Majok* had come in several days after he’d been bitten, unable to put much weight on the wounded foot. As I examined him, I could see the dead tissue on the outside of his foot, but looking closer it was clear that the muscle and tissue had also disintegrated inside. I’d never seen anything like it before: all the structure of the foot was gone, leaving only a dry shell.
It was hard to imagine the pain he must have gone through. In a case like this, there’s little that can be done except to amputate the foot. We didn’t have an operating theatre in Mayen Abun, but with the help of the logistics team, we were able to arrange a transfer to a hospital around 20 km away, which MSF supports with donations of medical supplies.
I don’t know what happened to Majok after his surgery. I do know that, whilst having a foot amputated is life-changing anywhere in the world, in rural South Sudan it can be a disaster for the patient and their family. Most people here survive through farming or cattle rearing, making it very difficult for people with significant disabilities to earn a living and support their families. Instead they must rely on their wider family or community, who are often already living on very limited means.
After 24 hours the swelling on Bol’s leg had started to reduce, and after 48 hours, he was able to go home. Thanks to his mum’s quick thinking and the easy access to the antivenom, he made a full recovery.
And during my time in Mayen Abun, this was the case for all the snakebite patients who were able to get to us promptly, within around 12 hours of being bitten. But like Majok, that just isn’t possible for everyone. Majok did manage to get to the hospital eventually, but in the more remote villages in the bush, even that is out of the question. One of the things I’d like to see is a distribution of rubber boots, which are inexpensive and have been shown to offer good protection from snakebite.
