available in fall 2025,” Cutrer wrote. Four management and 12 staff positions are also being eliminated as part of Sonoma State’s cost-cutting measures.
In addition, more than 20 programs have been identified for closure and others will be combined. University officials are also looking to close a half dozen academic departments.
All 11 SSU athletic programs, which compete at the NCAA Division II level, will be eliminated. However, SSU coaches have announced plans to file a lawsuit in an effort to save their sports.
California State University, Dominguez Hills
Anticipated budget cuts also drove layoffs at this CSU campus in Southern California, which let go 32 employees last month, many probationary or temporary workers, LAist reported.
“While these layoffs will be disruptive to our operations, the vast majority of our staff will remain employed at CSUDH continuing to provide the high level of support to our community that we are known for,” President Thomas Parham wrote in an email.
Other institutions across California are also likely to introduce cost-cutting measures in the coming months due to anticipated decreases in state appropriations that will limit funding. The 23 institutions in the CSU system are bracing for state budget cuts of nearly $400 million.
University of New Orleans
After consolidating five colleges into two in December, the University of New Orleans laid off 30 employees last month as it chips away at a $10 million budget deficit, NOLA.com reported.
Additionally, the university announced furloughs for full-time, nontenured employees last month, which local media outlets reported will affect nearly 300 workers.
“While these actions are necessary, we are deeply sensitive to the hardship they undoubtedly will cause. We remain fully committed to supporting those who are affected through this transition,” President Kathy Johnson said in a January announcement. “Our focus remains on protecting UNO’s academic mission and its vital role in the New Orleans region. We are pursuing long-term strategies to increase enrollment, secure new funding, and enhance operational efficiency to avoid similar measures in the future.”
St. Francis College
The financially struggling institution in New York laid off 17 employees last month, The City reported. It follows other moves administrators have made in recent years—including previous layoffs, the sale of the Brooklyn campus and the elimination of athletic programs—to help fix St. Francis’s financial woes.
Despite the institution’s recent struggles and multiple years of operating losses, President Tim Cecere offered the news outlet an optimistic outlook, noting that cost-cutting measures have put the college on a path toward sustainability.
“The college hasn’t been this strong in years,” Cecere said. “We have zero debt, which not a lot of colleges can say. Every dollar that comes in is optimized for the benefit of the students.”
St. Norbert College
Jobs and programs are on the chopping block as the small Catholic institution in Wisconsin navigates financial issues, The Green Bay Press Gazette reported.
At least 13 majors will be cut, including chemistry, computer science, history and physics.
An unspecified number of faculty members are also expected to be laid off, the newspaper reported, as the college aims to shave $7 million in expenses ahead of the next fiscal year.
Cleveland State University
Efforts to cut spending prompted Cleveland State University to drop three athletic programs—wrestling, women’s softball and women’s golf—Ideastream Public Media reported.
Cleveland State will also move its esports team from athletics to the College of Engineering.
The move comes as the university whittles down a budget deficit that reportedly stands at $10 million. Last summer 50-plus faculty members took buyouts as part of cost-reduction efforts.
Indiana University
More than two dozen jobs were eliminated from the state flagship’s athletics department last month—part of a cost-reduction effort in response to the House v. NCAA settlement, which will require IU and other institutions to begin sharing revenue with athletes starting in the 2025–26 academic year, The Indianapolis Star reported.
Of the 25 positions eliminated, 12 were reportedly vacant.
Western Illinois University
Furloughs for administrative employees who are not in a bargaining unit are expected as the regional public institution seeks to cut expenditures, Tri States Public Radio reported.
WIU is reportedly dealing with a $14 million deficit for fiscal year 2025.
The furlough program will run from the beginning of February through July 31 and is tiered by annual salary. Administrators making more than $150,000 will be required to take three unpaid days off each month, while those earning between $100,000 and $149,000 will be asked to take off two unpaid days each month and those making $99,999 to $75,000 will have to take off one unpaid day per month.
Catholic University of America
With the Catholic research university in Washington, D.C., facing a $30 million structural deficit, administrators are considering merging departments and potentially closing the Benjamin T. Rome School of Music, Drama, and Art, Catholic News Agency reported.
Officials did not specify publicly whether job cuts would be included as part of the overall changes, which are expected to go before CUA’s Board of Trustees for approval in March.
University System of Maryland
Amid state budget cuts, Maryland’s public university system will likely be forced to lay off employees.
Anticipating a funding cut of $111 million across the 11-campus system, officials may eliminate as many as 400 jobs through layoffs as well as closing vacant positions, The Baltimore Banner reported, which they estimate will save $45 million. Though a timeline for cuts was not announced, system chancellor Jay Perman said some jobs will be student facing, including advising, counseling and mental health services. Perman also noted that some faculty positions across the system will likely go unfilled.
The World Health Organization classified snakebite as a neglected tropical disease in 2017 and set a target to halve related deaths by 2030.
India, home to over 300 snake species, is at the heart of this global health issue, accounting for half of all snakebite-related deaths.
