A Hippo, a crocodile, a buffalo and some snakes...

It sounds very much like the beginning of a joke, doesn't it? But for David and Endless, these are just some of the causes of the medical events that they have to deal with.  David ended one of his recent newsletters by saying "Any update from Africa would not be complete without some snake stories". We agree. In the following article, we are given a down to earth account of some of the animal-based situations that occur in and around the Mukinge Mission Hospital in Zambia.

The hospital has a pool which is a blessing in hot weather. I help by cleaning out the leaves and putting in chemicals to keep it clean. While walking along the edge, I was interested in some unusual ripples. Thinking it was likely a stranded frog who needed rescuing, I peeped over the edge only to find a snake there to greet me. He wasn’t so much doing lengths for exercise, as trying to find his way out. The greeting consisted of coiling up into a ball in the water, puffing up and hissing at me. I returned the greeting by scooping him up in the leaf net and introducing him to my gumboot, which I happened to be wearing.

The occasional snake appears around the hospital too. I am afraid the theatre mop now has a short handle after I had a chat with one in the vicinity of the theatre door. Life is quite fine without a snake in the theatre.

One night, I observed student nurses taking matters into their own hands. A snake was heading down the path into the male medical ward. They armed themselves with large bricks which they picked from the rose garden border. The bricks are heavy and quite brittle and more or less explode on impact. I didn’t know these sweet student nurses were capable of quite such passion when it came to a snake hunt. Amidst much shrieking, bricks rained down shattering in all directions. One scored a direct hit, cutting the snake in half. Job did done?, the results were left there for the morning staff to see.

I did have a chuckle when I heard one of our neighbouring doctors filled her kettle and then went to place it on the cordless base. It wouldn’t “fit on” which is unusual. To her surprise, she found a small snake had coiled upon it. I am pleased it wasn’t inside our house.

While these encounters were "harmless", that is not always the case.

Our local snakes have a “cytotoxic” poison, which damages tissue, but unless the envenomation is large, there is nothing too bad. An exception is children digging for field rats. After fields are burnt, it is easier to track rat footprints to their hole, which can be quite deep. Teams of children then dig for all they are worth to get some extra protein, which is often in short supply in the villages.

In their enthusiasm, one may accidentally clout his brother on the head with a hoe, sometimes leading to quite serious injuries. Other times, one will put a hand down the hole to grab the rat only to have a resident snake bite it. The toxin in the enclosed space of a finger does much more damage, sometimes leading to the loss of a finger.

Essa was riding a bicycle with his friend and ran over a snake, giving them both such a fright they fell off, one landing on the snake, as their story goes. He was bitten, but this time it was an evil snake with a neurotoxic venom, which can paralyse the nerves and breathing. This is how the dangerous black mamba operates. Essa arrived at the children’s ward very floppy and having difficulty swallowing, water coming out of his nose when he tried. Snake venom may affect the muscles involved in swallowing. Most alarmingly, he had gone blind. Antivenom is available, but not without risk as it is of equine origin. We decided to sit it out, and to our delight, Essa recovered on his own in a few days.

Not only do we have to deal with the actual medical side of things, but we are also faced with understanding the traditional practices and superstitions that surround some of these snake bites.

Jackson was walking through a field and was bitten on the foot. The family put on three tight tourniquets at different levels and did lots of scarification. These are traditional cuts made with a razor blade. This day, they were multiple and deep. From our medical side, such traditional treatments make things worse. The lower leg and foot were ice cold. Clearly, no blood was reaching them due to the severe swelling. We made long incisions over the muscles in the leg and foot (fasciotomy) to reduce the pressure inside the leg to allow blood to go down. To the despair of family and medical staff, he suddenly died 2 hours later; we have no idea why. “Reperfusion syndrome” maybe, where a bunch of toxins held within the leg suddenly get washed out into the circulation. The family did not even take the body to the mortuary; loading him into a van and taking him home. But the chaplains had detected a problem. The patient is divorced; we don’t know why and had remarried, but had recently visited the home of the first wife. The question the relatives had was, “Did the first wife ‘send’ the snake?” The input of the chaplains is critical in these cases.

“Finally” was the name of a young man and he arrived on the ward at night in a disoriented state. He claims a long white snake was chasing him while he was riding his bicycle. We were informed, this particular snake can jump up and bite you on the forehead, which finishes you off there and then. Leaping from behind over the top of his head, he was just able to knock it away with his a hand, which the snake bit. There was a tiny wound on the hand, of no significance. What was going on in his the real or imagined world, I have no idea.

Since we are in Zambia, it does not the only snake we have to worry about.

Jebros claimed he was fishing when attacked by a buffalo. These attacks are rare, and it may be even rarer to survive. These animals have a fearsome reputation. The groin and thigh were badly torn open, covered in grass and dirt and after a day spent getting here, smelt ominously septic. The major blood vessels were miraculously intact, winking at us from the depths of the wound. No church that Sunday morning for the theatre team. An hour or so was spent cleaning and trimming the wound and then packing it with lots of honey, our favourite antibacterial wound dressing. Incidentally, I now have a supplier who will deliver 20litre containers of honey to the door. Jebros healed well, and I did not recognise him at follow-up until he had dropped his trousers and showed me the scar.

Gredson was a tough, wiry fisherman. While walking through tall grass to the river to check his nets, he came face to face with Mrs Hippo, who had a young one with her. In a twinkling, she latched onto his arm, causing a terrible crushing wound. On arrival here a day later, I could see right through the forearm. Sepsis had set in, and though we got things somewhat repaired, he now has a useless, painful, swollen arm which doesn’t bend at the elbow and the fingers have little function. He needs it off, but won’t have a bar of it. We pray he changes his mind before overwhelming infection sets in.

Jonas was paddling his dug-out canoe after a day’s fishing on the river. He had observed a crocodile in the distance, but it seemed too far off to be a problem. Crocs are remarkable for their speed, cunning and silence. The next thing Jonas knew, the croc had leapt into the canoe, latching onto his lower leg, attempting to drag him into the water. Jonas held on for dear life, and it was not until the canoe tipped over, spilling the day’s fish catch into the water, that the croc let go, seeing that some less troublesome dinner was at hand. The croc, however, did remain with the trousers. Only then could Davy shout for help and some game wardens came out to assist him. He had a terribly shredded lower leg and lost a lot of blood. “I could become a Christian right now,” he told the chaplain afterwards.

Thank you for bearing with me to the end of this. If any of you are still wanting to join us in the mission field, whether it be short term or longer do get in touch with the team at GC3. We have many needs here, ranging from Medical, surgical, anaesthetic, paediatric, obs and gynae, paediatric, nursing tutors, administration/accounting/IT, building, plumbing, electrical, mechanical, biomedical. Teaching (primary and secondary).

Come join us, you would be most welcome and you would have the added benefit of been able to write about your own snake experiences!

David & Endless

If you would like to know how you can become involved in medical mission or any other type of mission calling, then we would love to hear from you and help you to find your place in the world of Missions.