Monday, September 9, 2019

PAKISCARY

PAKISCARY
Smashed to the gills on the unstable chemical reaction between sleeping pills and alcohol was not how I had planned to arrive in the most hardcore country I had gone to yet. It had all started when the Australian company BHP Billiton began having extreme snakebite issues at their Zamzama gas fields in the Sindh desert. This is one of Pakistan’s most dangerous areas, because various factions were fighting in the name of ideology. The ideologically linked areas of “Special Importance” were, by sheer coincidence I am sure, almost the exact boundaries of large natural gas deposits. They all wanted to control these cash dispensers.
Zamzama security was tight and lethally efficient. The head of security and his offsider were both former British Special Air Service officers with combat experience in areas pretty much exactly like this. While they could control the bandits, they could not control the snakes. One worker was bitten when he came out from the mosque after midday prayers, put his big workboots back on and felt a stabbing pain. A large Russell’s viper had taken shelter from the sun inside one of the boots and was not happy about being disturbed. As no antivenom was stocked on-site, and the company plane was in Karachi picking up supplies, there was no alternative but the long drive to Karachi. Four high-speed hours later, while still being driven, the worker died from blood clotting issues including thoracic bleeding and intracranial haemorrhage. A second worker was killed when a Sind krait bit him in the neck while he was sleeping. He died just like my mate Joe Slowinski did: paralysis of the diaphragm, thus knocking out the ability to breathe, and leading to a death of slow suffocation. Then the site administrative manager was bailed up in a corner of his office by a six-foot black cobra. He escaped being bitten only through the quick action of the security staff, who shot the snake. This all occurred in the space of two months, when the warm monsoon rains brought the desert alive.
As the occupational health and safety issues had hit such an extreme that the site was in danger of being shut down, they contracted my mate Sean McCarthy and me through Snake Handler, the company run by Sean and his wife, Stacey. Snake Handler is the only company in Australia—perhaps the only one in the world—with certification from a higher educational regulator for occupational snake management courses. We were going to give a highly adapted version of this training to reflect the rather special set of circumstances. We don’t usually have to incorporate razor wire and bomb barriers into our educational plan!
The limo and driver picked me up at 3:30 a.m. for my business class Emirates flight to Karachi, with transit through Dubai. I was the point man on the operation. I was going to arrive seventy-two hours before Sean and get everything sorted with snakes and the on-site set-up. The flight to Dubai was a long one and I had been up all night preparing the pelican cases full of vital gear, so I definitely could use the shut-eye. I was armed with a new type of sleeping pill I hadn’t tried yet, one called Ambien. As I was prescribed it just the day before I left, I hadn’t had a chance to dig into the literature about its specific biochemical targeting. I had settled into a traveling routine using benzodiazepines like temazepam and other valium-like drugs, and naively treated this new pill the same way: I washed two down with a double white Russian, one shot of vodka for each. This is something I’d found works a treat with benzos: if I’m tired and take that combination, I have a nice little nap and wake up serene. If I’m not too tired, I don’t fall asleep and just enjoy this rather nice way to pass the time.
I woke just in time for the very tasty meal being served. Afterwards, I figured that since I had had such a lovely little nap and woken up so refreshed, I might as well repeat this chemical combination. As I was settling in ten minutes later, I heard over the loudspeaker, “Please fasten your seatbelt.” “Huh?” I thought. I wondered if we were stopping in Darwin to pick up more passengers. We couldn’t be much further than that. Could we? As it transpired, we were much further along in our journey. In fact, we were now arriving in Dubai. I had been unconscious the entire flight. I was quite relieved that I hadn’t woken in a pool of my own urine! I now faced a two-hour layover before the two-hour flight to Karachi with a short-fused chemical time bomb ticking away inside me that was going to go off very soon.
I quickly asked the stewardess to please get me six shots of espresso. She ignored the no-serving light, probably because she wanted to see me slam them in quick succession. It kept me awake but very high and wired as I went into the Emirates transit lounge, heading straight for more espresso. I had a double shot every twenty minutes. This kept me awake long enough to make my connecting flight. I stumbled toward the boarding gate; once onboard I closed my eyes for the shortest of naps, and next thing I knew we were in Karachi. Luckily, I had a local fixer hired by BHP to meet me and ease my way through the airport bureaucracy. Very helpful, since when I tried to talk to the customs officer in response to his questions, I was so inarticulate I sounded like I had a severe head injury. I was like a concussed kitten on a ketamine trip.
