Snakes, Scorpions, and Spiders
These animals are all Scary and the first letter of each name starts with an “S.” A Silly coincidence.
Over the last week I have had two of these creatures in my casita. I don’t walk barefoot!
I have not seen a snake in Nicaragua. Every morning I start my bird watching at 5:30, before the dawn breaks over the horizon. I walk briskly for about 30 minutes to an area along a stream (a deep and wide river in the rainy season). I spend an hour looking at the birds and then I walk back to the casita to get ready for the clinic. Most of the hour is spent on paths in the jungle. I am constantly on the look out for snakes. Every hanging vine and piece of wood on the ground is suspect.
About a week before I left for Nicaragua I listened to a very funny TED talk by Douglas Adams, the famous author of “Hitchhiker’s Guide to the Galaxy.” He also wrote, “Last Chance to See,” a book about endangered species. Adams visited the locales of all the endangered species he wrote about and since he was going to Madagascar, a place filled with deadly snakes, he consulted a world authority on snakebite. Adams’ anecdote about meeting with the Australian Herpetologist (snake expert) was hilarious. Adams asked the expert what to expect if he were to be bitten by a deadly snake.
“You die of course," the expert replied, "that’s what deadly means.”
The audience roared with this comment and so did I. However, the grim reality is that some snakebites are deadly and Nicaragua is home to a dozen or so the most deadly snakes in the world. There are 10,000 to 100,000 reported snakebites in Central America every year and of course most bites in underdeveloped countries are not reported.
So, I’ve decided that it is not a matter of IF I come across a snake, but rather WHEN and HOW OFTEN. My desire is to minimize encounters.
I do a lot of stomping when I walk in the jungle to send vibrations ahead to let the snakes know I’m around. I make noise. Stomping and noise doesn't help with bird watching. I do not move fast. I want to give the snakes lots of time to move. The same rules hold for preventing grizzly attacks back home. There should be Snake Spray.
The conventional acute care for snake bite is to immobilize the extremity, usually a leg or hand, to apply a pressure bandage with sufficient pressure to stop the return of the venous blood to the heart but to allow the arterial flow into the extremity, and to elevate the leg or arm.
I get asked a lot about snake anti-venom. Years ago, when I was backpacking in Thailand, I visited an anti-venom center. Handlers milked the venom from the various vipers and the liquid was sent to labs to prepare anti-venom. There could theoretically be an anti-venom for every snake and there are a number of products available, but none are approved by the US FDA and all are considered experimental because there are no good studies to prove if, or how well, the preparations work. To be effective at all, the anti-venom should be administered within 4 to 6 hours. Of course the anti-venom must be available locally and you must be able to identify the snake to choose the correct anti-venom.
Imagine a bird watcher person like me who is bitten by a snake on his leg in the jungle. The medical books suggest that the snake should be identified with a photograph. How many people bitten by a snake hang around to take a photo? The snake would likely slither away. Do you think that someone who was bitten would chase after the snake to take a photo? I don’t think too many snakes are identified by photograph.
The next question is how would this person immobilize and elevated the leg? That is not possible unless there is a convenient stretcher and four able-boded men to carry the person. So, this means that the only acute intervention would be a pressure bandage above the lesion, and a speedy retreat to the nearest anti-venom place.
The nearest anti-venom location is likely in the US. How fast do you think a person in Nicaragua could get from the jungle to the US? Could this be accomplished in less than 4 to 6 hours? Hmm. Not likely.
This all means that prevention is the key to survival.
DISCLAIMER: This blog was originally posted on http://helpnicaraguachildren.blogspot.com/. Please note, Dr Robson is not accepting donations at this time. However, he would greatly appreciate your comments and suggestions in support of his efforts.
