Wednesday, March 22, 2017

I was going to write this yesterday but found we had no water so had to tend to that before breakfast.  Our water pump had quit, apparently burned out or worn out.   "We pump many thousands of gallons of water daily.  They tell me that people from Bere town are coming to get water because wells are going dry.   Our last rainy season did not fill the water table up to near the top as usual.   It is a long time before there will be any water from the sky to put water in wells again at least until June or July..  It will take a lot of rain to soak this dry sandy ground again.   It is about 108F (about 42C) day and only 85 or 90F (72C) at night.  It was 92F last night in our bedroom at 2200.   We had a water pump to put in but did not have the proper connectors here or in Lai.   We bought another pump and finally found enough of the right fittings to connect it and had to redo the wiring somewhat.   That took most of the day.   Fortunately no real emergencies came in yesterday.   We plan to get proper fittings for the other pump so that when we need it we will have it.   There is another well that had not been used but recently had a pump put in it but not connected to the system or to its own water tower tank which is not built yet.   We made a connection from that pump ;into our main system so that hopefully now we can have back up system somewhat .  We really need the water tank built on top of the tower that is already built.  
A few days ago our blood bank refrigerator quit so we let them borrow our little one until another one can be bought.   Hopefully the blood was not damaged too much.   It will cost about USD500 or 600 to replace it.  It was about USD350 to fix the water pump.   I got word today that our generator has been repaired and will be brought back maybe tomorrow so I will need to spend some time helping or putting it back together connecting back to the motor and the electric system.   It cost about USD1000 for that besides our labor for everything.  
Our hospital census and our surgery load has decreased markedly this month.   Revenue is much decreased.   Money is scarce as had poor crops and low prices, prices are low for the country.   They say there is some kind of problem getting cattle across the border into Cameroon and Nigeria where they usually sell them.  
We have another lip to repair after a fight with another woman 10 days ago.  I saw a huge goiter but I don't want to tackle it unless we have better anesthesia and have Danae here to help and still may not as it is HUGE.   We did a mastectomy and axillary node dissection recently and she did well.   We recently had a man with severe right heart failure with very distended neck veins and short of breath even sitting up although his lungs were clear but very distant eart sounds .   We think he had a cardiomyopathy.   We don't have much to work with for cardiac patients.   He wanted to go see a "cardiologist" in NDJ.   I don't know if he made it there or not.   We had a placenta previa recently with mother and baby doing ok after c-section.  We also had a retained head with rest of baby hanging out and she walked in.  Of course baby was dead.   Was able to manipulate the head and extract it without too much problem.  
We have Staci Davenport MD here on visit and plans to be back long term in  less than 2 years from now.   Vadym Korzhos surgeon from Ukraine that is to be in Moundou wants to be here for a month or two to get some experience with me before he is on his own.   We visited him in Ukraine when we were there last August.   We also have two senior medical students here from Loma Linda Univ .  Tyler and Melissa Pender.   She is interested in internal medicine and infectious disease and he in general surgery.  Another doctor Sarah will be visiting here in May and hopefully will come back long term maybe about the  time we leave PR.  
Our emails are drbland42@gmail.com and dfbland01@gmail.com
Love ,   Dolores and Rollin
Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com  

Monday, March 6, 2017

March 1, 2017
I was beginning to write this evening then the electricity went off.  Our electricity is supplied by our Perkins 28 KV generator which we run 24/7.  We have two of them but one is not functioning now.  The one that has been running now had to have the generator part taken off ( it weighs about 500 lbs) and taken to Moundou where there is someone who can rebuild them.   Now the other one has had to  have the generator part have the same thing.  Hopefully the one that has been rebuilt will continue to operate all right.   Apparrently the life span is about 14000 hours  at least that is about when each has gone out.   It costs a lot or money to get them rebuilt (about $700) .   Tonight the problem was a broken fan belt and a sensor detected it getting hot so shut down the monitor.  We took a fan belt from the one that has the generator off and got this one going again so were were without electricity less than 2 hours.  We have also  an old Caterpillar 12KV generator which we can use if no big items are being used such as AC or blenders but can handle the water pump.   The Caterpillar is the one that was the only source of power before the present Perkinss generators were donated 4 yrs ago by Garwin McNielus of "one day church" fame.  Since all the new buildings were built there are a lot more lights than there were formerly.  When we first came here the generator was only run part time and only used very low wattage light bulbs ie. 5-10 watts and used battery power to run the lights when the generator was not running but would have to run the generator to pump the water to fill our water twoer tank.  We would be out of water frequently.   Now we have a float switch which automatically turns on the water pump when the water gets below a certain level in the tank.  Fuel for the present 24/7 operation costs a large percentage of the budget.  Recently the electricity went off early am Sabbath but the problem was the fuel tank was empty and someone had not ordered the barrels of fuel to keep it going .   Usually get several barrels of fuel at a time.  
Our business seems to be slowing a little except maternity is still about the same.  We had about 165 surgeries in Jan and 135 in Feb.  March will probably be less.   We have had lots of hernieas, hydroceles, prostatectomies and urethral strictures, and hysterectomies and some vesico-vaginal fistulas.   The fistulas are the most challenging.   Danae and I always do them together.  Some are repaired trans-abdominally,and some vaginally and some both.  We have an ovarian mass or cyst and ectopic pregnanciies fairly often also.  C-sectons and sometimes ruptured uterus also.  Yesterday one of our patients returned for check up that was very rewarding.   She had had a superior mesenteric volvulus with dead intestine requiring at least 7 ft (about 2 meters) of small intestine removed.  She almost died following surgery having to have a repeat surgery etc and was very emaciated but now she is doing quite well.  She even denied having diarrhea or  other symptoms of short bowel syndrome and had gained weight.   She is happy and we were ecstatic.   We recently had another psoas abcess which we drained and she did very well.   We have different kinds of cancers that come too late for anyone to do much for them.   Probably the most common are bladder cancer, ovarian cancer, cervical cancer, breast cancer, Prostate cancer, Burkit's , etc.   
This coming weekend is alumni weekend at Loma Linda Univerisity.  I graduated 49 years ago from medical school.  I plan to be at our 50th year class reunion next year.   
Our emails are drbland42@gmail.com  and  dfbland01@gmail.com.  

Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com  

Monday, February 13, 2017

Blog Feb 10, 2017
Kermit and Ronnalee (Olen's folks) left yesterday to return to the USA after being here about 2 weeks.  Kermit was doing some auditing and Ronnalee taught some in the new nursing school.  They had brought Toby (their grandson) with them.   He was sick yesterday probable malaria but seemed better when they left.  Olen went with them to NDJ to be sure they were all ok.   Olen and Danae and family will be leaving here March 14 to go on their annual leave and get back in time for Danae's 20 yr high school class reunion at Ozark Adventist Academy then they will drive our pickup camper to Colorado for a week of snow skiing then on to Oregon and the western US and will leave our pickup at Riverside, California at Gloria's (Dolores' sister) where we will get it when we fly to Rachel's (our oldest granddaughter) graduation Dental Hygiene from Loma Linda University May 27 weekend.  They have a week in Hawaii (a friend gave them free use of a condo).  Olen and Danae will be at Andrews University in Michigan May 6-7 weekend for graduation and to receive their honorary PhD then they have a wedding to go to May 14 weekend then they return to Chad.   We will be leaving about the time they return on our annual leave with maybe a few days in France on our way to LAX and Riverside.   After that we will spend a few days in the western US on our way back to Oklahoma.   We plan to return to Chad in July after Oklahoma campmeeting.   We are extending our time here from May to next Feb as the need is great and there is no replacement yet.   We have said that Feb 15 is our final date and will return to USA permanently more or less.   It is possible that I might do some short term relief work some place after that.  My 50 year LLU medical school class reunion will be about March 3, 2018 and I hope to be there.  
We have been busy with surgery with about 50 cases last week but the backlog has diminished a lot so now we are almost caught up with minimal waiting.   We had another typhoid perforation of intestine last week which did well also had one with appendiceal abcess.   We had a man with multiple stab wounds all over his body including by his rectum.  We did surgery and found a small hole  in a loop of intestine which we repaired.  He died a few days after the incident possibly a pulmonary embolus??.  The man had refused to give or loan 1000 cfa (about USD 1.65) and another man got angry and stabbed this man much.   Danae and I have done some repairs of vessico-vaginal fistulas lately.   They can be VERY challenging.  Sometimes we do it trans aabdominally and sometimes vaginal or both.   We have also had several urinary retentions that needed prostatectomies and /or urethra dilation.  
The first skin graft using our dermatome is doing well but the next two don't seem to be sticking.   Maybe I need some pointers on making the graft take or something.   Thanks for the new blades for the dermatome that got sent over here.   Initially it would not work so took it apart and soaked it in WD40 and finally got it functional.  
Our emails are drbland42@gmail.com and dfbland01@gmail.com.

Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com  

Wednesday, January 25, 2017

Blog Jan 21, 2017
    We are in the midst of the busiest part of the busy season and lots of elective surgeries have come in to be done but the maternity business is more now also.   There have been a lot of c-sections for various indications and a lot of ectopic pregnancies.   Keeping Danae busy.   She has had several c-section hysterectomies for different reasons.   We had another "torsion dermoid cyst" with hair and teeth a few days ago.  We had a strangulated internal hernia with about 2 meters (7 feet) of dead intestine that we had to take out.  We had a hemangioma of a child'[s hand that we did.  Had to remove her 5th ray (finger and metacarpal).  So far it looks ok.   Thanks to someone that sent blades for our dermatome so now we hope to do some skin grafts.   We have done one so far.   Today a woman came in with part of her lip bit off during a fight with another woman.
   It is beginning to warm up again but only to approximately 100F and 70'sF lows.  The dust is not as bad as it was so the sun can get through more.   We are getting quite a few papayas from our trees that we planted by our house.  The mangoes are in full bloom.  
Juniper likes to eat from "papa's" plate whatever he is eating.   She eats a lot.
  The 17 year daughter of one our local church leaders died this past week with widespread cancer.   She had almost died 3 weeks ago as her ereters were blocked but a percutaneous nephrostomy and some cyclophosmide et. prolonged her life a little.
  Pray for the newly baptized ones and the ones in some of the outlying villages that want to learn more about the love of Jesus. 
Our email are drbland42@gmail.com   and dfbland01@gmail.com.
Continue to remember us in your prayers.
Love,  
Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com  