Leaving the airport in a chemical stupor, at first I thought it would be a good idea to raise my arms like the returning messiah to the cheering crowd gathered outside. But my lone functioning brain cell expressed its doubt that the crowd was for me. The validity of this statement was recognized even by my gargantuan ego. The cheering crowd was there for some local politician/warlord (the difference between the two being slight, if it exists at all). The overenthusiasm of some, approaching religious rapture, to me seemed quite contrived. I concluded it was largely a rent-a-crowd to pump up the politician’s fragile ego and simultaneously artificially inflate the public perception of his standing. I just kept my head down while I was quickly shuffled off to a waiting armored Mercedes. During the drive to the safe house, I was hidden behind not only the tinted windows but also the black mesh sightscreens on the inside of the back seat passenger windows.
The next day I headed off to the University of Karachi to meet Syed Ali and his PhD student, Mehtab Alam. The previous government had been led by the military strongman Pervez Musharraf, the commanding general who had seized power through a military coup d’?tat. While his means of obtaining power left much to be desired, as did his bloody military history, he ironically was the best thing ever to have happened to the state of Pakistani science. Much of this was due to the incredible leverage wielded by the active nuclear program that was the brainchild of Abdul Qadeer Khan. As the University of Karachi was where Khan had his laboratories, it was the greatest beneficiary of the program.
While I had been impressed with the advanced state of some of the laboratories on campus, the legacy of this scientific investment caught me unawares. It included a countrywide Internet video–connectivity for science lectures, so that not only could someone from any part of the country view a lecture in real time, but they could also interactively ask questions of the speaker. The public seminar I gave on my venom research went in a very routine manner until we got to the question-and-answer session at the end. A twenty-something male looking like a stereotypical Middle Eastern villain from the latest unimaginative Hollywood action movie popped onto the screen: soil-stained checkered turban, scraggly beard, and close-together unblinking eyes. In surprisingly lightly accented English he said, “I don’t have a question, I just wanted to say that I have long followed the various updates of your webpage venomdoc.com and I just wanted to say that it is great and I have learned a lot about the snakes I also love.” For once in my life I was speechless. I almost fell off the stage, I was so stunned! I stopped paying attention to where my long strides were taking me as I cruised across the stage on autopilot while digesting the shocking incongruence between the hostile visage and the very kind words.
After the talk, Syed and I headed back to his lab with Mehtab. I had made arrangements with them prior to my arrival to secure some snakes for us to use in the training and thus not have to rely on catching snakes in the gas fields. Naturally, we would still go out snake hunting while in the desert, but our task was too important to risk not having sufficient numbers of suitable snakes on hand. Waiting in the lab were four Russell’s vipers and three black cobras. The Russell’s vipers were light amber with black-outlined maroon oval markings down the back, while the cobras’ patterns were pure indigo. Stunningly beautiful specimens of two of my all-time favorite snake types. In order to transport them to the gas field, we double-bagged them, put them into a sturdy box, and loaded them onto the back seat of a second armored Mercedes. In addition to the armed driver, another heavily armed private security agent rode in the front passenger seat, with a very large shotgun resting between his legs. My head was spinning slightly at the idea of venomous snakes being driven under armed guard across one of the world’s most dangerous deserts. Even for me, this was a new one.
However, despite being in a Mercedes with bulletproof windows and metal plating protecting the rest, it was still too dangerous for me to be driven to the gas fields. I would almost certainly disappear without a trace along the way. Instead, I would be flown there. The only question was when. There was sporadic gunfire on the streets near our safe house, which made it very difficult to get to Karachi airport. After much debate, which was a bit like a conversation of “Hey, when do you think the rain will stop?” but involving bullets, the decision was made to risk the run to the airport. Back into the Mercedes, I was off to the airport, much more alert than when I arrived. I was soon whisked through departures to a private plane and on my way.
After a four-hour flight, we were at the gas fields, where we were met by four-wheel drives driven by more bodyguards, carrying machine guns this time. At the compound, as my gear was being unloaded from the vehicles, I was given a site induction. It commenced with the pointing out of the panic button and gas mask located inside by the door in my quarters. This was accompanied by a briefing on what to do in the event of an armed or chemical attack upon the compound, including where the extraction points were. I then met with the site doctor in order to review their medical protocols and newly acquired stocks of antivenom. Their occupational health and safety write-ups regarding envenomation were actually quite complete and only needed a little modification, such as adding information about the use of pressure-immobilization bandages. As all the local snakes were devastatingly potent and extremely fast-acting, it was my professional opinion that such first aid was reasonable for all species.
