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Papua New Guinea: Venomous Problems
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Papua New Guinea: Venomous Problems
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The Health Show: Snake Bites

Snakebites kill hundreds of people every year in Papua New Guinea, but most of these deaths could be avoided if victims were able to receive a dose of anti-venom in time. So why isn't enough anti-venom being supplied to local health centers? This film investigates.

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Segment 1

TITLE
Venomous Problems
VOICEOVER
In a deeply superstitious country, this is a dark and fearsome demon that can bring untold trouble. Some here believe the snake embodies an evil old woman who snatches babies in the night. Mythology aside, the Papuan taipan is one of the deadliest reptiles in the world. Remarkably, in some areas here, venomous snakes kill more people then malaria, tuberculosis, and HIV/AIDS. In this very poor country, getting help is out of reach for many snakebite victims. The consequences of that can be devastating. For the past decade, one man's been trying to change that. He's a scientist, medic, teacher, and snake handler, and he's very lucky to still be around. David Williams' single-handed mission to save lives in Papua New Guinea will almost cost him his own.
DAVID WILLIAMS [Clinical Toxicologist and Herpetologist, Melbourne University]
Although it's not a snake that picks fights, it's a snake that finishes them.
VOICEOVER
My journey with him will also uncover corruption and incompetence in Papua New Guinea, a scourge that's endangering the lives of its people.
DAVID WILLIAMS
And this is about proper first aid for snakebites. All right, so we just want to get in, before the snakebite season starts properly.
VOICEOVER
About an hour's drive from Port Moresby, villagers gather for advice from the man they call "the doctor." David Williams is a clinical toxinologist who heads Melbourne University's Anti-Venom Unit in PNG. Unlike most of his peers, he's also a herpetologist and skilled at dealing with snakes.
DAVID WILLIAMS
And if a person stays very still and has this pressure put on after the snake's bitten them, it will slow down the poison.
VOICEOVER
David Williams has come also to inspect the village's tiny health center.
DAVID WILLIAMS
Okay, so let's have a look inside. Just want Steve to see what you've got to work with.
VOICEOVER
There seems to be no shortage of medicine, but what they need most is missing.
DAVID WILLIAMS
You still don't have any anti-venoms here?
CLINICIAN
No, doctor.
VOICEOVER
Without a fridge, the clinic can't store snake anti-venom and there's often no transport for a dash to Port Moresby. Even the clinic's nurse was a casualty. She died along with her unborn baby.
DAVID WILLIAMS
It's one of the very few conditions where you can wake up perfectly healthy in the morning, come into contact with a snake after breakfast and be dead in a box by nightfall. Well Mekia district is not very far from Port Moresby, about a hundred kilometers, but it has some of the highest incidence rates and mortality rates for snakebite anywhere in the world. There's a gentleman who's turned up here last night: he was out hunting in the bush and got himself bitten by a death adder.
VOICEOVER
The man will live because the clinic has a gas-powered fridge and crucial anti-venom. The bite victim is a lucky man. In this country, 90 percent of health centers don't stock the anti-venom. But David Williams has some spare vials, donated by his contacts in Australia.
DAVID WILLIAMS
Even though it's a year out of date, it's perfectly okay. In fact, on Moresby we've given people anti-venoms that were 10 years out of date because we've had nothing else, and that's worked.
VOICEOVER
It's a national tragedy. No one here can tell you exactly how many people die from snakebites. It could be as many as 600 a year across the country.
DAVID WILLIAMS
Most people here work in their gardens and they don't wear footwear. They've never worn shoes a day in their lives so that makes them especially vulnerable to things that they might tread on. Okay this is how people get bitten by snakes because a snake comes out in the morning like that, curls up, goes to sleep, nobody sees it. And, once you get within two or three meters, the snake becomes defensive. Ah, g'day buddy. All righty. He's cold as… Just hold that bag open, nice and low to the ground before he gets too cranky. Very good. So that's it, you've bagged your first taipan. It's too easy!
VOICEOVER
David Williams doesn't do this for thrills, nor does he relish the danger. It's an essential part of his job. At his so-called snake house at the back of Port Moresby General Hospital, he's on his milk run with Papuan taipans.
DAVID WILLIAMS
It's the pinnacle of evolution in the Australasian region. It has the longest fangs, the largest venom supply, the most toxic venoms, and probably the worst temper. That's called "not happy Jan." Look at that. Holy crap. There's enough there to kill all of us and everybody on this campus and then still have some to spare.
VOICEOVER
This is one of half a dozen taipans David Williams will milk today for his landmark research project.
DAVID WILLIAMS
So the venom we're collecting here is actually going to be used to produce an experimental anti-venom against Papuan taipan venom and the hope is that it will be as safe and effective as the current products but significantly less expensive.
VOICEOVER
His aim is to make freeze dried anti-venom so that it won't need refrigeration, but some of the donors in his project are less than willing participants.
DAVID WILLIAMS
He's going to play up. Why aren't you happy with me?
VOICEOVER
To find out more about this anti-venom shortage, I went to Port Moresby General Hospital.
REPORTER
And how often do you get snakebite victims that need to be admitted to intensive care?
SISTER PATRICIA RAURELA [Nurse, Port Moresby General Hospital]
We receive snakebite victims every day. They really come in through the hospital, especially the emergency department.
VOICEOVER
Sister Patricia Raurela is the Emergency Ward Head Nurse. She takes me to the medicine fridge.
REPORTER
How many should you have in there? SISTER PATRICIA RAURELA: We should have three each, especially the polyvalent. We should have three each, otherwise the whole lot of them we should be having enough stock in our fridge.
VOICEOVER
This is the hospital's fourth shortage of anti-venom in the last 12 months. Often, the fridge is bare.
DAVID WILLIAMS
The Government of Papua New Guinea simply can't afford to buy all the anti-venom they need. The biggest issue is the cost of the Australian anti-venoms. In 1972 it cost AUD$40 for a vial of anti-venom. In 1988 it cost about AUD$200, now it costs over AUD$2,000.

