We don’t have to worry too much about snakebites in the United States. But it is an ever present threat in the tropics, including Central and South America, Southeast Asia, Australia, and equatorial Africa (or pretty much anywhere in Africa). Here I would like to share with you some stories about people who had their lives radically changed by an unfortuitous snakebite. You will notice that the majority of these names are women, and some are children.
Concester
“When I grew up in the village I was warned that snakes are a great enemy, and if I am bitten I would die. So I grew up knowing that if I see a snake I must run away or hit it with a stick to kill it because it will kill me. This was realized in 2010 when I lost my dear 17-year-old daughter Emily Nafula Mwila. After school in the evening, Emily went to fetch vegetables in the farm. At 6:40, after I returned from looking for water, I found Emily sleeping, and I inquired what was happening because that was unusual. Emily said while crying that she was bitten by a big snake while fetching vegetables. Immediately we took her with a swollen left leg to Merceline’s home (the traditional healer) but Emily was in pain and she could not talk well. As usual, Merceline spit where Emily was bitten, but at this time Emily could not talk and she was breathing very fast. The son of Merceline said we should give her uncooked eggs, but we decided to take Emily to Kimaeti hospital. Unfortunately, we did not move more than 100 meters from Merciline’s home before Emily was no more. I am here (at this snake awareness training) today after I heard about this from Isaac. After today, I will champion this training everywhere as I remember my daughter whom we lost to snake bite, so that we have no more death from snakebite. I will be an ambassador of the Upendo Conservation Area”.
Elizabeth
Elizabeth Nanjala Wamalwa is 96 years old from Mwiruti village. She is a widow with 9 children – 4 boys(men) and 5 girls(women). Even though all her children are adult none went to school due to their family’s poor background.
Elizabeth told us that while sweeping her house at 6 am on November 26, 2021, she was bitten by a snake. She shouted “Snake!” when she saw a brownish snake in the corner of the house. The snake was killed by her grandchildren, and she was taken to a nearby dispensary in Kimwanga where the wound was washed, and they put medicine in the wound. She went back home but by evening the left leg was really swollen. She was back in the dispensary the following day with 3 chickens to pay for further treatment. After 3 days treatment the swelling in her leg was reduced though the skin near the wound turned black (necrosis or dead tissue).
Then, on the morning of July 14, 2022, while weeding her vegetables, she felt a sharp pain on her right leg. She sat down in pain until her son came, and as they checked on the leg they realized it was a snake bite. They had no money to go to the hospital. The leg was swollen by evening but the following day she was taken to Machwele Dispensary where she was treated and went back home. The leg continued to swell and later the wound had a watery discharge. Even now, the wound continues to expand and fester – it seems to heal and then gets worse again. The leg was in a worse situation when the Upendo Conservation Area’s Community Health Volunteer, Everline, was called upon by a neighbor when she heard about our snakebite trainings. Everline went and started supporting Elizabeth’s cleanness and medication. She needed proper medical attention, but the family seemed to have given up due to the financial challenges. The Upendo Conservation Area worked with Elizabeth to provide the funds for the wound to be treated properly and today she is able to get around with a crutch.
Dorcus
Dorcus is a caretaker for the Upendo Conservation Area. “In the year 2020, we were shopping in Mwiyenga Centre late in the evening and it was becoming dark. As we were walking and talking, I was in bare feet and I stepped on something. When I checked I saw a black snake moving away. I shouted “SNAKE” and all my colleagues ran away. Immediately I felt pain on my left foot and noticed blood and realized I had been bitten by that snake. My friends were nowhere. I tried to go home, but it was so painful. I was assisted to a traditional healer who was not there. By midnight, I realized I was in Medical View Hospital in Bungoma. After treatment, I was required to pay 21000 Kenyan shillings (about $182). It was so difficult to raise such money, and we had no option but to sell the only cow we had for milk. I thank God I am well. I really appreciate the Snakebite Awareness Training. It’s going to change the mindset of our community members towards snakes and take the necessary precautions to remain friends and not enemies with snakes. Considering what I went through, I will remain a good ambassador of the Upendo Conservation Area as we create awareness to other communities.”
