Thursday, August 16, 2007

Journey to the valley of the snakes.

Adamu looks out of the window, he speaks in tentative English: “I feel so ashamed in my heart because my son is in danger.”
Three days before, his three-year-old son Abdul Sawal was bitten by a snake as he played with his sisters at home. Adamu and Abdul’s mother Aisha grabbed their only son and set out on a day-long journey from their home in Karim-Lamido local government at the north of Taraba state to reach the famous snake bite clinic of Kaltungo.
The family had to walk 15 kilometres from their village to the nearest road where they waited for a bus to take them across the Muri Mountains. By the time they arrived in Kaltungo it was the middle of the night.
In a grown man it can be too late to treat a snake bite after 36 hours. Although he’s quite big for a three-year-old, Adamu’s survival for whole day before being treated is nothing short of a miracle, his parents say.
Adamu said: “I felt so ashamed that this happened, but he is better now. He is not in pain, almost back to normal.” Abdul’s leg was still swollen. He lies covered by a yellow blanket on a bed at the back of the women and children’s ward. Every bed is occupied with a child, or an elderly woman who has been bitten by a snake. Over 30 per cent of the people treated at the Kaltungo hospital come from other states along the Benue river valley and all have stories about the desperate journey to get help. It is a panic-filled rush to get to the hospital, it is one of three specialist centres treating bites from Echis Ocellatus -the carpet viper.
Most Nigerian snakes, like the spitting and gold cobras, or the puff adder will scatter when humans are around, but when threatened by a larger predator the carpet viper will hold its ground. If the threat comes closer –the speckled scales on the coiled whip body hide it perfectly in the rocky ground of the Benue river valley- this small snake will try and protect itself in the only way it knows. It will lash out biting whatever is closest to it, usually the foot or the hand.
The venom of the carpet viper prevents blood from clotting. The poison takes hold and the flesh swells up dramatically. After a few hours any cut on the body will not close. Blood begins to ooze uncontrollably from the bite, then from the nose, from the gums, from the eyes and finally from the very pores in the skin. If treatment comes too late, the swollen flesh can start to die and the patient’s leg or arm literally starts to rot. This putrefying necrosis can cause death by infection. A death from snakebite is painful and protracted.
The Ministry of Health says there are 174 recorded snake bites for every 100,000 people in Nigeria. According to these figures one in every five African snake bites occurs here. If you take Nigeria’s large population into consideration, that’s not completely surprising, but because most of these bites occur in the Benue river basin, at the hospital in Kaltungo they see nearly 3000 cases a year. An average of eight new cases come in every day, with bites that need to be treated urgently. Until recently treatment wasn’t free, and there wasn’t enough anti-venom to go round. Now the government spends N200 million on a drug from South Africa, and provides it for every hospital, but people still turn up at the Kaltungo clinic.
There are two peak times for snakebites in Nigeria, in May when farmers plough their fields, and during the hot dry season, when people sleep outside to escape the ovens of their rooms. According to Dr Ibrahim Jalo Daudu, who as a young doctor cut his teeth on the snake bite problem in the early 1980s and is now the director of the Millennium Development Goals task force in the Federal Government, the snakes come out in search of their insect and mammal prey which are in turn attracted to the fallen fruit of the Deleb Palm, or Giginya tree. The research that Dr Jalo Daudu contributed to began the process of developing a specialised anti-venom for the west African carpet viper, currently in the testing phase at the Kaltungo hospital. The drug EchiTab, is produced by injecting small doses of venom into sheep or horses –who have a natural immunity to snakebite- and then collecting their antibodies. The project is run in partnership with Liverpool School of Tropical Medicine, but soon an anti-venom factory is to be built in the Kaltungo region.
Dr Jalo Daudu said: “The problem is that anti-venom production is not a profitable business. Nigeria used to buy expensive anti-venoms from French or German companies, but they stopped making them because they couldn’t make a profit. The government could never afford enough anti-venom and there were shortages. But now the government is taking it seriously and is subsidizing the purchase of anti-venom from South Africa.”
As I’d left Dr Daudu’s office in Abuja, I asked if he thought we’d see any snakes at all in Kaltungo?
“Oh yes, you will see!” he said chuckling, “be careful, if I was you I’d take a stick and some stout shoes!” He told me a story about an Indian volunteer doctor who had turned tail and fled when he’d seen the number of snakes living in the Kaltungo hospital grounds.
The fear of snakes is a powerful thing. Last year a colleague and I almost stepped on a snake as it was basking on a newly laid road. It whipped itself into the air at us with a hiss. All I saw was its pink mouth flying toward me. My colleague pushed me out of the way and leapt four feet in the air in an attempt to get away from it. The day before leaving for Kaltungo I dreamed I was bitten by a snake. I ran through hospital rooms searching for a doctor, but they were full of other victims, blood streaming down their grim visages, seeping from every pore. They just laughed at me and beckoned.
If the stories about the snakes in Kaltungo were true, I didn’t know how people lived so close to so many snakes.
We’d been in Kaltungo less than an hour before we caught a glimpse of what we thought was our first snake. Walking back from a restaurant my colleagues and I saw a black coiled body in the light of a torch. It was in our path, and we approached with caution. It didn’t move. It was looped over itself right in the middle of the path. No one else walking past seemed bothered about it. Peering closer, looked at it, and saw it was a length of rope. My imagination had been working overtime.

