MARSHALL: 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 has 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: Although it’s not a snake that picks fights, it’s a snake that finishes them.
MARSHALL: 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: [talking to group of villagers] And this is about proper first aid for snakebites. All right so we just want to get in, before the snake bit season starts properly…
MARSHALL: About an hour’s drive from Port Moresby, villagers gather for advice from the man they call ‘the doctor’. David Williams is a clinical toxicologist who heads Melbourne University’s Antivenom Unit in PNG. Unlike most of his peers, he’s also a herpetologist and skilled at dealing with snakes.
DAVID WILLIAMS: [talking to group of villagers] 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.
MARSHALL: David Williams has come also to inspect the village’s tiny health centre. There seems to be no shortage of medicine, but what they need most is missing.
DAVID WILLIAMS: You still don’t have any antivenoms here?
CLINICIAN: Ah, no doctor.
MARSHALL: 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 kilometres, 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.
MARSHALL: 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% of health centres don’t stock the antivenom. It’s a national tragedy. No one here can tell you exactly how many people die from snakebites. It could be as many as six hundred 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.
[snake on the ground] 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 metres, the snake becomes defensive. Gidday buddy! [catching snake] 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!
MARSHALL: 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.
[milking snake] 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.
MARSHALL: 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 product but significantly less expensive.
MARSHALL: His aim is to make freeze dried antivenom so that it won't need refrigeration, but some of the donors in his project are less than willing participants.
DAVID WILLIAMS: [snake moving rapidly] He’s going to play up! Why aren’t you happy with me?
MARSHALL: To find out more about this antivenom shortage, I went to Port Moresby General Hospital.
And how often do you get snakebite victims that need to be admitted to intensive care?
SISTER PATRICIA RAURELA: We receive snakebite victims everyday. They come in through the hospital, especially the emergency department.
MARSHALL: Sister Patricia Raurela is the Emergency Ward Head Nurse. She takes me to the medicine fridge.
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.
MARSHALL: This is the hospital’s fourth shortage of antivenom in the last twelve months. Often the fridge is bare.
DAVID WILLIAMS: The Government of Papua New Guinea simply can’t afford to buy all the antivenom they need. The biggest issue is the cost of the Australian antivenoms. In 1972 it cost $40 for a vial of antivenom. In 1988 it cost about $200, now it costs over $2,000.
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.
MARSHALL: 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.
DAVID WILLIAMS: Oh #*#*!
MARSHALL: Are you all right?
DAVID WILLIAMS: Okay, let’s go. I’ve been bitten.
MARSHALL: Shit!
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. [placing snake in back of car] Someone come and get me boot off.
MARSHALL: All right just start from here and go down?
DAVID WILLIAMS: Start from the... over the bite, yeah. Tight.
MARSHALL: I need a bit of... any other bandages here?
DAVID WILLIAMS: Get another bandage... get as many as you have to.
MARSHALL: Get rid of the sock?
DAVID WILLIAMS: Get rid of the sock. Need another bandage starting higher up... need to get a move on... just give me a couple of seconds. Get everything in the car.
[David on mobile] 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.
MARSHALL: Okay you’re in the back? Get in, get in.
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.
[To David lying in back of car] All right David we’ve almost reached the motorway mate. Not far now.
His vision is blurred, his airway is tightening. He has trouble breathing and speaking. His blood pressure is dropping.
[To David in back of car] All right Dave, we’re almost there mate.
Without antivenom he will certainly die. [Getting him into emergency and calling for assistance] It’s David Williams! You nurse on duty? Black taipan, a bite to the thigh. Twenty-five minutes ago… bandage too tight…
Port Moresby General Hospital is a place where David Williams saves lives. Now, his own survival depends on scarce antivenom.
How much stock have you got of that?
DOCTOR: This is the last one we have in stock at the moment. The next snakebite that comes in, no (anti)venom to give them.
MARSHALL: Within half an hour of receiving the antivenom he’s coherent once more and talking to his wife and child. By the end of the evening, his recovery has been remarkable.
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.
[Visiting David at home next day] Hi Steve!
MARSHALL: Good morning David how you doing?
DAVID WILLIAMS: Oh mate like I’ve been hit by the Mac truck of the animal world but …
MARSHALL: Yeah, it looks like it. Give us a look at that! [bite on leg]
DAVID WILLIAMS: It’s really sore mate.
MARSHALL: 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.
MARSHALL: Papua New Guinea’s management of its antivenom 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 $500 before supplying it to the health department, but then up to 25% of stock simply disappears from the government medical stores.
I have a tip off that some stolen antivenom is for sale at a local chemist. My visit is secretly recorded.
How much is it per vial?
CHEMIST: I’m not sure if this is the right price but eight thousand five hundred.
MARSHALL: Eight thousand, five hundred kina?
CHEMIST: Yeah.
MARSHALL: For all six?
CHEMIST: Just one.
MARSHALL: I’ve been to a chemist in town here…
DAVID WILLIAMS: Yep.
MARSHALL: And they offered to sell me Australian anti-venom for around eight thousand 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 centres.
MARSHALL: 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 centre. So they’re paying for the stuff twice basically and paying for it the second time at more than double the price.
MARSHALL: 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 five hundred dollars.
CHEMIST: But this is from India, not from Australia.
MARSHALL: Yeah… still the same?
CHEMIST: Yeah... the same thing.
MARSHALL: You sure?
CHEMIST: Yeah.
MARSHALL: All right thanks for your help…
[Visiting David] 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 anaesthetic but other than that fine.
MARSHALL: I take my bargain purchase to David Williams for analysis.
DAVID WILLIAMS: [Laughing] 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 Krait, Russell’s and Saw Scaled Vipers. This antivenom can kill people.
MARSHALL: Not only is there a black market for stolen antivenom in Papua New Guinea but I’ve discovered a new illegal trade. My next stop was the Health Minister, Sasa Zibe.
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, that it wont 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?
MARSHALL: 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. [into store] Ah m’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.
MARSHALL: A poor nation is throwing away millions of dollars on expensive antivenom. Those in greatest need have little hope of getting help.
DAVID WILLIAMS: Papua New Guineans have got to wake up to themselves and realise 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.
MARSHALL: In a country of eight hundred 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.
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