Benedict Moran: In this hospital in eastern Nigeria, doctors are receiving the
first patient of the day. 19-Year-old Pwagrida Samson
was bitten in the foot by a carpet viper. It’s a small, aggressive and highly
venomous snake that is common in this part of the country.
Pwagrida Samson: I was in the field and
walking to go to the toilet and I stepped on a snake and was bitten. Now I’m
having a lot of pain where the bite is.
Benedict Moran: This hospital isn’t an ordinary one. It deals exclusively with
victims of snakebites. And Samson is a typical patient in typical danger. Venom
from a carpet viper prevents coagulation, and without treatment, he could bleed
to death. Samson first treated his injury at home in his village, using
traditional remedies. But after two days, the bleeding continued, so he
travelled more than 100 miles over difficult roads to come here. Now, his foot
is severely swollen.
Dr. Agom
Dauda Ibrahim: There is swelling
already so the tissue is compromised so if there’s an infection, the infection
can set in rapidly much more than in a normal tissue.
Benedict Moran: This is the only hospital of its kind in sub-saharan
Africa. Demand for its services is strong.
Benedict Moran: We’ve only been here at the Kaltungo
Snakebite Hospital for about thirty minutes and within that time three patients
have been admitted here.
Benedict Moran: Globally, around 120,000 people a year die from venomous
snakebites, according to the World Health Organization. To put that in
perspective, in 2018, more people died of snakebites than were killed in war.
India and neighboring countries in Asia have the highest number of fatalities.
In Africa, the highest caseload is in Nigeria. At least 10,000 people a year
here are bitten. One in five of them die. Many more deaths and injuries go
unreported. So says doctor Abdulrazaq Habib, of the
research coalition known as the Global Snakebite Initiative.
Dr. Abdulrazaq
G. Habib: Only about 8 percent of
victims of snakebites go to a formal hospital, meaning over ninety percent are
faceless, no one knows them, no one has seen them. If we are not aware of them,
how can we speak for them.
Benedict Moran: Habib says snake venoms can contain numerous proteins, enzymes,
and toxins that not only prevent blood from coagulating, but can also destroy
cells, or cause blood pressure to plummet. They also can disrupt signals in the
nervous system, causing muscle paralysis. The WHO recently moved snakebite
poisoning to the A-list of neglected tropical diseases targeted for
elimination.
Dr. Abdulrazaq
G. Habib: In contrast to the rest
of the neglected tropical diseases, snakebite is the greatest killer, many of
them they maim, they may leave you disabled, you may be diseased, you may be
ill but really they don’t kill, you know, and snakebite is the one that really
kills and it kills within a very short period of time.
Benedict Moran: Here in Nigeria, farming is the main source of income.
Benedict Moran: Snakes are often found in fields just like this one, places where
families are also cultivating. That’s why snakes are so dangerous, especially
for children.
Benedict Moran: In the fields just behind the hospital Marlon Dela shows us where
the small but dangerous carpet vipers live.
Marlon Dela: The smaller ones are more dangerous than the big ones and have
more venom in them, to make antivenom we use a lot of the small ones.
Benedict Moran: Antivenom is the only effective therapy against a venomous
snakebite, and it’s important to use it quickly. Delay can be deadly. The
Nigerian government usually supplies antivenom to Kaltungo
Hospital for free. But doctors here say they are overwhelmed by patients, and
the hospital’s supply has run out. A representative from the state ministry of
health told us that its budget for antivenom isn’t big enough to meet demand.
That means the patients have to buy it themselves, at
a private pharmacy nearby. Each vial costs around 100 US dollars and the
standard dosage for successful treatment is two vials. That’s a huge expense
when half of the country's population survive on less than two dollars a day.
There’s also a worldwide shortage of anti-venom. The WHO says only half of the
anti-venom needed globally is currently being produced. Adding to this problem,
several pharmaceutical companies have recently stopped the production of
antivenoms specifically intended to treat some kinds of snakebites found in
Africa. The reason? Snakebite victims are mostly found among the rural poor,
which means there’s not a lucrative market for those producing an antidote. Mwele Malecela is the WHO’s
director of its department of control of neglected tropical diseases.
Mwele Malecela: There were groups producing antivenom in the past. But then the
motivation to produce it, given the market base, made it impossible for them to
continue doing so.
Benedict Moran: Across africa, faced with a lack of
affordable, accessible anti-venom, victims often try home remedies. In South
Sudan, 10-year-old Awien Maguor
is having surgery at a hospital run by Doctors Without Borders. She was bitten
by a Puff Adder, another deadly snake, while sleeping. Her uncle says they
tried a wide assortment of traditional treatments.
Athian Akol Madut: They told us to give the child a raw egg. Then they cut half a
frog and put it in on the wound to stop the venom spreading in the blood. We
also gave the child a potion made of ground seeds and leaves. We tried all
these things but there was no improvement.
Benedict Moran: Nearby is Nyandeng Goch.
The 60-year-old was bitten while farming. She too first relied on traditional
medicine.
Nyandeng Goch: The wound was bleeding and I called my relatives to come and help
me. They came, and they dug a hole and I put my foot inside the hole for two
hours and they buried my foot with soil.