There is quite a debate globally among health professionals regarding the use of such bandaging. It’s standard for use on Australian snakebites because the effects are almost exclusively upon the nerves and blood, with local effects being typically only minimal. For non-Australian snakes, particularly vipers, there is a great reluctance to use them, based on the logic that it might make local tissue destruction worse due to the venom being concentrated in a small area. The latter is a reasonable consideration where a species is not highly toxic and deaths are rare. This is particularly the case for snakes such as American rattlesnakes, where the local tissue damage is so severe that necrosis may set in and the affected limb require amputation.
However, I am of the view that if it is a “life versus limb” consideration, there is absolutely no question about whether a compression bandage should be used. If I were bitten by a species known to be armed with a venom that causes local tissue death and was not likely to die before I could reach a hospital and have antivenom administered, I would certainly forgo the use of pressure-immobilization first aid. But if I were bitten by a species of any type for which lethal effects might occur before proper medical help could be reached, then I would apply pressure-immobilization first aid without hesitation.
While there was much hot-air debate, there had been shockingly little actual research into whether pressure-immobilization bandaging actually worsened the local effects. Interestingly enough, one of the few studies that had been conducted was actually upon Russell’s viper venom. The evidence gathered revealed that not only were the systemic effects slowed down, but the local effects were not worsened. In any case, a bite from the local snakes would be fast and lethal either through neurotoxic actions (black cobra and Sind krait) or devastation of the blood chemistry (Russell’s viper and saw-scaled viper). So in my professional opinion, pressure-immobilization bandaging should be administered routinely and quickly. I discussed all these nuances with the site doctor and he assiduously made notes. Their antivenom stocks consisted of either Pakistani or Saudi Arabian products and thus, between the two, they would expect reasonable cross-reactivity with the local snake venoms.
The next day, I unpacked the snakes. They had arrived during the night while I slept lightly, bathed in the dull red glow of the panic button and with my gas mask within easy reach. As I was setting up the office that was to be our headquarters for the next week, I felt it was appropriate to have the movie Team America playing on the laptop, but to avoid any “misunderstandings” I kept the volume very low.
We were going to train representatives from the security and engineering teams, so I then went to meet the team leaders of these two staff divisions. The first order of business was to inspect the sites where bites had occurred, or where snakes had been reported. Unsurprisingly, the epicenters were areas of shelter, food, or water. I inspected what measures they had taken to mitigate risk. As with their medical plan and antivenom stocks, they had done a very thorough job. I was able to point out some areas in building construction where metal grates had been put in to block access to snakes, but where some erosion had occurred during the torrential rains. This was how the krait had bypassed the snake-proofed doors and entered the sleeping quarters, resulting in the death of one of the workers. Most loose material was on flat pallets raised off the ground by resting on large blocks, thus creating an unfavorable habitat for snakes. Waste disposal behind the kitchen was also an area of superb management. All food waste was double-bagged to reduce the smell signature to mice or rats, and the large waste bins were emptied into garbage skips offset from the buildings. This was still the inevitable major attractant to snakes, due to the inherent populations of rodents, but the Pakistanis had done as good a job as could be expected and certainly far and above that which I had seen at other sites across the globe.
After this very long first day, I hit the site gym and then settled down to watch cricket with some of the staff. Once they found out I was a bit of a cricket tragic, they invited me to play in the game held each evening. The matches took place under the floodlights of the guard towers, with one of the machine-gun-toting guards acting as the umpire. Obviously, dissension was nonexistent. To discourage power hitting, any smash over the razor wire security fence was given only two points, not six, and the person was out. The reason for this was that the compound was on lockdown status each night, which meant the cricket ball could not be retrieved from outside the compound until first light the next day, by which time the children from the nearby local village had already picked it up. The team I was on fielded first, so I quickly had a chance to unleash my signature style of bowling, which is as erratic as it is fast, with each run-up just as likely to result in a no-ball as a cartwheeling wicket. One hit bystander later, I had secured my team a pair of wickets. Once we were batting, as I have a natural urge to crush a cricket ball, one that cannot be denied even if I’m trying to keep the ball on the ground and run safely for points, it only took three deliveries to tempt me to step up to a spin ball and hit it sweetly. Up it flew through the moth cloud around the lights and disappeared into the darkness beyond the fence. Two and out for me.
