Bauchi communities groan over snakebites as multi-million naira clinic rots away 

• Lack Of Anti-venom, Poor Treatment, Others Bane Of Facility
Rabiatu Adamu, 17, a resident of Duguri in Alkaleri Local Council of Bauchi State was bitten by a puff adder, in September 2020 while assisting her parents on the farm.

The parents who are also farmers, depend on firewood sales for their survival and hence could not afford quick medical treatment in Kaltungo, Gombe State, and Garga in Plateau State, where most victims receive treatment. Consequently, they resorted to home remedies.

Two years later, the snakebite has refused to heal while Adamu cannot walk beyond 50 metres without taking a break.

“I have not been attending school for about two years now since that incident. I have even started thinking about amputation because I cannot bear the smell again. I am tired of chasing flies away from the rotten flesh at the point of the bite. My uncle suggested that we should amputate the leg, but my father is still insisting on traditional treatment,” she lamented.

In Gaji, about 20 kilometers from Duguri, 62-year-old sugar cane farmer, Shehu Abubakar, described his farm as a favourite habitat of snakes.

He said due to the nature of sugar cane, which attracts various insects, including frogs and toads, snakes are often found on his farm. Since he discovered this, Abubakar said he rarely plants sugar cane as the farm became unsafe for him and his family.

Duguri, Bandibit-Shafan-Duguri, Mansur, and Gaji communities around the popular Yankari Games Reserve in Alkaleri Local Council of Bauchi State, have continued to lose their loved ones to attacks by poisonous snakes despite the government’s effort to stem the tide.

Investigation revealed that hundreds of residents particularly farmers have been killed while many are at risk of a leg amputation due to poor treatment from snakebite. Many residents of the area disclosed that the risk of being bitten by a snake is high due to its proximity to Yankari Games Reserve, and the rocky terrain, which serves as a haven for different species of deadly, venomous snakes.

Most farmers in these communities are being forced out of their farmlands except those who can procure rain boots and gloves.
To stem the tide, the state government through the Community and Social Development Agency (CSDPA), under the Gender and Vulnerable Investment Component (GVIC) spent N9, 985, 800 to construct a snakebite clinic in Duguri in 2020, to cater to victims of snakebites in local councils including Tafawa Balewa and Kirfi LGAs.

The project was carried out under the Community Driven Development (CDD) where stakeholders under an umbrella body – Old Aged Group collaborated with the agency to execute the project. Findings showed that the CSDA through the support of the World Bank provided 95 per cent of the contract, while the community contributed five per cent in kind.

But two years after the construction of the clinic, snakebite has continued to be a leading cause of death in these communities. Findings show that the project lacks enough personnel and medical equipment to cater to victims of snakebites in the area. These victims from Bauchi communities travel as far as Gombe and Plateau states to seek help and some pass on in transit.

Gaji-based Abubakar is presently morbidly afraid of entering his farm because of the situation, even as his sugarcanes are mature and ready for harvest.

“I contracted some boys to harvest for me, but after killing five snakes on the farm they left. They said they cannot risk being bitten by snakes because there is no treatment facility nearby. The snakes have been disturbing us, particularly this rainy season,” he said.

Abubakar Ibrahim, a resident of Mansur Community in Alkaleri Local Council lost his brother to a snakebite in September 2021. He was traveling on a motorcycle when he was bitten by a snake.

For him to access quick medical treatment, he had to travel to Kaltungo Snakebite Hospital in Gombe State using longer routes via Yalo and Futuk communities due to bad roads. Ibrahim said his brother died before reaching the hospital in Kaltungo.

“These issues mostly happen during the rainy season when the rivers are full and snake holes are wet. This will force the snakes to come out of their habitat in their numbers. Farmers go through a lot during this period. I have friends that have deserted their farms this season, many of them said that they would purchase grains during harvest and sell them when the prices appreciate. They are all afraid of snakes,” Ibrahim said.

It took another resident of Gaji Community, Rashida Mohammed, 24 hours to discover that her four-year-old son, Usman Mohammed had been bitten by a snake. The minor who could not express what happened to him until much later had followed his parents to the farm where he suffered the snakebite.

Mohammed said: “We just relocated to our new house and we discovered that we were encountering snakes daily in the house. There is no room in the house that we have not seen, and killed snakes, including the surroundings of the house.”

Two weeks after that experience, she said that her 18-year-old son, Khalid, was also bitten by a snake, and he could not go out for two weeks while under treatment, and because of severe pain.

