Snakemen…David Williams (centre) with his assistant Owen Paiva (left) and snake handler Jasper Gabugabu with a deadly death adder.-Picture by MALUM NALUAustralian Venom Research Unit clinical toxinologist and herpetologist David Williams – popularly known as ‘Snakeman’ because of the number of lives of snakebite victims he has saved - leaves Papua New Guinea next week to take up an appointment to the World Health Organisation based in Geneva, Switzerland.
He will be working on a project to improve access to snake antivenoms in the developing world, particularly in Africa and Asia.
Mr Williams has worked and lived in PNG for almost 15 years, and even though his posting to the WHO is temporary, he said that leaving PNG even for a little while was perhaps the most difficult decision he has had to make.
“I have made the best of friends here, in towns, cities and in villages in far-flung provinces,” he said,
“I have been welcomed into homes and communities with warmth and generosity.
“I have seen Papua New Guinean people at their best, and I have had the great privilege to help some of them, when they were at their worst.
“It has been for me, the most challenging, confronting, frustrating, alarming, and yet at the same time uplifting, inspiring, insightful and educational time of my life.
“Papua New Guinea feels more like ‘home’ to me, than my own country, Australia does, and I will miss it very much while I am gone.
“I hope that the Minister for Health will give me the opportunity to come back to PNG and continue my work here, once my appointment to WHO ends.”
For the past four years, Mr Williams has been studying the clinical effects of snake bite at Port Moresby General Hospital, and at one stage, even became a patient himself, after being bitten by a 2.5m long Papuan taipan at Napa Napa during the making of a documentary on PNG’s dire antivenom woes for the ABC Foreign Correspondent programme in 2007.
Through his work, the lives of many snake bite patients have been saved, and with the development of a new taipan antivenom that costs less than 1/8th the price of the current antivenom, he hopes that many thousands more lives will be saved in years to come by enabling the national government to supply more antivenom to many more parts of PNG than ever before.
But regardless of which antivenom is used to treat snake bite, Mr Williams says that the secret to saving snake bite patients lies in having a well-trained and responsive health work force.
“In rural health centres, such as Veifa’a in Mekeo, the snake bite mortality rate has plummeted as a result of the training we have given to local health workers, and because of their willingness to embrace this new knowledge” he said.
“To some extent, rural health centres who have trained staff and access to antivenom, now do much better at managing snake bite than even Port Moresby General Hospital, perhaps because the staff are in the same boat as their community members – any one of them can be bitten by a snake, so they are acutely aware of just how urgent an emergency snake bite is, and they take extreme steps to manage snake bite well.
“It is sometimes a bit more difficult at PMGH, which has a very under-resourced emergency department that is grossly overcrowded and often under-staffed; patients sometimes fall through the cracks.
“We have also had ongoing problems with access to antivenom at PMGH.
“Supplies that run out on a weekend often cannot be replenished until the next Monday, and this means patients admitted on a Saturday or Sunday may not get antivenom when they need it, resulting in a poor prognosis.”
Mr Williams also said that while work needed to be done to prevent unnecessary deaths after snake bite, that people should have confidence in the medical service provided by the hospital.
“Nursing staff, particularly in the ED, Ward 7 and the intensive care unit are among the most-dedicated and professional health workers in the country, and the care they provide to snake bite patients is exemplary” he said.
“There are also a number of young doctors coming up through the ranks now who take a serious interest in the treatment of snake bite, and they should be encouraged to consider toxinology as a career sub-specialty, because PNG badly needs local snake bite experts in its hospitals.
“The most wonderful memories I have from my time in PNG, are of people who survived their snake bites.
“I consider it a privilege to have been able to help make it possible for these men, women and children to take back their lives and go home to their families.
“There is nothing better in this world than the smile on the face of a person whose life you have helped save.”
In Mr William’s absence, the snake bite project will continue, and will be managed by his colleague, emergency physician Dr Simon Jensen while the day-to-day operations of the snake bite laboratory will be handled by Owen Paiva and Jasper Gabugabu in collaboration with Dr Jensen and Prof Lohi Matainaho, dean of research at University of PNG.
“We also expect to have a number of visits from other University of Melbourne collaborators and other visitors in coming months to support Owen and Jasper, and to further develop specific projects,” Mr Williams said.