We arrived at the hospital under a gloomy grey sky. It was raining, and it looked as if it was going to stay that way. The valley was lush and verdant, crunchy underfoot. I looked where I was going -everywhere. The hospital was busy, women sat under the covered walkways on cloths spread out on the concrete floor, waiting for their family in the wards. The snakebite unit is spread over two male and one female wards and a research laboratory.
Dr Yusef Peter Ofemile took us to the laboratory where he showed us their collection of preserved snake bodies. The 32-year-old doctor returned here to his birthplace two years ago to study for his masters in toxicology. Coming from an area like this must have influenced his decision to study the effects of poisons, and help in producing a cure.
He said: “It’s useful to have a collection of specimens so people can identify what bit them, if they can’t bring the snake in that did,” he said, opening the small jar. The sickly aroma of formaldehyde cut my nose as I peered at the coiled body of the small viper. Its body has a bluish tinge from the preservation. It’s thinner and smaller than I’d expected.
Dr Peter says: “A small puff adder can look like a carpet viper, so we have different specimens at different stages of growth.”
He took a snake skin from the desk, and flattened it out with his hands. The dry skin sounded like smoothing a crumpled paper bag. “This one is a spitting cobra, Naja Nigricolis. The man who was bitten stopped to kill it, skin it, cook and eat the flesh before coming to the hospital!” The Benue river valley, the doctor explains, is rocky and sandy, unlike the Niger valley which is marshy and unsuitable for snakes. The reason why there are so many in the valley is that they have many young. A high percentage of young snakes will be eaten by their predators, birds and larger mammals. They have evolved over millions of years to be poisonous at an early age to protect themselves.
“We don’t encourage people to kill snakes,” says Dr Peter. “They hold a valuable source of venom, from which anti-venom is derived, and which could also hold the secret to effective treatments for other diseases. And if people kill the snakes it will effect the ecosystem.” The snakes keep insect and rat populations in check.
They pay a man called Dala Husseini to catch snakes for milking. Dr Peter milks the snakes himself to collect the venom. It’s a risky business. “I just take the snake and with a beaker hook the teeth on the side.” The milky venom drips out of the fangs into the glass.
Dala Husseni started catching snakes 27 years ago when Dr Jalo Daudu arrived with the British Professor David Warrell from Liverpool school of Tropical Medicine to begin the EchiTab project. He uses a stick and his hoe to catch them and sometimes he picks them up with his bare hands. Through a translator he says: “I am not afraid of them, I am used to snakes, to how they moved. I am not afraid of them. They all have their own ways of attacking. The carpet viper does not attack you until you step on it.” Dala can catch 20 snakes in a day, and during the beginning of the EchiTab project he and his partner caught over a thousand snakes to send to Abuja for clinical tests.
He says: “Some people when they’re bitten by snakes will just take it as an act of god, and not seek treatment. Other people believe that they can send snakes to harm people. Once I found a snake in my pocket, but whoever sent it there was disappointed.” He was once bitten by a snake on the hand, but the bite was dry, no venom was injected.
In the men’s ward we found eight-year-old Mohammed, bitten by a snake on the ankle. He was working with his family on their farming plots near Bauchi. Mohammed is the fifth out of Abdul Kadir Yakubu’s seven children to have been bitten by a snake.
Abdul Kadir said: “We are afraid of snakes but we don’t have any choice but to work on our farms.”
Mohammed had a small black stone on his ankle covering the site of the snake bite. It is a traditional medicine that people believe sucks out the poison. But it doesn’t work, doctors say. The stone simply absorbs blood, but not enough to draw all the venom out. After the stone is saturated, it simply falls off, and the poison continues through the body. Other traditional methods of treating bites have been tested, and none of them contain any healing powers.
Another patient receiving treatment, Umaru Dantala described the feeling of being bitten: “I was in the field trying to get something to eat for my family. It bit my leg. It hit me very hard, I was in great pain. I couldn’t move my leg, it was hot. I had to travel six hours on a motorbike from Taraba state to get here. I thought I was going to die. I thought this is it for me. I am very afraid of snakes, but I cannot do anything else. I have no profession but in the farm to get food for my family.”
People who live in Kaltungo have hit on a reliable way to make their fields safe. Igbo traders in town brought with them pigs to breed and eat. One day someone noticed that pigs have a hearty appetite for snakes, and that for some reason snake venom doesn’t affect them. Dr Jalo Daudu thinks it could be because the venom can’t get through the layer of fat under the pigs skin. Muslims in Kaltungo tolerate the animals they consider filthy to clean the fields of reptiles. We met Naomi, an 80-year-old woman, told us they let the pigs loose on the field and they make short work of the snakes. A Christian herself, she used to breed pigs before her Muslim husband asked her to stop.
She said: “A scorpion sting will kill a pig, but snake bite won’t. They protect us and drive out the snakes from our farms. Before there used to be many in this village, but this year, not so many.” Four of her children have been bitten in the past. Many other farmers we spoke to in the village said they were no longer afraid of working because of the pigs.
We asked Dala Husseni if he could catch us a snake. “I would have to go into the bush, there are none really around here,” he said.
We didn’t see any live snakes in Kaltungo, and my fears seemed a little unjustified. Just before leaving I even gingerly walked through a patch of long grass, looking all the time for movement, but there was nothing.