“It happened on the farm while he was looking after some animals. He didn’t know that he had been bitten by a snake until he started feeling weak after two or three days. It was at this point that he was taken to a traditional doctor for treatment,” she said.

Adamu Nasir, who resides in Duguri was helping his father on the farm last August when he was bitten by a snake on his left leg. Nasir said he fell to the ground and pulled off the snake as it was sinking its fangs into his leg. Soon after, Nasir started feeling dizzy and was rushed to Duguri township to seek medical attention.

“Before arriving at the village, I became unconscious with a severe headache. I was later taken to a local traditional snakebite healer who gave me some medicine before the headache subsided. I started getting better. She also gave me some other medicines during the three days that I spent in her care. Honestly, it was a terrible experience, and I had several sleepless nights,” Nasir recalled.

Adamu Mohammed has witnessed several deaths arising from snakebites in his Duguri community. He was in primary school in 1960 when his best friend was bitten by a snake while playing behind his house. He shouted and not long after, he lost his life. Now the district head of Duguri, Mohammed said he and many residents are afraid of engaging in any farming activity.

The district head said that between 2012 and 2013, the community recorded a very high mortality rate from snakebites as 210 victims died.

In Cheledi and Yerima Tukur communities in Kirfi Local Council, snakebite victims are facing a similar challenge. Victims are often taken to Alkaleri General Hospital where the anti-venom injection is not always available.

“We took my brother to Alkaleri General Hospital, but we could not get adequate treatment and we had to rush him again to Kaltungo, which is about 138km from here. He nearly died on the road before we got there. We spent close to N150, 000 on his treatment. Being a farmer, how much was his entire harvest? He could not afford it without the support of family members,” Abubakar Saleh, a civil servant in Cheledi said.

Jabir Mubarak, a resident of Yerima Tukur, stopped farming in 2015 after a snake attack. Having escaped death by the whiskers, Mubarak was bedridden for two years until an NGO came to the rescue and paid for him to be properly treated in neigbouring Gombe State.

“When the snake bit me seven years ago, I was taken to the Alkaleri General Hospital, where there was no drug. There, we were referred to Duguri, but when we got there, the story was the same as there was no drug.”

Duguri-based Ibrahim Jumba, a farmer, has had multiple close calls with death. On one of the occasions, he was bitten by a snake on his left leg while working on his farm. After killing the snake, he sought help from his fellow farmers who ferried him on a motorcycle to a traditional healer in the village.

He recalled: “I was taken to the house of this woman, a traditional healer. She tried her best, but I wasn’t getting better. Consequently, I was taken to the hospital where they gave me two injections, and I was transfused with two pints of blood. It was there that I got better. I was just discharged recently after a test indicated that the venom has been treated and thank God I am getting better.”

Jumba’s ordeal forced him to abandon his farm located around the hills in his neighbourhood. He now cultivates in his backyard.

“I don’t go to farm again. My children now help me fetch firewood and sell so that we can get what to eat because we don’t have any other source of income.”

Due to the poor state of the snakebite facility in the area, victims from Duguri and other communities in Bauchi State continue to flood health facilities in Kaltungo, Gombe State, and Garga, in Plateau State in search of treatment.

A doctor at the Kaltungo treatment facility who does not want his name in print disclosed that the majority of snakebite victims treated in the facility are from Bauchi State.

“Patients from Bauchi State are responsible for using the majority of the drugs in our facility. The free drugs and anti-venom injections donated by North East Development Commission (NEDC) are often expended on patients from Duguri and adjoining communities in Bauchi State.”

The Village Head of Bandibit-Shafan-Duguri, Yusuf Idris, corroborated the doctor’s position, adding that the community regularly seeks medical attention from neighbouring states, especially Garga in Plateau State, but it comes at a huge cost.

“Our major problem is that we don’t get access to Garga during rainy days because of a river, which usually floods the only road, thus making it impassable,” Idris said.

Multi-million Naira Snakebite Project Yet To Make Impact
THE Duguri snakebite clinic project, a public-private partnership (PPP) was built through direct labour under the joint supervision of the CSDA and Old Aged Group. The project designed to have a consulting room, laboratory, reception area, general ward, observation/labour rooms, dispensary, card room, matron office, health talk area, and toilets, lacks all the essential facilities to function.

A visit to the facility revealed there are no windows, medical equipment, and furniture for any meaningful medical treatment to take place.

