Inside West Africa’s Leading Snakebite clinic

Words by Sam Bradpiece 

Photographs by Guy Peterson

Inside West Africa’s Leading Snakebite clinic

Words by Sam Bradpiece 

Photographs by Guy Peterson

Fatoumata Lamourana was oblivious to the Green Mamba’s approach. But as the 68-year-old led her cattle through the scrubby bushlands of Gomba, she felt its short fangs penetrate the flesh above her ankle. 

Within less than half an hour deadly neurotoxins had surged through her bloodstream attacking her nervous system. By the time Fatoumata arrived at Kindia’s Centre de traitement des envenimations, Guinea’s only specialized snakebite clinic, her eyes had rolled to the back of her head, her breathing was shallow and she was unable to speak. Doctors drilled an intravenous catheter into her left tibia to deliver antivenom. Fatoumata’s veins had collapsed. 

As his patient lay writhing in bed, Mohamed Ciré Diallo – the chief physician – conceded the prognostic was bleak. “When snakes lash out at herders, they are normally riled up after being trampled by cows. An angry snake will release much more venom than usual,” he said.  

Researchers estimate that some 3,600 people are killed by venomous snakes in Guinea every year. The small West African nation of 13 million people accounts for well over 10% of all such deaths on the continent

Sometimes the Guineans bite back. At a bushmeat restaurant in Kindia, the town where the clinic is based, snakes are descaled, boiled and served at £2.50 per dish. But this does little to dent the abundance of serpents imperiling local residents. 

“Guinea is like a miniature Africa,” said Mamadou Cellou Baldé of Guinea’s state-sponsored National Institute of Applied Biology (IRBAG), which houses the clinic. “We have four biomes: mangroves, mountains, savannah and forests. This provides considerable habitat for different snake species.”

Neurotoxic envenomations from mambas and cobras account for some 70% of fatalities at the clinic – a percentage that Baldé says is likely to increase as the mamba population grows due to deforestation. The rest are mostly caused by vipers whose venom can cause patients to blister at the wound and hemorrhage from the eyes and mouth.

But no matter the culprit, victims are routinely treated with INOSERP, a polyvalent antivenom developed with collaboration from Professor Baldé and his team. Patients are asked to pay 850,000 Guinean Francs (£86) per dose, often indebting themselves to do so. 

“I try to reason with the families,” said Dr Diallo. “In our culture it is customary to organize a ceremony and sacrifice a cow when someone dies. The cost is often double that of lifesaving antivenom.”

Dr Cara Smith - an American researcher from ASF carries a spitting cobra found under iron beams at a chicken farm on the outskirts of Kindia.

Most envenomations require multiple doses of antivenom and practically every patient at the clinic receives at least some free vials from Asclepius Snake Foundation (ASF), an American organization that provides vital clinical and material support to the clinic. No one is sent away. 

But elsewhere in Guinea the situation is dire. Of the country’s eight regional health centers, the best-stocked has a reserve of just 18 anti-venom vials – half the strength of those at Kindia clinic – and some have none at all. “If you take Guinea as a whole, there is obviously a need for way more antivenom than we can provide,” said Jordan Benjamin, ASF’s founder. 

Most patients travel to the Kindia clinic by motorbike, sandwiched between two family members to keep them steady. The bumpy journey along the country’s dirt tracks and potholed roads can take hours – and a mamba bite can kill within less than one. Many patients, like Fatoumata, are hypothermic by the time they arrive. Countless others die on the road. 

Naby - the clinic’s chief snake hunter - looks into the thick bush on the outskirts of Kindia while searching for snakes. He lost a finger after being bitten several years ago.
Papa Daboh - a traditional healer - shows off a bundle of leaves he uses to treat snake bites. Traditional healers are still a popular option for people living in remote parts of Guniea who are unable to get to a medical facility or who can't afford official healthcare. This can lead to very serious complications down the line.

Traditional healers remain a fast, cheap, yet dangerous, alternative. In a forest clearing outside Kindia’s town center, Papa Daboh gathers bundles of leaves to be crushed and then dried in the sun. He claims to have inherited the gift of healing from his father and that his patients pay only what they can afford. 

“You should mix this powder with water and add lemon juice for flavor,” he said. “You will vomit for three days and the venom will exit your body.” 

Far from purging venom, which travels in the bloodstream, this method only serves to dehydrate and weaken patients, causing a shift in electrolytes and reducing their chances of survival. Other healers are known to make incisions around the puncture marks, applying herbs, dung or charred cow bones to draw out the toxins. This frequently leads to infection, necrosis and amputation, even in cases of non-toxic snakebites. 

But when Papa Daboh boasts of a 100% success rate, it is possible he is telling the truth. Snakes can take weeks to regenerate metabolically costly venom, meaning they frequently deliver ‘dry bites’ in which no venom is released. Humans, who are not considered worthy prey, are regularly on the receiving end of this phenomenon. But not everyone gets lucky. 

Fatoumata Lamourana lays in her daughters arms on a bed at the ASF/IRBAG snakebite clinic. Fatoumata had been bitten by a green mamba and spent many hours traveling through the rain by motorbike to get to the clinic which provided life saving anti-venom. Fatoumata reminds in critical condition more than 12 hours after the bite.
A forest cobra is inserted head first into a plastic tube to prevent it from turning on the scientists before it is injected with ketamine to make it easier to harvest its venom at the National Institute of Applied Biology.

14-year-old Mohamed was bitten by a mamba in June. His family took him to a local healer and served up a concoction to make him spew. When that didn’t work, they embarked towards the clinic. 

As Mohamed thrashed around, ripping out his IV drip, medics had to hold him down. Six doses of antivenom later, his vital signs began to stabilize although his respiratory muscles were exhausted. Close to midnight, he jolted upright and died from a cardiac arrest triggered by what herpetologists describe as ‘secondary envenomation’. Mohamed was the third member of his family to suffer a fatal snakebite in the space of twelve months.

“The worst cases we get at the clinic are people who first went to visit a traditional healer,” said Dr Diallo. “The key thing is that they waste time and delay treatment. The only effective solution is to administer anti-venom as soon as possible.”

Martin walks through the bush on the outskirts of Kindia looking for snakes to be caught and harvested for their venom - an activity known by insiders as ‘herping’.
A dried snake hangs on the rearview mirror of a car Alpha Baldé drives on the way back from a ‘herping’ trip.

ASF researchers spend their days scouring the bush around the clinic to search for snakes – an activity that insiders know as ‘herping’. Captured serpents are taken to a lab and administered a dose of ketamine that leaves them slithering drowsily into a corner. Their venom is then extracted and sent for analysis of the toxins within. This data is cross-referenced with clinical records to help better inform medical practice and develop evermore effective antivenoms.  

The decades of research since the first antivenom was introduced to Africa in the 1950s was key to saving Fatoumata’s life. Despite community pressure to stay with a local healer, her family brought her to the clinic almost immediately. After five days of treatment and six doses of antivenom, she made a full recovery. 

“When I was bitten, people told me not to come to the clinic. They told me I would die. Thank God I was brave enough to make the journey,” she said, returning home to her flock.

Fatoumata Lamourana stands surrounded by her family ready to climb on the back of a motorbike and head home after 5 days of treatment and six doeses of anti-venom at the IRBAG clinic.