Segment 2

DAVID WILLIAMS
All righty. That's a nice-looking snake. I've invested a lot of time and a lot of effort here and every time we go out into the bush and we grab one of these snakes by the tail, you fully have to expect that this is the snake that's going to bite you and it's going to kill you.
VOICEOVER
They were prophetic words. Less than an hour later, as I prepared to say a few lines to camera, just out of shot, David Williams was in trouble.
REPORTER
Oh mate.
DAVID WILLIAMS
Oh fuck!
REPORTER
Are you all right?
DAVID WILLIAMS
Okay, let's go now. I've been bitten.
REPORTER
Shit!
VOICEOVER
David Williams knows the deadly venom is already in his body. While we stand in shock, a cool-headed scientist secures the reptile.
DAVID WILLIAMS
Come on, hurry guys.
REPORTER
What color?
DAVID WILLIAMS
No, not the s-kit, the blue bag. Someone come and get me boot off.
REPORTER
All right just start from here and go down?
DAVID WILLIAMS
Start from the ... over the bite, yeah. Tight.
REPORTER
I need a bit of ... any other bandages here?
DAVID WILLIAMS
Get another bandage, more bandages. Get as many as you have to.
REPORTER
Get rid of the sock?
DAVID WILLIAMS
Get rid of the sock. Need another bandage starting higher up.
REPORTER
Alright.
DAVID WILLIAMS
You need to get a move on. Just give me a couple of seconds. Get everything in the car. We are leaving, we're heading back to Port Moresby General Hospital and then Steve will come and get you. Okay? Bye. I've got to go, bye.
REPORTER
Okay, you're in the back? Get in.
VOICEOVER
Within a matter of minutes David Williams is dangerously ill. He's having an allergic reaction to the venom and is lapsing into anaphylactic shock.
REPORTER
Alright David, we've almost reached the motorway mate. Not far now.
VOICEOVER
His vision is blurred, his airway is tightening. He has trouble breathing and speaking. His blood pressure is dropping.
REPORTER
Alright Dave, we're almost there, mate.
VOICEOVER
Without anti-venom he will certainly die.
REPORTER
Trolleys, trolley, trolley. Snakebite, snakebite. Help, help. Get in the other side. You're alright mate. We're here, we're here mate. C'mon. Keep that leg still, eh? Keep that leg still. Okay, emergency: let's go. It's David Williams.
VOICEOVER
Port Moresby General Hospital is a place where David Williams saves lives. Now, his own survival depends on scarce anti-venom.
REPORTER
How much stock have you got of that?
DOCTOR
This is the only vial we have in stock at the moment. So, the next snakebite that comes in, no [anti-] venom to give.
VOICEOVER
Within half an hour of receiving the anti-venom he's coherent once more and talking to his wife and child.
DAVID WILLIAMS
Yeah, much better than it was 20 minutes ago.
VOICEOVER
By the end of the evening, his recovery has been remarkable.
REPORTER
How important was that first aid on the spot?
DAVID WILLIAMS
Um, probably the difference between you talking to me now and you not talking to me now. I think without it, you might have been giving a eulogy.
DAVID WILLIAMS
Alright Steve.
REPORTER
Morning David. How are you doing?
DAVID WILLIAMS
Aw mate, like I've been hit by the Mac truck of the animal world. But I'm going to get there.
REPORTER
Looks like it. Let's have a look at that ...
DAVID WILLIAMS
It's really sore, mate.
VOICEOVER
David Williams will need to convalesce for several weeks after his life-saving treatment but the experience has left him indignant.
DAVID WILLIAMS
And for a hospital like that, that treats sometimes four or five snakebites in a day, for it to only have one single vial in the fridge is just not good enough.
VOICEOVER
Papua New Guinea's management of its anti-venom stocks is a national disgrace. Latest figures show, one quarter of its entire pharmaceutical budget is spent on importing the drug from Australian company CSL. Melbourne-based CSL has an exclusive deal to sell to a wholesaler in PNG. That company marks up the price of each vial by about AUD$500 before supplying it to the health department. But then up to 25 percent of stock simply disappears from the government medical stores. I have a tip-off that some stolen anti-venom is for sale at a local chemist. My visit is secretly recorded.
