Medical Zambia


Picture courtesy of Alastair Anton

Dr John Seaman, my boss when I worked for Save the Children Fund from 1979-1984), first introduced me to the term MAMBA – “Miles and miles of bloody Africa”. But this blog post is not about monotonous stretches of acacia scrubland in the Sahel. It is about the notorious snake.

My neighbour sent me this photograph of a snake coming down from a tree against which he had been leaning five minutes earlier. It is a black mamba, the most deadly snake in Africa. Contrary to its name, black mambas are usually grey or even brownish snakes, but their name comes from the black colour inside their mouths. This is not a view I want to witness.

These snakes can grow upto three metres long. They avoid contact with humans, only striking when they feel threatened or trapped. But they often strike repeatedly. A mature snake can inject 100mg of highly potent venom in each bite. This is double the amount needed to kill an adult human victim.

They can move quickly, 10 mph for short distances. It can rear up 40% of its length, allowing it to inflict bites on the upper body. When fully grown, they have no natural enemies in the wild. They eat rodents, birds, bats and even other snakes.

Juvenile mambas are lighter in colour

The venom acts swiftly and many people who are bitten do not survive long enough to get medical attention. The supply of anti-venin is parlous, with manufacturers stopping production on commercial grounds. It can take 10 ampoules of anti-venin to treat envenomation.

Zambians might seek help from a traditional healer before going to a clinic. I was fascinated to learn how a sangoma (witch doctor, medicine man) would treat mamba bites. First, one must carve a basin-like depression in a large termite mound*. The victim has to pass urine into the depression and make a thin paste with the powdered earth, and this is then drunk.

My colleague, an old Africa hand, asked, “But this poison gets into the blood, into the central nervous system. How can drinking his muddy urine counteract this?”  

“No, you misunderstand,” said the sangoma. “The family of the victim has to drink the paste, not the victim.” As if this made the treatment more rational.

*Interestingly, mambas often live in holes in termite mounds.

By Dr Alfred Prunesquallor

Maverick doctor with 40 years experience, I reduced my NHS commitment in 2013. I am now enjoying being free lance, working where I am needed overseas. Now I am working in the UK helping with the current coronavirus pandemic.

2 replies on “Mamba”

OF COURSE the family of the victim has to drink the urine-mud! When the situation is that dire I suppose you’ll grasp at any hope, no matter how illogical. As for me, I’ve just crossed Africa off my bucket list (sorry, but lethal snakes that strike repeatedly at the upper body are a deal-breaker). Please don’t every go near a tree again.


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