The following day was spent finishing the site inspection and typing up the report, including required improvements to the already excellent snake-proofing of the complex. I then carefully considered a number of areas for the different aspects of training. We wanted to make it as realistic as possible, particularly for the more challenging advanced aspects, but we, of course, did not want to lose a snake in the process. After that, I repeated the previous evening’s activities: workout, dinner, watching a bit of cricket on the television, then the regularly scheduled Night Test.
It was interesting to consider the social dynamics of such a pressure cooker of a remote site in a hostile environment. In line with the social norms of Pakistan, and with the majority of the workers being Pakistani Muslim, it was a male-only camp, which would be expected to lead to pent-up sexual frustration. However, this was very much not the case. In fact, there was a higher level of social benignity than I’d experienced in such situations previously. I put the strict ban on alcohol down as the major positive contributing factor. Of course, guards walking around with machine guns no doubt were also a massive contributor to the startling lack of the typical fuckwittedness that characterizes remote mining towns in Australia.
The following day Sean arrived and it was time to get down to business. First up was a series of lectures by Sean and myself regarding venomous snakes, their toxins, their natural history, and how to safely work with them. The core message was simple, but one with a deadly efficient message: it is safer to catch and remove a snake than it is to try to kill it. This was coupled with the fundamental premise that snake reduction through good planning is the ideal scenario. It is, of course, unrealistic to expect a snake-free environment, but the numbers can be minimized through the reduction of favorable habitats. Then it was on to the training.
We started the workers off on rubber snakes to familiarize them with where and how to grip a snake with the tongs without damaging it, while a team member had the hoop-bag ready for the snake to be deposited into. We emphasized the basics: the snakes are much more likely to go into a black bag, thinking it is a hole, than they are into a white bag. We also stressed the importance of double-bagging in order to minimize the odds of escape; and lastly, that the bags must be placed inside a sturdy, crush-proof, well-ventilated container. We finished the day with the participants’ first experience with live, large diadem snakes, because they are a species very ready to bite, while at the same time being harmless to humans. This desensitized them to the concept of getting close to that which they fear the most—and a bit of blood always reinforces a lesson. However, this crew was the most attentive and diligent of any group Sean or I had ever worked with. They displayed a willingness to listen and the ability to learn. They also had a tunnel-vision focus upon the task at hand. There weren’t any mishaps with any of these long, agile snakes—other than that a few of the crew discovered the joys of getting crapped on by a snake.
At the conclusion of the day, we joined them for a new evening activity: beach volleyball. There was a well-set-up court on the far side of the compound, also under guard tower lights. The game was far less intricate than the ones I was used to playing in my competition team in Brisbane. The players packed themselves, about twenty to a side, into a solid mass of beard. There was a conspicuous lack of bumping or setting. Rather, hits largely consisted of a unique style that looked like some sort of mutated tennis two-handed backhand. The balls rocketed back and forth at high speed, often with some unexpected spin brought about by the unorthodox hitting style. Bumping was merely a case of it hitting off someone’s head at high speed. When Sean and I did a tidy bump-set-spike between the two of us, we were looked at like the white aliens we were. Quietly, and just between us, Sean and I named this new game “scud ball.”
The next day we gave a brief review lecture that was a synopsis of the previous day’s training and had all the teams redo the tasks they’d learned. We had them working in teams of three: one with a hook, one with a pair of tongs, and one with a bag. We had them switch equipment and roles until all were adept and the teams fluid. We then brought out the venomous snakes, first placing them on the wide lawns with shortly shorn grass. The cobras and vipers provided good examples of the two basic snake types of the region: thin, fast-moving snakes that are difficult to capture but, once captured, are easy to handle; and stout, slow-moving snakes that are easy to capture but then very difficult to handle due to their strength and long mobile fangs. We stressed a hands-off approach to snakes, and that under no circumstance should they try to pin a snake and grasp it behind the head. Emphasized continuously were the three Cs: calmness of demeanour, clear line of sight, and communication between team members.
Over the next few days we rapidly moved them on to more progressively challenging tasks, such as retrieving a cobra from under a lawnmower or a viper curled up in a large flowerpot. We then placed three large cobras inside the large metal garbage skip, and multiple vipers underneath as well as within the stacked containers of glass bottles. The final exam for each team of three was finding multiple black cobras let loose at night among the bins, gardening equipment, or rubbish. We also took them out into the field to show them the natural ecology of the snakes so that they could better understand their behavior. Whenever we left the compound, Sean and I were each assigned at least three bodyguards with machine guns to accompany us at all times. Of course, we used them as assistant snake catchers.
