These two lakes are at Arba Mintch. Arba Mintch means forty springs. There were many more springs than forty. It is the only place in Ethiopia where we were prepared to drink the water straight from the tap. The two lakes are separated by a narrow strip of land and there is a creek running between the two. Yet their surfaces are about a metre and a half different. Abiya is higher than Chomo
Monkeys – we didn’t see a lot of monkey bites. There are of course many different types of monkey. In one place where we lived there were dozens of them. We had a lot of bananas but, against what we expected, they rarely ate them. They loved our guavas. There was a large tree abutting the back of our house. They would steal as many as they thought they could hold, run along the roof ridge and, no doubt accidentally, dropped some as they ran. Those dropped would clatter down the tin roof into the gutters; which was annoying, particularly at night! They would sit on the window looking through the bars, and you wondered who was looking at whom!
Guereza monkeys, brilliant with their black and white colours, leaping from tree to tree were gorgeous to watch. Staying for a break at the one of the Rift Valley lakes we saw lots of those monkeys with ‘painted’ backsides. They were thieves, watching carefully and awaiting the moment, they’d jump down and steal food from your table or even your hand.
Hyenas – people think that these are only scavengers, but they are prepared to attack living animals or humans. They can cause rabies. At night time our workers would not walk alone. There were always at least 2 or preferably more of them and armed with dullahs (heavy sticks) when walking outside..
The two cases which stand out in my mind are of two boys who came in (at separate times) both having been scalped. (photos below the ‘more’ line) The bone on the top of their heads was laid bare over many sq cms. You cannot graft onto bare bone. We had to drill multiple holes through the outer table of the skull, being very careful to not go right through the inner table of bone. The tissue in the centre of the bone (the marrow or medulla) granulated out through these holes and when it had covered the bare bone totally we could skin graft it. Both boys eventually did well even if they were prematurely bald, and needed to wear protection to protect their grafted skin from trauma and the sun. Thin (split) skin grafts don’t become normal skin again.
Wild boars (called kekero there). With their long tusks and bites they could tear skin and do a lot of damage. We had some that visited us daily in our garden. They learned how to turn on the tap in our back yard using their tusks – in order to get a drink. I wouldn’t have minded if they had only thought to turn them off. The locals told us when we arrived at that University that rhinoceroses came every afternoon. They got it wrong. We never saw a rhino but daily had boars visit us.
Crocodiles are very common in the Rift Valley lakes. Crocodile teeth tear the skin and shatter the bones. We saw a lot of their bites as the people fished from very flimsy balsa wood boats.
Hippopotamuses- I clearly remember a number of hippopotamus bites, all very dramatic. The story of one boy is fascinating. The villagers were short of meat and decided a hippo would be good meat. Half the village got behind him and half on the other side; many with spears. Those at the back began to drive it forward. It began to move. The others were ready. The hippo saw them; didn’t like what he saw; began to charge at full and frightening speed. The villagers fled but this boy slipped and fell; the hippo was on him. The villagers killed the hippo and probably enjoyed the meat. The boy was brought to the hospital. He had a big gash on his chest, exposing but not breaking his ribs and a cut slicing his left buttock in two and the cut extending to the back of the knee. It was deep enough to expose the sciatic nerve, over a long segment, but did not divide the nerve.
Another hippo bite that comes to mind is when a woman was leaning over near the edge of a lake doing her washing. A hippo came up behind her and bit her buttocks from top down laying them as if it they were an open purse. Fortunately it was mainly skin and fat and was repaired fairly easily.
Insects bite are probably the commonest and they cause lots of problems. There are thousands around the world who die every year from malaria. The enlarged spleens which they often get make them more prone to getting ruptured spleens from traumatic episodes. There are also other nasty mosquito spread diseases. Ticks also bite and they can cause a variety of diseases. Scorpions – their stings cause severe pain but usually not much else. Young children may get worse reactions as a few varieties are venomous. Injecting directly around the site with morphia gave the quickest and best results. You quickly had very happy customers. The above almost always cause medical diseases although there can be complications requiring surgery, and I’m a surgeon – so I tended to deal with bigger mouths and more traumatic bites.
Snakes – Their bites are not consistent in how they behave; that is they are either venomous or non- venomous, and there are a variety of venoms. The non-venomous just give you a nip without poison – scary but these are really a fairly minor issue. The venomous ones have a variety of ways of causing major problems. Among them are neurological problems, bleeding diatheses, tissue death, allergic reactions, kidney failure. It is nice if you have specific antivenins available depending on the type of snake, but our patients tended to arrive late, and antivenins are much better if given early. The polyvalent antivenoms which we held in stock were not as good at any rate. The major problems we saw were of tissue damage with massive swelling needing splitting of the skin to relieve pressure, and often cutting away the dead tissue. Amputations were occasionally necessary, but more often we could cover the dead areas with skin grafting. Continue reading “Bites 1 – garden and domestic”→