Tackling health epidemics in Nigeria is a tough job, even with sometimes inadequate personnel, leaving citizens helpless in many instances. Nigeria has gone through many phases of handling health crises with the latest being monkey pox. By October 25, there were 94 suspected cases in 11 states. They include
Akwa Ibom, Bayelsa, Cross River, Delta, Ekiti, Enugu, Imo, Lagos, Nasarawa, Niger, Rivers and the Federal Capital Territory (FCT). The Minister of State Health, Dr Osagie Ehanire, said though there were no fatalities, monkey pox seems frightening. Last year, the outbreak of meningitis ‘C’ in mostly northern states killed 813 people out of the 8000 suspected cases. However, in 2014, the case of Ebola was quickly contained. There is a current complaint over inadequate anti-venom to tackle snake bites in some states.
In Plateau, the Comprehensive Health Centre, Zamko in Langtang North Local Government Area of the state was established in 1996 by Jos University Teaching Hospital (JUTH) to among other cases be responsible for treating snake bite patients.
But recently, the Snake Bite Ward at the centre was deserted because of lack of anti-venom to treat patients. Some residents of Zamko told Daily Trust that recently, many victims of snake bite brought to the hospital from Plateau, Taraba, Benue and Nasarawa states died. However, an official at the hospital debunked the report, saying only two patients lost their lives while the others didn’t die at their centre. Another official said about 10 people died outside the hospital after the centre rejected them due to lack of anti-venom.
According to the “Admission & Discharge Register” of the centre obtained by Daily Trust, in the past three months, it admitted a total number of 256 people. They include 115 men, 95 women and 46 children.
In August 2017, 62 were admitted – 30 men, 20 women and 12 children between the ages of four and seven years while in September, 86 were admitted – 35 men, 35 women and 16 children between the ages of six and 10 years. In October, 108 were admitted including 50 men, 40 women and 18 children between the ages of two and 10 years.
A medical officer at the centre said the sudden upsurge in snake bites was as a result of lack of anti-venom in the hospital.
“It is not a sudden rise, it has been there, is just that people are not privy to information in the rural area. It has become rampant because of the lack of anti-venom. For almost a month now, there was no anti-venom in the hospital,” he said.
Nansak Nimze, 34, from Kapshe who lost his daughter to snake bite, said the incident happened when his daughter, Yachit, went to the farm for harvest last week Saturday.
“I was in Langtang when my wife called me that a snake had bitten our daughter while they were working in the farm and they took her to the hospital in Zamko. I rushed to the hospital and the doctors told us there was no anti-venom to give to her,” he said.
A victim, Lokhfa James, 32, a teacher, said he spent about N74,000 to survive snake bite. “The snake bit me around 7pm on September 27, 2017,” he said.
James, who teaches at the Cobertive Prestigious Academy, said he was unconscious when his friends took him to the hospital.
“I felt as if I was on fire as the poison moved inside me. I was vomiting as my friends moved me to the hospital. I was afraid not knowing what would happen to me. I wedded a few months before then and I kept thinking about my wife,” he said.
According to him, the doctors bought four anti-venom drugs at N9,000 each from a source but they weren’t working. He said he had to order the anti-venom from Jos for N38,000.
He added that two women who were admitted same day died.
“The doctors gave one woman about nine injections, but she eventually died. A man also bled to death due to lack of anti-venom,” James noted.
Another victim, Ruth Zingfa, also a teacher, said she spent about N152,000 to be treated when the snake bit her on the right leg at the farm on September 5 at Jimokfi.
She said she witnessed seven deaths because some of the victims didn’t have money to buy the anti-venom. The councilor representing Zamko Ward in the local government, Nankpah Rimdan, said the issue of snake bites and anti-venom were discussed in a town hall meeting two weeks earlier.
The Chairman, Management Committee of Langtang North Local Government Area, Brian Dadi, urged the federal government to fully equip the hospital with anti-venom so that people wouldn’t be confused on where to receive treatment.
“The federal government should always be prompt and make sure that the shortage of anti-venom comes to an end because people are dying,” he said.
The Medical Officer of the Centre, Istifanus Bako, said for almost a month there was no anti-venom in the hospital.
He said during the cold season, incidences of snake bites are very low but that children are usually bitten by snakes when they put their hands in holes hunting for rats.
He added that from March to the beginning of the rainy season the patients cut across the different age groups due to the harsh weather which makes snakes to come out of their holes due to the heat.
On why the Snake Bite Ward was empty, he said the hospital didn’t have any case of in-patients because it didn’t have anti-venom and it is unethical to admit when there are no drugs to take care of victims.
He disclosed that when there was anti-venom in their centre, they could admit about 10 to 15 patients daily.
“In the last three weeks, we did not treat any patient because of lack of anti-venom and I can’t tell the reason why the anti-venom is not available and because of its scarcity about two have people died,” Bako said.
He confirmed that they sold the anti-venom at N38,000 and sometimes, one dose wouldn’t work, and the patient would be given two or three doses.
“We have two types of anti-venom drugs which include polyvalent and monovalent and both aren’t available which makes our work difficult and frustrating,” he added.
Victims helpless in Gombe
In the last three weeks, about 22 people have died while on admission at the Centre for Anti Venom Treatment and Research of the General Hospital, Kaltungo in Gombe State, our correspondent reports.
The figure was recorded as a result of lack of anti-venom drugs hitherto given free to victims of snake bite who thronged the centre from neighbouring states.
The drug and other lines of treatment were given to victims free by the federal and state governments since 1999 when the centre was established.
