This is a compound crush fracture of the left humerus due to a bite by a hippopotomus. The author calls this a ' hippo nibble', as it is relatively minor compared to two patients he has also treated in Uganda who lost their arms, and one patient who lost a leg due to hippo bites. A hippo, who weighs 2 or 3 tonnes, is said to cause most of the severe injuries of any of the African game. It will take a bite out of anyone who gets between them and their young, or between them and the water.
Wounds also tend to be infected after a hippo bite.
The author advises against bathing wounds, or even swimming in the shallow waters of Lake George in Uganda. This lake abounds with hundreds of hippopotomus, and the bottom 4 feet of the lake is composed almost entirely of 'hippo dung'.