On 20th September, Dr John Oakley and Ray Krai visited Obo health centre to provide clinical support to the staff during the OTDF communication patrol. At Obo Health Centre there are three health workers – a registered nurse and two community health workers. They had general clinical knowledge about how to treat a snakebite case from their studies and first aid training provided by the North Fly Health Services Development Program and CMCA Middle and South Fly Health Program (collectively ‘the Program’) some time ago. However, they were not confident in the use of that knowledge, especially without the availability of antivenom drugs.
Dr Oakley did a short training needs analysis and identified several clinical areas that needed strengthening and the management of snakebite was one of them. He gathered all the staff and ran a 3-hour clinical session on how to manage snakebites especially without antivenom drugs. The specific clinical management without antivenom included immobilization, application of a pressure bandage, running the blood clothing test, monitoring signs of envenomation and the use of non-antivenom drugs, neostigmine and atropine. At the end of the session the officers expressed their appreciation of the session. The Program team then left to continue their patrol.
On 2nd October a young girl was bitten by the venomous death adder near Obo. Knowing there was no antivenom drug available for death adder and the risks ahead, an officer quickly applied all the skills and knowledge he had learnt about snakebites on the girl. He gave an initial dose of neostigmine and atropine at the health centre when the patient showed signs of envenomation. Neostigmine and atropine slow down the blood to the body’s main organs giving time to reach a facility where antivenom can be administered. He kept the patient on an intravenous fluid and left for Kiunga at 3am on 3rd October. Along the way, the patient showed further signs of envenomation, so the officer gave another dose of the same drugs and continued general observations. It took them a total of 9 hours traveling up the Fly River, arriving at midday. The patient was picked up at the waterfront and rushed to the hospital where she was managed well and recovered.
The Officer-In-Charge Mr Junlai Nawali expressed his appreciation to the Program team especially Dr Oakley for the timely session on snakebites a week earlier that saved the girl’s life. He said, “I really want to thank Dr Oakley and the team for providing us with that session on snakebite. I’d only thought about the death adder antivenom to be used on such a case without much attention to the other two drugs. I used the neostigmine and atropine after I learnt from the session and it really worked in saving that girl’s life.”
CMSFHP is funded by the CMCA portion of the Western Province People’s Dividend Trust Fund through Ok Tedi Development Foundation (OTDF). The Program is managed by OTDF and implemented by Abt Associates.