It was midnight, and I was in Brooke’s Point, hours away from our Kemantian clinic, when an urgent message awoke me: “Minan, an 11-year-old boy named Janis, was bitten twice on his arm about eight hours ago. The family is only now getting him to the clinic.” Immediately I was awake and started praying for Janis.

Janis had been bitten by a Wagler’s pit viper, locally known as a legyan. The venom of this snake, though dangerous, is rarely lethal. In fact, in our 20-plus years here, we had never heard of a Wagler’s fatality.

When Janis’ parents brought him to our clinic, his arm and chest area were swollen, but his vital signs were stable. Since it was the middle of the night, no air transportation was available, and the lowland pharmacies where we could purchase antivenin wouldn’t open until mid-morning, the staff treated Janis’ bites with an electrical shock device, which has a good track record in these types of cases. All the rest of the night and early the next morning, Janis remained stable. But as the morning progressed, his vital signs began to deteriorate.

When the pharmacies finally opened, we discovered that they stocked only cobra antivenin. Hoping it would help, we bought some. But about the time our courier began his arduous run up the trail toward Kemantian, Janis went into cardiac arrest. After many long minutes of valiant CPR, the nurses finally had to admit defeat. We all mourned the loss of another life.

Living remotely with limited resources brings many challenges. Without reliable electricity at our clinic to support refrigeration, we have not been able to stock temperature-sensitive medicines like antivenin. We are hoping to update our hydro-electric system so that it will run more reliably and to repair the vaccine refrigerator or replace it if need be. These measures will help us more readily respond to snakebite emergencies.

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