Benedict Moran: Dr. Habib says these remedies don’t work against venomous
snakebites.
Dr. Abdulrazaq
G. Habib: If anything
it’s harmful. Delay is a major predictor of dying, if you delay either in
seeing a traditional herbalist or through some other means or you are using
some local remedy, that delay could be adverse, it could lead to more
complications or even death.
Benedict Moran: But often people have no choice. Nigeria doesn’t produce
anti-venom. The country lacks the expertise, production facilities, and funds.
Instead, it buys it from companies in the United Kingdom and Costa Rica, which
create it through a process that includes injecting sheep and horses with venom
and harvesting the antibodies the animals create. Back at Nigeria’s Kaltungo hospital, head nurse Abba Abese
is monitoring patients closely.
Abba Abese:
We are telling them the position they will
maintain for treating the patient. They should not lie on the affected leg
because it adds pressure and it’s always painful and the swelling will
increase.
Benedict Moran: One of her patients is 12-year-old Abubakar Dahiru,
who was bitten while tending cows. He’s been in the hospital for seven days.
His parents are worried after nurses administered an unusual amount of
antivenom. He has needed more than the usual two vials.
Abba Abese:
On arrival he had this antisnake
venom given to him. The following day it was repeated, the following day it was
repeated again, this is the fourth one.
Benedict Moran: Dahiru’s bite won’t stop bleeding. So he also had
several blood transfusions.
Abba Abese:
Because of the open wound, the bleeding is
everywhere the anti snake venom will not be enough
for him too, it’s over-diluted and is oozing out so he has little in his body
and cannot contain it so another one has to be added again. So
like that, like that, because of the continuous bleeding. There is a sign of
improvement now compared to when I came early in the morning.
Benedict Moran: The World Health Organization recently labeled snakebites an
epidemic and made helping snakebite victims a high priority. It has launched a
roadmap to cut in half death and disability by snakebites by 2030. It includes
a push for more research on snakebite treatments and funding to help countries
stockpile anti-venom.
##
|
TIMECODE |
LOWER
THIRD |
1 |
0:22 |
PWAGRIDA SAMSON SNAKEBITE PATIENT |
2 |
1:05 |
DR.AGOM DAUDA
IBRAHIM KALTUNGO SNAKEBITE HOSPITAL “THERE’S SWELLING ALREADY, SO THE TISSUE’S
COMPROMISED. SO
IF THERE’S AN INFECTION |
3 |
1:09 |
[CONTD] DR.AGOM DAUDA
IBRAHIM KALTUNGO SNAKEBITE HOSPITAL “THE INFECTION CAN NOW SET IN RAPIDLY, MUCH MORE THAN
NORMAL TISSUE.” |
4 |
1:22 |
KALTUNGO, NIGERIA BENEDICT MORAN SPECIAL CORRESPONDENT |
5 |
2:41 |
DR. ABDULRAZAQ G. HABIB GLOBAL SNAKEBITE INITIATIVE |
6 |
3:06 |
KALTUNGO, NIGERIA BENEDICT MORAN SPECIAL CORRESPONDENT |
7 |
4:54 |
MWELE MALECELA WORLD HEALTH ORGANIZATION |
8 |
5:14 |
DOCTORS WITHOUT BORDERS |
9 |
5:58 |
NYANDENG GOCH SNAKEBITE PATIENT |
10 |
6:17 |
DR. ABDULRAZAQ G. HABIB GLOBAL SNAKEBITE INITIATIVE |
11 |
7:03 |
“WE ARE TELLING THEM THE POSITION THEY WILL MAINTAIN FOR
TREATING THE PATIENT.” |
12 |
7:05 |
“THEY SHOULD NOT LIE ON THE AFFECTED LEG BECAUSE IT ADDS
PRESSURE AND IT’S” |
13 |
7:10 |
“ALWAYS PAINFUL AND THE SWELLING WILL INCREASE.” |
14 |
7:28 |
ABBA ABESE HEAD NURSE, KALTUNGO SNAKEBITE HOSPITAL “ON ARRIVAL HE HAD THIS ANTI-SNAKE VENOM GIVEN TO
HIM. THE FOLLOWING DAY IT WAS” |
15 |
7:33 |
ABBA ABESE HEAD NURSE, KALTUNGO SNAKEBITE HOSPITAL “REPEATED. THE
FOLLOWING DAY REPEATED AGAIN. THIS IS
THE FOURTH ONE.” |
16 |
7:45 |
“BECAUSE OF THE OPEN WOUND THE BLEEDING IS
EVERYWHERE. THE ANTI-SNAKE VENOM |
17 |
7:49 |
“WILL NOT BE ENOUGH FOR HIM TOO. IT’S OVER DILUTED AND IT’S OOZING OUT SO HE
HAS LITTLE” |
18 |
7:54 |
“IN HIS BODY, CANNOT CONTAIN HIM, SO ANOTHER ONE HAS TO BE
ADDED AGAIN.” |
19 |
7:59 |
“SO LIKE THAT, BECAUSE OF THE
CONTINUOUS BLEEDING, THERE IS A SIGN OF” |
20 |
8:02 |
“IMPROVEMENT NOW COMPARED TO WHEN I CAME EARLY IN THE
MORNING.” |