Nigeria Journal 2023 07 16: Snake Bite

7 min readJul 16, 2023

I mentioned in my last journal entry that our German Supply Chain Manager had not been out to the IDP camps. Right after that, he and I and our midwife were out having a beer when our discussion turned towards the experience of being in the camps — and what he was missing by being stuck in his office all the time. Truth is that spending time in the camps is the only thing that makes this job worthwhile. If it wasn’t for the time spent eyeball to eyeball with the community the other frustrations of this job would have driven me to resign weeks ago. As fate would have it, we were on the cusp of Eid Kabir, and we found out that we had a 2 day holiday. I promised to take him out to the camps on the holiday — partly to show him what he was missing, and partly because I wanted to check on the progress of a new contractor who we hired to complete shelters that had been abandoned uncompleted by a previous contractor.

We struck out Wednesday morning on the first day of the 2 day national holiday. I’ve always been to the camps on a working day, so it was unusual for us to be the only NGO employees there. Normally there are about 25 national staff there running the clinics. There are crowds of people queuing for services and a packed waiting area outside the pharmacy. But today there is nobody around the clinic, everything is quiet.

We’ve had a few recent visits from a variety of VIPs, so I am comfortable giving a tour and explaining all our active projects. We start at the front of the clinic building and circle around so I can point out the expansion plans, the aging diesel generator, the future solar installation, etc. As we come back around to the front there is a beat-up Toyota Corolla out front that wasn’t there when we started. I don’t initially give it any mind.

One of the camp leaders walks up to me, quite casually, and tells me “We just received a snake bite victim from the farms.” We’ve been discussing the risk of venomous snake bites in our management meetings, so I am curious. I ask him about the frequency of snake bites. I ask him who has the anti-venom shots. He is as cool as a cucumber, but what he is telling me seems incongruent with his demeanor. There are no anti-venom shots at the camp, they will have to wait until the NGO comes back on Friday, after the holiday. “But, maybe since you are here you could call the medical staff from your organization.”

Then they pull the man out of the back of the Corolla.

He is unresponsive. His left leg has swelled to twice its normal size and is shockingly green. When they lay him down on the porch in front of the clinic his eyes are rolling back in his head. A crowd is gathering and giving me worried glances.

It is amazing how quickly my perspective changes from “I am here to observe and explain” to “Oh shit, I’ve got to become a protagonist in this drama!” Fair enough, I am wearing the white NGO vest with the word “Doctors” in the logo. I start making frantic phone calls. I am able to get our Medical Team Lead on the phone. When I relate what I see he tells me he plans to make a referral to one of the hospitals in town, something they do regularly. It requires one of our doctors to be there to admit the patient. He says he will call me back in 5 minutes. While I’m waiting, I get our driver to retrieve the Land Cruiser and prepare to load the guy in the back. I check my phone to see when I called the MTL, it’s been over 4 minutes so I wait until it’s been 4:59 and hit redial. I’m not a doctor, but this snake bite victim is my first pseudo-patient and I don’t want to lose him. The MTL answers “I’m working it!”, and I’m like “OK, but he can’t wait much longer!” Soon he has the hospital identified, and the doctor on the way there.

The family, or maybe camp leadership, insists on putting the patient back in the old Corolla for transport to the hospital. It’s about 40 minutes from the camp to the hospital. Loading his limp body takes some time, then there is way too much discussion about who else will ride in the car and where everyone will sit. I feel like I am the only one who sees this as a crisis and expects extreme urgency. Eventually, everyone is loaded in, sitting on laps, and the doors close. The driver turns the key, the starter motor turns but the engine doesn’t catch. He waits a few second, tries again — no luck and the battery is fading. He waits longer, and I start opening the back doors of the Land Cruiser. But on the third try the engine comes to life.

I watch them drive through the camp towards the highway on it’s edge. Halfway to the road the Corolla comes to a stop. The doors fly open. Everyone is changing seats again. Finally, it proceeds to the highway, turns right towards Makurdi, and disappears.

Days later, I hear that he survived after a series of blood transfusions.

I’m back in tour guide mode, and take the Supply Chain Manager to see the shelter construction site. There are piles of freshly cut timber and the sounds of hammering everywhere. After weeks of frustration — of excuses and legal action, contract negotiation, bureaucracy, financial nitpicking, angry arguments, and a despairing sense of incompetence — I am overjoyed to see actual action. And it’s a frenzy of activity. The contractor’s team has organized everything and it looks like they’ve enlisted an army of IDPs. Men are hammering, women are pushing wheelbarrows of sand. Kids are emptying the wheelbarrows with buckets — spreading the sand on the floor of the shelters. The sky is blue, everyone is smiling — there is a wonderful feeling of community endeavor.

These shelters are austere, little more than a tent. You can stand up inside, but each family gets a space that is about 8’ by 4’, with a sand floor, a wooden frame, plastic fabric walls, and a corrugated metal roof. One door, one window, and a narrow strip of mosquito netting for ventilation. It is modest, but I have to believe transformational for families who are otherwise exposed daily to the Sun and rain. This last batch of shelters, which will house 800 families, will obviously be done within the next week.

I’m explaining the incredible progress to my German friend when he looks around and says “Joseph, this is unacceptable, they are using child labor”.

It was the last thing I expected to hear, and I had to take a few moments to walk away and ask myself “Am I missing something here, have I become too focused on the ends and lost track of the means?” A memory that came to me was of when the basement flooded in my childhood home and every kid who could wring a wet towel into a sink was expected to pitch in. But it is something I will continue to ponder.

When I mentioned it to my right hand man, my Nigerian Logistics Supervisor, he laughed. He said the previous guy who had my job (and is Dutch) had complained about kids working to the Project Coordinator (who is Sudanese). He was told “If you have a problem with kids doing chores in the camps, you don’t understand Africa”. I don’t know the details of that complaint, but I am thinking that maybe the 1970’s Glen Burnie Maryland I knew has more in common with Africa than today’s Germany or Netherlands — at least with respect to child labor.