While 95% of Indian snakes are non-venomous, it’s “The Big Four” species — the Indian cobra, common krait, Russell’s viper and saw-scaled viper — that cause the most harm said Dr. Sushil John, a public health doctor and amateur herpetologist from Vellore.
“These snakes cohabit in the same spaces as humans, thriving in India’s agricultural fields, forests and urban outskirts,” said John. “So, they often come into close contact with people and might bite them.”
A study conducted between 1998 and 2014, called the Million Death Study, found that almost 58,000 people in India died from snakebite each year. Second to India in recorded snakebite deaths is Nigeria, with a reported 1,460 deaths per year.
The missing data
“Though India had a severe snakebite problem, accurate data on snakebite deaths in India was elusive for a long time,” said Dr. Ravikar Ralph, a physician at the Poison Control Centre at CMC Vellore.
In 2011, the official reported number of snakebite deaths was only 11,000. The deaths reported in the Million Death Study highlighted the severe underreporting of snakebite mortality in the country.
“This is because most studies available at the time were hospital-based, which led to the gross under-reporting of this issue,” said Ralph. “We knew from grassroots work that most patients were not reaching hospitals on time.”
“Either people didn’t realize that being bitten by a snake required medical management, or they went to traditional healers, causing fatal delays in hospital-based care,” said Ralph. “The Million Death Study used community-based data collection to circumvent that barrier and document accurate numbers.”
Harvesting the cure
Snakebites are unique compared to other health issues. Snake venom, a potent mix of proteins, can destroy tissue, paralyze muscles and impair blood clotting, often leading to severe disability which is most likely loss of limbs which were bitten or death if untreated.
“Unlike diseases caused by other agents such as viruses or bacteria where one can eliminate the causing agent, a similar approach cannot be taken for snakebites,” Ralph said.
Antivenom is the only specific treatment that can prevent or reverse many of the effects of snakebite, when given early and in the right dosage.
To produce antivenom, snake venom must be first collected, or “milked,” from live snakes kept in a specialized facility. Only one facility in India, located in Tamilnadu, harvests venom for anti-venom production in India.
The venom is then diluted and injected in small doses into animals like horses, prompting their immune systems to produce antibodies. These antibodies are then harvested, purified and processed into antivenom.
But India’s only anti-snake venom treatment targets only The Big Four snakes.
“There are over 50 venomous snake species in India,” said Gnaneshwar Ch, project lead of the Snake Conservation and Snakebite Mitigation project at the Madras Crocodile Bank Trust.
“The anti-snake venom’s limited scope means bites from less common species remain inadequately treated,” he said
Despite its importance, antivenom is also not widely available, and its cost can be prohibitive for many rural families. The gaps in stocking and distribution further worsen the issue.
While many countries produce antivenom, they tend to cater to the locally available species of snakes making it impractical to import it from other countries to India in order to solve the availability crisis.
A national action plan
The WHO has called for concerted global action to reduce deaths and disability in priority nations. In 2019, the WHO launched an international strategy for preventing and controlling snakebite, which was then regionally adapted for Southeast Asia and published in 2022.
The Indian Union Health Ministry then launched the National Action Plan for the Prevention and Control of Snakebite Envenoming (NAPSE) in March 2024. The NAPSE aligns strategically with the WHO’s global roadmap and its regional adaptation for Southeast Asia.
Many stakeholders need to join forces in order to balance snakebite mitigation with snake conservation, experts say.
“Snakes tend to be very important to every ecosystem they are found in,” said Dr. Sushil John. “If snake numbers fall, we would see an increase in rodents which the snakes keep in check by eating. They would then destroy crops and spread diseases to animals and people.”
While this strategy appears to be heading in the right direction, some experts caution that there might be barriers to implementation.
“While public hospitals may adopt the reporting system, many Indians seek private health care,” said Professor Sakthivel Vaiyapuri, a venom pharmacologist at the University of Reading in England. “Mechanisms to ensure private hospitals comply with reporting requirements are essential.”
Vaiyapuri helped work on the National Action Plan. He said health workers who are to report snakebite must understand the significance of their role which will motivate them to record the data accurately. He also said someone must verify the entered data independently to ensure accuracy. He suggests developing a mobile app to streamline data collection.
While Vaiyapuri worries about the logistics of implementing such a plan for massive surveillance, there are also other worries about unintended consequences for snakebite victims, according to Dr. Anand Zachariah, a toxicologist at CMC Vellore.
“When India made maternal deaths notifiable, many private clinics in India stopped treating high-risk pregnancies because they worried about the reporting process getting them in trouble if something went south,” said Zachariah. “I fear snakebite becoming a notifiable disease might trigger such defensive practices among physicians.”
But he admits that at this point, the fear is only theoretical; what will eventually happen remains to be seen.
“Despite the challenges, I think [the National Action Plan] is a pivotal initiative in tackling snakebite envenomation in India,” Vaiyapuri said.
“By fostering accurate data collection, promoting intersectoral collaboration and engaging communities, the plan holds significant potential to drive meaningful change — ensuring effective prevention, timely treatment and a significant reduction in snakebite-related deaths and disabilities,” Vaiyapuri said.