Findings by The Guardian showed that partial services at the clinic commenced in mid-2021 with only 10 doses of anti-venom (EchiTab Plus ICP Liquid) as part of the project proposal specifications made by the community.

At the clinic, a dose goes for N50, 000. Due to the limited number of EchiTab Plus doses, most residents of the area have stopped visiting it whenever medical emergencies arise.

Findings also show that the clinic has been “converted” into a primary healthcare facility where pregnant women deliver babies contrary to the original purpose of the project.

Presently, only a small section of the facility is set aside for Sagir Abubakar, a staff who treats victims of snake bites whenever anti-venom donations are made by individuals, or non-governmental organisations (NGOs).

Persistent unavailability of the anti-venom and the huge demand for same has made residents of Duguri and adjoining rural communities conclude that the snakebite clinic is non-functional.

Dusty planks and unused roofing sheets are kept inside a room tagged “consulting room” while the entire facility is surrounded by grasses. The facility is still without electricity.

The clinic has always been faced with a lack of anti-venom as patients would have to pay before the anti-venom is administered.

At the facility, not less than 10 snakebite victims report weekly for medical attention, according to available records. Sometimes, a patient may require two injections, which would cost at least N100, 000,” said Abubakar.

One of the major factors that have forced many victims of the incessant snakebites to seek medical attention in neighbouring states is the outrageous treatment fee.

However, in 2020, the state budgeted N6bn for the construction and renovation of primary healthcare centres (PHCs), but the Duguri Snakebite Clinic, which is now more or less a PHC did not receive any government attention throughout the year.

According to the Bauchi State Auditor-General’s Report, as of December 31, 2020, only N2.9b representing 49 per cent of the budgeted sum was spent on the projects.
Prohibitive Medical Costs Force Residents To Seek Traditional Healers
LONG before the Duguri project was built by the CSDPA, residents of the community strongly believed in their self-help traditional method of treating venom, which remains inexpensive. This partly explains why the arrival of the snakebite clinic was somewhat an unappreciated gesture.

Findings revealed that nine out of 10 snakebite victims in Duguri are treated using traditional herbs. The outrageous fee for anti-venom injection and its unavailability has not helped the situation. Abubakar, the officer-in-charge of the snakebite facility confirmed that the facility has been out of the anti-venom for weeks.

Seventy-two-year-old Furera Ibrahim, a snakebite healer, and resident of Duguri has been treating victims for about 45 years and charges her mostly farmers patients N10 with two chickens.

“I give victims of snakebites medicine that make them vomit the contaminated blood before I continue with the treatment. In the process of treating them, if the venom is still in a patient’s stomach, there is medicine I’ll give for it to be vomited and from there I will continue with the treatment and by God’s grace, the patient will recover. Sometimes, I treat more than 10 patients here every week.

“My treatment attracts only N10 and two chickens or N4, 010. That’s what I inherited as charges from my parents, but if someone who has the means gives me more than the stipulated amount, I will collect it. Now, chicken is expensive and because of that, I charge N4, 010 only to lessen the cost to the people. Even if 20 patients, that’s what each of them is going to pay, and people are being healed by the power of God,” she told The Guardian.

Community Adopts Crowdfunding To Treat Patients In Neighbouring States
DUE to the rising poverty level among rural dwellers in Bandibit Shafan Duguri community, about 10 kilometres away from Duguri township, residents have resorted to crowdfunding to assist snakebite victims, and stop them from dying untimely deaths.

The Village Head of Bandibit-Shafan-Duguri, Mr. Yusuf, informed The Guardian that the strategy was adopted when residents were dying of snakebites. He said a traditional healer in the community helped with treatment of minor cases while severe cases are taken to either Kaltungo or Garga.

“We have a lot of snakes meandering around from August to September. It is about this time that the snakes reproduce and are everywhere in the community. In most cases, they hide in trees or anywhere they feel comfortable, and once you step on them ignorantly that they bite. Six people were recently bitten by snakes in the community, “ he told The Guardian.

He added that patients taken to snakebite clinics in neighbouring states are administered one or two doses of anti-venom, which is between N35, 000 to N40, 000 in Garga community, Kanem Local Council of Plateau State.