“We anticipate lodging an application for ethics approval to conduct a clinical trial of the new taipan antivenom before the end of this year, with a start date for the trial in 2010.
“If the taipan antivenom succeeds then we will look at developing a new bivalent death adder/small-eyed snake antivenom in 2012.”
He will be working on a project to improve access to snake antivenoms in the developing world, particularly in Africa and Asia.
Mr Williams has worked and lived in PNG for almost 15 years, and even though his posting to the WHO is temporary, he said that leaving PNG even for a little while was perhaps the most difficult decision he has had to make.
“I have made the best of friends here, in towns, cities and in villages in far-flung provinces,” he said,
“I have been welcomed into homes and communities with warmth and generosity.
“I have seen Papua New Guinean people at their best, and I have had the great privilege to help some of them, when they were at their worst.
“It has been for me, the most challenging, confronting, frustrating, alarming, and yet at the same time uplifting, inspiring, insightful and educational time of my life.
“Papua New Guinea feels more like ‘home’ to me, than my own country, Australia does, and I will miss it very much while I am gone.
“I hope that the Minister for Health will give me the opportunity to come back to PNG and continue my work here, once my appointment to WHO ends.”
For the past four years, Mr Williams has been studying the clinical effects of snake bite at Port Moresby General Hospital, and at one stage, even became a patient himself, after being bitten by a 2.5m long Papuan taipan at Napa Napa during the making of a documentary on PNG’s dire antivenom woes for the ABC Foreign Correspondent programme in 2007.
Through his work, the lives of many snake bite patients have been saved, and with the development of a new taipan antivenom that costs less than 1/8th the price of the current antivenom, he hopes that many thousands more lives will be saved in years to come by enabling the national government to supply more antivenom to many more parts of PNG than ever before.
But regardless of which antivenom is used to treat snake bite, Mr Williams says that the secret to saving snake bite patients lies in having a well-trained and responsive health work force.
“In rural health centres, such as Veifa’a in Mekeo, the snake bite mortality rate has plummeted as a result of the training we have given to local health workers, and because of their willingness to embrace this new knowledge” he said.
“To some extent, rural health centres who have trained staff and access to antivenom, now do much better at managing snake bite than even Port Moresby General Hospital, perhaps because the staff are in the same boat as their community members – any one of them can be bitten by a snake, so they are acutely aware of just how urgent an emergency snake bite is, and they take extreme steps to manage snake bite well.
“It is sometimes a bit more difficult at PMGH, which has a very under-resourced emergency department that is grossly overcrowded and often under-staffed; patients sometimes fall through the cracks.
“We have also had ongoing problems with access to antivenom at PMGH.
“Supplies that run out on a weekend often cannot be replenished until the next Monday, and this means patients admitted on a Saturday or Sunday may not get antivenom when they need it, resulting in a poor prognosis.”
Mr Williams also said that while work needed to be done to prevent unnecessary deaths after snake bite, that people should have confidence in the medical service provided by the hospital.
“Nursing staff, particularly in the ED, Ward 7 and the intensive care unit are among the most-dedicated and professional health workers in the country, and the care they provide to snake bite patients is exemplary” he said.
“There are also a number of young doctors coming up through the ranks now who take a serious interest in the treatment of snake bite, and they should be encouraged to consider toxinology as a career sub-specialty, because PNG badly needs local snake bite experts in its hospitals.
“The most wonderful memories I have from my time in PNG, are of people who survived their snake bites.
“I consider it a privilege to have been able to help make it possible for these men, women and children to take back their lives and go home to their families.
“There is nothing better in this world than the smile on the face of a person whose life you have helped save.”
In Mr William’s absence, the snake bite project will continue, and will be managed by his colleague, emergency physician Dr Simon Jensen while the day-to-day operations of the snake bite laboratory will be handled by Owen Paiva and Jasper Gabugabu in collaboration with Dr Jensen and Prof Lohi Matainaho, dean of research at University of PNG.
“We also expect to have a number of visits from other University of Melbourne collaborators and other visitors in coming months to support Owen and Jasper, and to further develop specific projects,” Mr Williams said.
“We anticipate lodging an application for ethics approval to conduct a clinical trial of the new taipan antivenom before the end of this year, with a start date for the trial in 2010.
“If the taipan antivenom succeeds then we will look at developing a new bivalent death adder/small-eyed snake antivenom in 2012.”
No comments:
Post a Comment