REPORTER
How much is it per vial?
CHEMIST
I'm not sure if this is the right price, but ... 8,500.
REPORTER
Eight thousand, five hundred kina [PGK]?
CHEMIST
Yeah.
MARSHALL
For all six?
CHEMIST
Just one.
MARSHALL
I've been to a chemist in town here ...
DAVID WILLIAMS
Yep.
REPORTER
And they offered to sell me Australian anti-venom for around 8,000 kina per vial.
DAVID WILLIAMS
Yeah come in spinner! You're being ripped off, basically. I'd say it's ... it's probably stock stolen from the medical stores or from the health centers.
VOICEOVER
David Williams has records of every vial of anti-venom brought into the country and can trace stolen stock.
DAVID WILLIAMS
Okay, it's disappeared from the health department, been sold off by these guys back to a health center. So they're paying for the stuff twice basically and paying for it the second time at more than double the price.
VOICEOVER
I decide to go through with the deal. This time the pharmacist tells me it's my lucky day and offers me a vial for the equivalent of just AUD$500
CHEMIST
But this is from India, not from Australia.
REPORTER
Yeah … still the same?
CHEMIST
Yeah ... the same thing.
REPORTER
You sure?
CHEMIST
Yeah.
REPORTER
All right thanks for your help … alright, see you soon.
REPORTER
So how's the leg today?
DAVID WILLIAMS
Yeah it's okay mate. It's a bit numb, sort of like if you're given a local anesthetic but other than that fine.
VOICEOVER
I take my bargain purchase to David Williams for analysis.
DAVID WILLIAMS
Oh yeah, you've got to be joking. Okay, well, this is a big worry. This doesn't work in Papua New Guinea. This anti-venom's worthless. The only things this can be used to treat are Indian cobras, Indian kraits, Russell's, and saw-scaled vipers. This anti-venom can kill people.
VOICEOVER
Not only is there a black market for stolen anti-venom in Papua New Guinea, but I've discovered a new illegal trade. My next stop was the Health Minister, Sasa Zibe.
REPORTER
I want you to have a look in here, minister, just to open up the envelope and have a look. Just take your time to read that. Minister I bought that from a pharmacy in town here. It's Indian snake anti-venom. The problem is, is that it won't treat snakebites in Papua New Guinea and if I got bitten by a snake and I was administered that, it might well kill me.
SASA ZIBE [Minister for Health, PNG]
Gee. Seriously, this is a very serious case. This is pathetic and I cannot tolerate this. Can you tell me which shop you bought this?
VOICEOVER
Within minutes the outraged health minister had me in tow.
SASA ZIBE
I am now going to the city pharmacy to check the illegal anti drug venom sold in this shop here. I'm going in to check on that now. Ah ma'am, I think what you are selling is illegal. I am the Minister for Health. And this can kill them! And you are not supposed to sell the drug like this here. And I'm now cracking down, as the Minister for Health. I'm not going to tolerate my people to sell any drugs out in the street and this is to start with you. Thank you.
VOICEOVER
A poor nation is throwing away millions of dollars on expensive anti-venom. Those in greatest need have little hope of getting help.
DAVID WILLIAMS
Papua New Guineans have got to wake up to themselves and realize that people shouldn't have to die from treatable diseases or treatable injuries like snakebite. It's completely unnecessary and they shouldn't have to put up with corruption and particularly corruption in health because that costs people lives.
VOICEOVER
In a country of 800 languages and a multitude of cultures, some here believe that snakebite is just reward for those who commit adultery or steal, but a crime on a much larger scale seemingly goes unpunished.
TITLE
[end credits]