“They are helping us there; we prefer taking patients to Garga because it is closer to us than Kaltungo. The one (snake bite clinic in Duguri) has no drugs. A cab driver will demand N20, 000 as transport fare to travel to Duguri from here, that’s why we prefer to go to Garga, which is easily accessible. However, the problem is that a river has overflown its banks and taken over the road leading to Garga. We are battling with this problem and we want to plead with the government to help us establish a hospital so that we can be getting treatment very close to us,” Yusuf said.

We Have Done Our Part —CSDPA
THE CSDPA, which supervised and funded the Duguri project, through the World Bank insists that it has played its role, so other sustainability responsibilities should be shouldered by the Old Aged Group and Alkaleri Local Council.

Findings showed that CSDP only funds projects based on demand by community elders, who must form a committee, and write to it based on their needs. The agency’s benchmark is N10m and five per cent of the project sum must be provided by the community group.

The Guardian learnt that the project proposal and sustainability strategy were submitted to the CSDP and the group said that it would be sustained by goodwill from well-to-do individuals in the community. Since then, the group has found it difficult to rally community support for the sustenance of the clinic, Aisha Chinade, Desk Officer, Gender and Vulnerable Investment Component of the CSDP explained. She said that the agency released the entire project fund in three tranches to the group.

“They carried out the project under what is called Community Driven Development (CDD) approach. They got the money in their account and they did the project. They also executed their Group Development Plan (GDP), which includes their sustainability plan. Here, they stated how they intend to maintain the clinic,” Chinade said.

Sustainability Burden On Aged Group
MANAGING and stocking the facility with anti-venom injections has become a very difficult task for the community to execute.

Findings by The Guardian revealed that the price of anti-venom has continued to soar due to market forces. There is more demand for the vaccine than its supply.

A popular anti-venom, Echitab-Plus, sold for between N25, 000 and N30, 000 in 2021, now goes for between N50, 000 and N55, 000, and this is from the manufacturer.

The Chairman of the Old Aged Group, Isa Mohammed Duguri, confirmed that the CSDP fulfilled its duties of financing the project, but the group has been finding it difficult to sustain the project.

He added that the District Head of Duguri, Alhaji Adamu Mohammed, at the takeoff of the clinic, donated more than 20 doses of Echitab Plus to be administered freely to victims.

According to him, the clinic also serves the purpose of a regular PHC where other services are provided by seven staff of Alkaleri Local Council, including the lone staff who treats snakebite victims.

BSPHCDA Helpless As Govt Fails To Release N8m Anti-venom Fund 
THE Executive Chairman of the Bauchi State Primary Health Care Development Agency (BSPHCDA), Dr. Rilwanu Mohammed told this reporter that he sought for N6million for anti-venom injections from the Governor and it was quickly approved with N2million added to the initial request –making it N8million. He, however, lamented that the fund is yet to be accessed as the Treasury Department has failed to release the money to save residents of Duguri and other communities from dying.

“Last year, seven people died in the Community. I have not gotten the data for this year. They have been going to Kaltungo in Gombe State for treatment.”

He said his Agency has made efforts to make the snakebite treatment centre functional by merging its operations with a well-established Primary Healthcare Centre in the community but it is yet to materialize due to lack of funds.

“We have accommodation for the staff and all the equipment is there. We are waiting for the money to be released for us to start.”

In 2020, Prof. Habib led the NSRIC delegation on a courtesy call to Governor Bala Mohammed where both parties agreed to work on tackling the menace. The NSRIC said it trained health personnel and donated vaccines and other equipment for snakebite treatment but the state government has not done enough to stock up medical facilities with anti-venom.

Prof Abdulrazak Habib is an infectious and tropical disease physician, epidemiologist, and a key player at the Nigerian Snakebite Research and Intervention Centre (NSRIC), Bayero University, Kano. Reacting to the findings of this report, Prof. Habib stressed that Bauchi State, where most snakebite cases are mostly recorded in Nigeria needs to prioritize the provision of anti-venom.

“We met him (Governor Bala Mohammed) two years ago and he was very excited. Unfortunately, his village Duguri is one of the highest endemic snakebite locations in the country and there have been cases in the literature and newspapers –so he was very excited. He requested a design of a snakebite treatment centre from us, and we did and submitted it. Bauchi State is one of the states we operate even though we don’t have money for now.

“We told him that we don’t want anything for ourselves we just want him to provide anti-venom for his people. He said he would do that but I don’t know his political disposition now, whether he will keep to his promise or not,” he said.

• This investigation is supported by the John D. and Catherine T. MacArthur Foundation and the International Centre for Investigative Reporting