Janefer
Nine year old Janefer had taken supper at her mother’s home, and went to sleep over at her sister-in-law’s house. Upon arrival, they shared stories with her sister in-law until it was past 9;00 and then went to sleep. In the early morning, when it was still dark, they went outside to relieve themselves (without a flashlight). Her sister-in-law led the way and immediately after her passing, Janefer stepped on something slippery and in a blink of an eye she felt hard, painful piercing on her right leg. She tried to check what had bitten her, but she couldn’t see as they had no torch nor matchbox to light the way. Her sister-in-law was so terrified and could not even dare to check what had bitten Janefer. She could barely move her leg, so she limped with the support of her sister-in-law and went straight away to inform her mother. Her mother and father tied her leg with a piece of cloth and proceeded to call Gloria (one of the snake awareness trainers) who told them to go to the hospital immediately. They then proceeded to take Janefer to the local health centre where upon arrival, the doctor asked for 200 Kenyan shillings (about $1.50) for registering, but they didn’t have the cash and therefore Janefer was not treated. The doctor informed them that even if they could find the cash and return tomorrow, Janefer would only get a tetanus jab since there’s no snake anti-venom vials in Bungoma county hospitals. They then proceeded to another hospital a further 30 km away, and by then it was almost midday. Upon arriving in the hospital she was checked and given an injection and some medicine and told to return the following day. Therefore, they returned home after all desperate attempts to access any nurse or doctor. The following day, her father then took her back with the support of Silas Wekesa Muchenje (Director of Upendo Conservation Area) and the trainer Gloria. There was heavy leg swelling In the morning. During the two-day treatment process, the leg was only better during the morning hours and would exponentially swell and become more painful three hours later. There being no improvement, snakebite trainers of Upendo Conservation team intervened and took her to the Referral Hospital. After a few days in the hospital, the swelling and pain had subsided, and Janefer was able to return home. We presented her with a flashlight so she would never have to go outside after dark again.
Catherine
Catherine is a member of Upendo Conservation Committee. She shared that until the introduction of the snakebite awareness training, she could not listen to anything concerning snakes, or any picture of a snake. This was because her grandmother Zipporah from Siboti, who is now 83 years old, was bitten by an unknown snake while assembling firewood in the late evening outside her house about 18 years ago. They discovered late that it was a snake bite when she was really in pain. She was taken to a traditional healer because of traditional beliefs and the lack of an available medical institution. This left her right leg paralyzed and later all lower limbs were affected; she is now in a wheelchair. At her age, she needs constant support. Catherine appreciates the awareness training and she says that fear and beliefs are slowly being buried. She says she will pass on the same training in the Siboti area.
Pili
On 26/2/23 just some few minutes before 6am, the little girl (9yrs old) while asleep felt a sharp pain on the hand. She assumed that she was bitten by a scorpion. She immediately woke her siblings, sharing the same room and asked them to accompany her to their neighbor’s house just about 100 m from their house to go borrow some herbs that she would rub on the bite area to ease the pain.
On reaching there, the neighbor asked them if they killed the scorpion and whether they had informed their father who was sleeping in a different room of the house. They asked for a headlight/torch to go look for the scorpion. It is at this point that they went back and saw the snake on the bed. All this time the pain was building up….the brother started screaming that his sister has been bitten by a snake. This is where the father heard the noise and woke and the neighbor came also. The father entered the room and slashed the snake which was now slithering under the bed.
The neighbor tied up the hand just above the bite site to prevent the venom from spreading. They called a boda boda (motorcycle) to come bring the child to the hospital. On arriving at the nearest medical facility and being a Sunday, they were informed there’s no antivenom so they should proceed to another health facility. They arrived at another hospital at 8am, but by 4 pm nothing had happened so someone called the County Executive Committee Member for health after noticing some negligence and called the hospital administrator to ask about the case. The hospital admin finally brought the antivenom to be administered at 4pm.