Mr Garba Bawa of Kaltungo Local Government Area of Gombe State lost his 18-year-old son when he was admitted in the hospital for over three days without getting the anti-venom.
“A snake bit my son when he was collecting maize from the farm around noon on that fateful day. We rushed him immediately to the hospital but we were told that there was no anti-venom. He spent three days and we had to leave when we realized that his condition was deteriorating. He died two days after we left the hospital,” Bawa said.
Several others were also feared to have died after they left the hospital when they could not get the lifesaving free drugs supplied to the centre.
According to unofficial figures obtained by Daily Trust, over 77 people have died from various cases of snake bite in the past one month due to the non-availability of the anti-venom.
“About 77 patients left the hospital during the crisis, and we are afraid that most of them couldn’t survive due to the bad state they were brought to the hospital before they left,” a source at the hospital told Daily Trust.
However, official figures at the hospital revealed that 22 people were confirmed dead in the past three weeks while on admission at the hospital. The data showed that Gombe State recorded fewer deaths because victims from far places were mostly affected as they usually arrived the hospital late and in critical condition.
The medical officer in charge of the centre, Dr Abubakar Sa’idu Balla, said the number of deaths was relatively small for Gombe because of the proximity of the hospital to the people.
He said the centre serves the 11 endemic local governments in Gombe, Adamawa, Bauchi, Borno, Yobe, Taraba, Plateau and Jigawa states as well as Cameroun.
He said the number of victims admitted at the centre had fallen to 10 daily from 12 because drugs were out of stock.
According to official data from the hospital, from January to September, about 87 to 89 patients died while receiving treatment. But in October alone, when the hospital experienced drug shortage, no fewer than 22 deaths were recorded.
Investigations by Daily Trust revealed that there was a high number of patients bitten by snakes from March, April and May when people were active in farms in preparation for the rainy season. There was also a high influx between October and November, when they go for harvest. Dr Balla said during these periods, the centre received as many as 20 patients daily.
According to him, if victims come on time, about 100 per cent of them would be treated, but if they arrive late and in bad state, the chances of survival would be slim.
“When people bring patients and they learn that we don’t have drugs, they just leave and other people upon hearing that they would stop coming to the hospital. Stock out is a serious challenge because whenever it happens, the case of mortality increases. The stock out has entered its third week. But the hospital has gotten a little relief supply, and it is not free, patients have to pay for it,” he said.
Sixty-five-year-old Malam Abubakar Yusuf, said whenever there was availability of drugs, he didn’t fear going to farm because in the event of a snake bite, he would be treated free.
“Because the snake bite is connected with farming activities, the more there are free drugs, the more people will be trooping to the hospital. In fact, some people don’t even go to farm if there are no drugs.
“So whenever there is drug stock out, people are afraid to go to farm. In other words, to get the much needed food security, there is need for the country to be producing these drugs,” Malam Yusuf said.
A 13-year-old boy, Aliyu Musa, was rushed to hospital in state of coma. He was bitten by a snake for over a week, but was not taken to the hospital until his condition worsened.
His brother, Ibrahim Musa, said they applied herbs but realized that his condition was getting worse and decided to “try the hospital”.
Ibrahim said when they arrived, they were informed that there was no longer free drugs and spent over N75,000 to purchase the drugs and he stabilized.
Malam Abubakar Abdullahi brought his 15-year-old son, Basiru, after trying various herbs to no avail in Futuk village of Alkaleri Local Government Area of Bauchi State before he finally took the boy to hospital.
“When he was bitten, we tried various herbs before we finally came here,” he said.
Our correspondent observed that apart from the non-availability of drugs, the centre itself is in a very deplorable condition and over-stretched. There is no blood bank in case of an emergency, with an epileptic power supply. Some patients were seen sleeping on the floor.
A worker said the hospital had problem of bed space during the period of high influx of patients. According to Dr Balla, the hospital needs at least 21 nurses and attendants each for the male and female wards who should work in shifts.
“There is inadequate manpower compared to the number of patients. Even though some nurses are on course, we still need more hands, now we have only eight nurses, eight attendants and only one medical doctor,” he said.
“The only solution is frequent supply and possible production of anti-snake venom in the country. Attempts have been made to eliminate the snakes, but it turned out to be disastrous because the snakes are creatures that are made to balance the ecosystem.
“The snakes are reducing the number of rodents and insects that are affecting farms. If the snakes are killed, that will have negative effect on the crops that are harvested. Rodents will devastate the farms,” Dr Balla added.
A lecturer at the Department of Geography, Gombe State University, Gombe, Malam Ibrahim Yahaya, said the area was infested with snakes because it is a dry land, rocky and Sahel with low vegetation.
“The snakes lay their eggs on the rocks where they are hatched. The area is also fertile, as such there are farming activities always which give the snakes rodents and insects to feed on,” he said.
Reacting to the non-availability of the anti-venom, the Gombe State Commissioner for Health, Dr Kennedy Ishaya, said the centre ran short of supply because more people were trooping in to get the free drugs.
“In the whole of the Northeast zone, only Gombe is providing the anti-venom free, therefore people are overstretching the centre and exhausted the available drugs because the treatment is entirely free,” he said.
The commissioner said the state government had released N8.8 million to the centre to procure the drugs.
“In addition, the state government has also built a multi-billion naira ultra-modern snake bite hospital in Kaltungo. All things being equal, the hospital will be commissioned this month by Governor Ibrahim Hassan Dankwambo,” Dr Ishaya said.