KATHMANDU, JUNE 30 Snakebite is no longer just a Tarai problem. Cases are increasingly being reported from Nepal's hills and mountain districts, including Solukhumbu, home to Mount Everest, forcing health authorities to expand treatment services into areas where snakebite was once considered rare and where hospitals were never equipped to handle venomous bites. Climate change is reshaping the map of where venomous snakes live and bite, and the government has begun responding by establishing treatment facilities in mountain regions. Take Sotang Rural Municipality in Solukhumbu. At an average elevation of 2,173 metres, it sits far above the Tarai plains, and yet, snakebite has become routine. According to Rural Municipality Chair Khilaraj Basnet, snakebite cases have become frequent enough that local authorities have been lobbying federal and provincial governments to establish a dedicated snakebite treatment centre at Sotang Primary Hospital. Their efforts appear close to success. A technical team from the Epidemiology and Disease Control Division (EDCD), together with provincial health officials, has already inspected the hospital, and Basnet said the centre is expected to begin operating by Shrawan or Bhadra. 'I have been informed that the process is nearing completion,' Basnet told The Himalayan Times. 'We have also started procuring ventilators required for the treatment centre.' Basnet noted that a snakebite patient arrived at the hospital on the very day the assessment team visited. 'That was not merely a coincidence,' Basnet said. 'It showed that snakebite is no longer rare in mountain areas.' The hospital has also witnessed a sharp rise in other animal-related emergencies, Basnet added. Of the 720 anti-rabies vaccine vials allocated over the past three years, about 600 have already been used-far exceeding its normal annual allocation of 50 doses. Health experts say Sotang reflects a broader trend now emerging across Nepal. Data from the Bipad Portal recorded 54 snakebite incidents between June 23 and June 30 alone, spread across multiple provinces. Separate figures from the National Disaster Risk Reduction and Management Authority (NDRRMA) show 50 snakebite incidents between mid-January and mid-April this year, resulting in four deaths and 47 injuries. Notably, Karnali Province, a predominantly hilly and mountainous region, reported one fatality and six injuries, highlighting the disease's growing reach beyond the Tarai. Separately, Nepal Police recorded 70 snakebite-related deaths and 532 injuries during the first five months of the current fiscal year (Shrawan to Mangsir), alongside 226 snake rescue operations. Together, the datasets point to a public health problem that remains severe in the plains while gradually expanding into areas previously considered outside traditional snakebite zones. The phenomenon has already been observed in some of Nepal's most remote mountain districts. In Mugu, doctors at the District Hospital reported in 2023 that venomous snake species usually associated with the Tarai had begun appearing in higher-altitude settlements. The district still lacks a snakebite treatment centre, forcing many patients to travel long distances for treatment, a delay that can prove fatal. At the time, hospital chief Dr Kamal Dhungana cited shortages of trained personnel, anti-snake venom, intensive care facilities and ventilators as major obstacles to effective treatment. Scientists increasingly believe climate change is driving the expansion. A widely cited investigation by The Guardian found that rising temperatures are pushing venomous snakes into higher elevations and previously unaffected regions worldwide-a trend that closely mirrors observations by Nepali health workers. In Banke, forestry officials say extreme heat is forcing venomous species such as Russell's viper and common krait into residential areas in search of cooler shelter. Read Also: Venomous snake sightings rise in Banke amid heat Senior Division Forest Officer Shankar Prasad Gupta said at least one snake is rescued every day in the district, with rescue teams sometimes responding to three incidents daily during peak periods. A total of 140 snakes has been rescued in Banke during the current fiscal year. Despite the spread into hill districts, the Tarai-Madhes remains Nepal's snakebite epicentre. According to The Lancet Global Health, around 40,000 people suffer snakebites annually in Nepal, with more than 3,000 deaths, most occurring in the hot, humid agricultural plains. The World Health Organization estimates between 20,000 and 37,000 snakebite cases occur each year, with annual deaths ranging from 1,000 to more than 2,700, depending on the methodology used. Treatment facilities are concentrated in the Tarai, and so is the Ministry's recognition of the problem. Its national snakebite management guidelines identify snakebite as a major occupational hazard for farmers, plantation workers, herders and fishermen in the plains, while also warning that sleeping on floors in open-style homes raises the risk of nighttime bites during the monsoon. According to the Ministry of Health and Population's national snakebite management guidelines, antivenom remains the only specific treatment for venomous snakebite. The guidelines also identify delays in reaching hospitals as the leading cause of death, warning against traditional practices such as applying tourniquets or relying on faith healers, which often worsen patients' conditions. Nepal has committed to the World Health Organization's target of reducing snakebite deaths and disabilities by 50 percent by 2030. But as venomous snakes continue moving beyond their traditional habitat, health workers say the country's response must move just as quickly. For communities like Sotang, where snakebite treatment once seemed unnecessary, the challenge is no longer preparing for a future threat, but responding to one that has already arrived.