In reality the number of people who get bitten by a snake across the country in a year is a tiny fraction of the number who contract malaria every day, or those suffering from HIV or Aids.
But the fear of snakes in rural people is understandable. No one is going to stop going out into the snake’s habitat, and in the valley of the snakes, one could be under any rock, or using a hoe in the course of trying to feed your family you might not even see the fleeting glimpse of the snake before it bites. The length of time it takes for people to get to health centres, and the slow agonising death without treatment, adds to the visceral fear.
But the problem seems to be one that researchers have been able to do something about. It was heartening to see a clinic well stocked with necessary drugs and motivated staff. Deaths at the clinic have reduced to less than 20 a year over the last five years.
As we left the gates of the hospital I saw Adamu catching up on some rest underneath a tree. He saw me and waved goodbye, the relief finally evident on his face.

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5 Comments:

Blogger Ejura said...

First time here.
LOL at yor celebrity status in Abuja as an Oyibo! Hollywood has got nothing on you.
Very long post-couldn't read it all. Snakes huh.
The first time I ever held a snake was in Ghana and most people thought me wierd. I had so much fun at their expense though.
I'll be back at my leisure time.
Ciao!

2:17 pm  
Blogger Ejura said...

Ok I decided to read it all-might not find my way here next time.
Funny dream you had there.
I've always wondered about that stone. So it doesn't really work?
I've never been bitten by a scorpion talk more of a snake. Oh, there was this time I felt pain shoot up my leg at night-i screamed as I reached for the light. The culprit was an ant-it was painful nonetheless.
Enlightening post.

2:34 pm  
Blogger Dami said...

very good post,
just one clinic in the whole area?
considering the number of people one would expect the lg or state govt to build another clinic and also encourage local anti-venom drugs from the state or country instead of importing it

8:05 pm  
Blogger Oyibo! said...

As the piece says a new factory producing anti venom developed by a team of Nigerian and British researchers will be built in Kaltungo soon.

2:31 pm  
Blogger Dami said...

Good, thanks

3:46 am  

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