Sunday, January 1, 2017

Dec 31 2016
New Years Eve and the drums are beating, probably will be most of the night.   It is dusty and has been since the "harmattan" blew in Christmas day.  "Harmattan" is the north wind and dust that comes in about this time of year from the Sahara.  Visibility was less than 1 km (about 1/2 mile)) although it is better today.  The dust shields out some of the sun's heat so temperatures are only about 60F (15C) low and 80+F (27C) high but the locals feel this is cold.   The mangoes and kapok are blooming.   We are getting several papayas from the trees by our house.  
Christmas was very dusty.  We had a while elephant gift exchange here on the compound and of course there were gifts for the grandkids.  We also ate very well Christmas afternoon but the meal was delayed because of a surgery for an acute abdomen. (Sound familiar you medical people?)
We had two unusual cases Friday yesterday.   One was a 13 yr girl that presented with a few days of severe abdominal pain and no menses yet and had a mass in her abdomen.  At surgery a 6-7 cm lobulated mass that was twisted on a pedicle.  When the mass was opened we found hair and cartilage, bone and teeth so a "torsion of a dermoid or teratoma".  The same day we had a lady that came in with severe abd pain for several days and "constipation" for a week.   It was an intussisseption of mid small small intestine with ruptured dead intestine with much bowel contents in the abdomen.  Had to do a bowel resection and reanastamosis.  Both look ok so far.   We also had a Fulana lady that had been bit on her foot by a donkey that she was trying to separate from another in a fight.   The lady's foot was badly mangled with a lot of skin missing and bare bones visible.  She needs amputation but refused and left to go to the local "traditional healer" (witch doctor).
Pray that the love of Jesus can spread and bring peace and that we will be ready for His coming that is one year closer than before.
  
Our emails are drbland42@gmail.com and  dfbland01@gmail.com
Continue to remember us in your prayers.

Love,
Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com  

Monday, December 26, 2016

Dec 25, 2016

Merry Christmas to one and all.   Hope each has had plenty of good family time and great feasting.   
Today we had a laparotomy for a man that had been stabbed two times in back and flank so lunch maybe waited a little then we had a white elephant gift exchange which was interesting and fun.   Olen got Danae a donkey which she wanted.   I hope she likes it when it does its morning braying at 4 am.  The camel is at least quiet.  .   Also got a little hedge hog which is quite cute.   I hope it survives the dogs and cats and kids.  Two days ago we also had a man stabbed in flank which we examined under anesthesia and his wound just went through a lot of muscle but not enter the peritoneum.  The one today went just posterior to the colon and along the edge of kidney and did not penetrate any intestine or stomach or spleen.   Possibly could have injured the tail of pancreas not sure.   Both are doing ok so far.   
Have recently started another group in a farther out village Moundala that has a good group of adults and children that are attentive and interested in the Bible stories and studies.   Some of them can read and want a Bible so hoping to get a few for them by next week.   Pray for them that the interest will continue.   
Yesterday there was a campmeeting at Bendele and also a baptism for 43 at the river.   One was a Fulani man and also two of his nephews  He has been through a lot to become a Christian including being ostracized from his family.   It is difficult for a Moslem to become a Christian but some take that step anyway.  He is strong and energetic and will be a good worker for God.  
We need to be thankful for the freedoms that we still enjoy as many do not have them and even in America many are being lost.   Pray for our country and for those that want to become a follower of Jesus.  
Have a happy and prosperous New Year as we are one more year closer to Jesus soon coming.  
Our emails are  drbland42@gmail.com and dfbland01@gmail.com.

Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com  
Dec 22

Dolores has been busy baking and cooking different things for this coming weekend to try to make a little Christmas cheer for all of us especially the grandkids.   We are not traveling anywhere (no where to go to)  as many of you will be doing.  
Danae and i have done 2 vessico-vaginal fisutula repairs this week.  We have had a few other minor surgeries and some usual things such as hernias and hydroceles.   I did a flap reconstruction covering for a penis  that appears to be doing ok.  He had lost almost all of the skin of his penis and most of scrotum from a severe necrotizing infection.  We also did a pinch skin graft to a leg that had been severely burned on an exhaust pipe of a motorcycle.  Overall it has been slow lately as far as surgery is concerned but probably will pick up in a week or two.  
We are all well..  The camel and dogs and cats are well also.  The grandkids of course are excited about Christmas gifts that they might get.   
Out here there is almost no commercialization of Christmas as there is back in the USA.  There is more to do about New Years than Christmas.   Many people know nothing about Jesus and the plan of salvation.  
Our other children and grandchildren are getting together today at Janelle's in Oklahoma City.   At least last year we were all together for our 50th wedding anniversary.
Our emails are  drbland42@gmail.com  and  dfbland01@gmail.com.  

Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com