Pili spent the next month in the hospital, getting blood transfusions and wound care every other day. The wound continued to heal and Pili was soon being released from the hospital to go to her aunt’s house, where she would continue to get the wound cleaned and bandaged changed. When it came time to decide whether she needed a skin graft, the doctors decided that the wound was healing well enough on its own and she would not need surgery!
Joseph
This is the story of Joseph, a little boy of 10 years who was bitten on the foot by a puff adder, a deadly venomous snake which is common in Africa. He was treated with antivenom at a couple of hospitals, but he had a reaction to one of the antivenoms and his legs swelled up all the way to his groins. The doctors had to do a surgery called fasciotomy to relieve the pressure from the swelling and drain the pus. The scars from this surgery and snakebite remain with him to this day and cause him a great deal of pain. Unfortunately, Joseph’s family is very poor, and they did not have the money to continue getting Joseph the proper treatment. The wound got infected and he needed proper treatment and medication – if the wound was not treated, Joseph could end up losing his limb due to infection. Due to some donations from wonderful people, Joseph was able to get the wound cleaned out and a broken bone removed. He continues to get the wound cleaned every couple of days at the local dispensary, but has to wait three months to get the plastic surgery he needs to repair his foot.
Luciana
At around 9 am on the morning of 29 April, 2023, Luciana Mbaka went out to tether her cows when a large snake came at her, wrapped around her ankle, showed its “hood”, and then bit her twice. She had the presence of mind and bravery to reach down and grab the snake and pull it off her leg. It slithered away into the grass. She compared the length of the snake to the height of an IV drip stand which would be an estimated 1.5-2.0 meters. The width was about the size of a person’s wrist. Looking at some photos, she identified the snake as an Ashe’s spitting cobra (and was adamant it was not a black-necked spitting cobra), but these are not reported from Mbeere. The symptoms and description do match the boomslang with its threat display (flattened head and white under the chin), but the circumstances seem unusual.
Her daughter helped her to apply a tourniquet fashioned from some rubber material just above and below the bite site. They then called a boda boda which took 30 minutes to arrive. While waiting they tried some home remedies such as applying butadiene and sisal juice to the bite site.
She was brought to Mbeere Level 4 Hospital, arriving around 10 am where she presented with bite marks and a swollen leg on the shins above the foot and below the knee. The bite marks were oozing blood and cellular fluid, and she began to bleed from the gums She mentioned tingling at the bite site as well and feeling cold. In the late afternoon of 29 April, she began to have headaches which had spread to her neck and back by the afternoon of 30 April.
She was initially given one vial of PANAF antivenom about one hour after the bite by a nurse from the hospital. The pain initially subsided and they thought she was out of danger. Another nurse contacted Claire Taylor of the Taylor-Ashe Antivenom Foundation for assistance. She said the patient should be admitted for observation. She was also given the contact information for Dr. Eugene Erulu, a physician with significant snakebite experience.
On the morning of 30 April, a fang was removed from under the skin in the leg, and the wound was continuing to bleed as the blood was not clotting. There was no blistering around the wound. Dr. Erulu recommended that they administer four more vials of antivenom intravenously about 30 minutes apart. They then applied a pressure bandage. Dr. Erulu suggested that the hospital run a full hemogram include a 20-minute whole blood clotting test, but the hospital did not have the reagents required to complete the tests. In the afternoon, Luciana began to feel worse and became lethargic, so much so that she could not get out of bed to use the bathroom. She went through intermittent periods of sleeping. Around 4 pm, she began to vomit after being fed some porridge and given some milk. She vomited again about two hours later, and the vomit was black. She was having no trouble breathing, but she began to feel dizzy. Her blood pressure was reported to be stable at 172/70.
Overnight, Luciana worsened to the point that she was referred to Embu Level 5 Hospital because the bleeding got much worse and the blood was no longer red but dark inc color. At Embu, she presented with excessive bleeding, mental confusion, high blood pressure (184/136), headache, neck and back pain, vomiting, and high fevers. She was given 5 more vials of antivenom and also a tranexamic acid injection. Sadly, Luciana passed away around 6:30 am. Two of our trainers went to the funeral to honor Luciana and we were able to help pay for the funeral expenses.
Tending To the Garden 
Leave a comment