Among the participants was the site doctor. At the beginning, he was terrified of snakes but he gamely took the course and by the end of it was absolutely in love with the diadem snakes and posed for a picture holding one, which he then proudly displayed on his desk. That was a notably special outcome of the training. The cross-cultural communication between the group and us was among the most satisfying of my life.
Yet there was one very unsettling local interaction. As we were driving through one of the nearby small villages on the way back from snake catching, I spotted graffiti in the form of a ten-foot-long, three-foot-high multicolored flag with a sword horizontally across it and boldly written Arabic lettering above. I did not need to understand the local language to get the gist of what was being so clearly stated. I rolled the tinted window down and started snapping photos, only to be photo-bombed by a man with wild eyes who appeared from nowhere right in front of my face. He filled half the photo, with just a red motorcycle in view in the remainder of the frame. Ten minutes later, the same motorcycle caught up with us at high speed; the figure riding it, clothed from head to toe in white cloth and with familiar wild eyes, gave me a death stare. I was convinced that he was a suicide bomber and that we were going to die. The guards felt the same. They trained the machine guns on the motorcycle as we accelerated away. Had he pulled closer, they would have opened fire and filled him with holes. That was enough for me.
This was the last time I left the compound before we returned to Karachi. Back in my room, while typing up the notes for the day, the Bullet for My Valentine song “Scream Aim Fire” seemed rather appropriate to have blasting out of the speakers, as did Slayer’s “War Ensemble.”
Back in Karachi, we milked the cobras and Russell’s vipers used in the training and Syed stored the venoms away. I expressed my gratitude for his and Mehtab’s help and invited them to visit me in Australia. Once at the airport, we ran into a few complications that were trivial issues magnified by a generalized hostility toward Westerners. First was that I had forgotten to print out my itinerary, so the petty dictator at the door was not going to let me in, even though Sean had his. After much arguing, I managed to catch the eye of an Emirates agent walking past and we were ushered in. Then at the security scanning of our luggage, our snake hooks and tongs were viewed with grave suspicion. The language barrier was not helping our cause and we were getting nowhere with our explanations of their non-weapon nature. Luckily, when a more senior person was called, he looked at me and said two English words, “National Geographic?” He had recognized me from various nature documentaries on television and we had no more concerns.
They did, however, all take great interest in my Toughbook laptop computer—not out of concern, just marveling at it. So I decided to demonstrate its famed indestructibility by slamming it against the corner of a desk. The underside of the laptop made an audible crunching sound as it impacted. In my showing off, I had inadvertently discovered the computer’s Achilles heel. There was a small region that, for reasons beyond me, was not heavily reinforced and I had punched a hole into the computer, with various bits of important-looking wiring now hanging out. As we turned the corner down the hall to go to our flight, I could still hear them laughing loudly, with evident delight.
Three days later, we arrived back in Australia just in time for Christmas. On December 28, 2009, the Taliban attacked Karachi for the first time ever. A massive bomb turned the windows of our safe house into a storm of slicing triangles, illuminated into a cascade of reflected color in the dust-filled air as the harsh sunlight beamed in through jagged cracks in the wall. Forty people were killed and scores more injured.
I spent Christmas, New Year’s, and all of January incapacitated with some sort of dysentery I had picked up in Pakistan. Eight pints of blood-laden diarrhea came out of me over the course of each day. I lost many pounds due to the malnutrition resulting from the inability to keep anything inside me. My doctors struggled to get on top of it. Treatment was hampered by an inability to diagnose exactly which weird microorganism was causing it. Since the doctors could not give it a name, I just ended up referring to it as Pakistass.
Once I recovered, Syed flew over and we investigated the venom samples. It turned out that the black cobra venom was extremely different from that of other cobras. While it affected the nerves as potently as any other cobra venom, it also attacked the muscles like sea snake venom would. The cheap Indian antivenom, which had flooded the market, turned out to be completely useless. Worryingly, while the Sind krait had venom effects typical of other species of krait, the Indian antivenom also did not affect it. This had huge implications, since the Pakistan-specific antivenom was in very short supply and the Indian antivenom was currently supplied as a cure. Based upon our results, Syed and Mehtab spearheaded a new initiative to develop antivenom for Pakistan that would take these results into account.

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