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  

Monday, December 12, 2016

Blog 12 Dec 2016
It is cooling down here so only in the 90'sF highs and in the 60'sF lows.   It is somewhat dusty but will be more later when the "harmattan" moves in from the desert up north.
  
Danae is doing ok today but had severe vomiting and diarrhea a few days ago requiring a lot of IV fluids. (see Olen's blog   www.missionarydoctors.blogspot.com)    Her vision is about same and with dark glasses does not bother her very much in bright light.  Vision ok in dim light.   I think they came up with "Acute zonal ocult outer retinopathy" as her diagnosis from all her super specialists etc at the Univ of Maryland which they really don't know what it is or cause or treatment or prognosis.   It has not gotten any worse so far.   Several of us have had the gastrointestinal upset with nausea or diarrhea probably a virus but nothing like Danae had.   Dolores had the malaria last week but is ok now except for a headache today.   The kids are all fine now.   
We have been enjoying the papayas from our trees in our yard almost more than we can eat but goes good in fruit salads and for the kids also.   The mangoes are blooming a lot now.  The guavas are past.   They are still bringing us fresh tomatoes to buy which are quite good.  
The hospital census has been variable mostly 60-80.   The surgeries have not increased as much as normal for this time of year although had 22 the first 3 days of last week.  Had a large 2 cm perforation of intestine from typhoid last week that we had to repair but he is doing ok now.   Also had two appendectomies which is unusual especially one that was not ruptured yet.   Most have already formed an abces.  We had a fistula repair bladder to uterus-cervix.   We have one man that had a severe infection of penis and scrotum losing skin of penis and part of scrotum.   I plan to do a reconstruction of his penis with a flap of skin from scrotum and another flap to cover that area.  
We have no student missionaries this year.   I guess they are afraid of possible danger from Boko Harem although we think that is very minimal.   It is probably more dangerous in some of the most dangerous cities in the USA such as St. Louis, Kansas City, Springfield,Mo, Detroit, etc.
  
Our emails are drbland42@gmail.com and  dfbland01@gmail.com.   
Have a great Christmas and New Year!
  
Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com  

Wednesday, November 23, 2016

It is holiday time back in USA with Thanksgiving tomorrow and Christmas in a month but it does not feel like holiday time here.   It is about 100F in the daytime and dry and dusty although we had a 0.3 inch shower a few days ago which it is not supposed to do in dry season so for a few days humidity is high.   We are going to have a Thanksgiving meal about 1500 tomorrow with several local people invited.  
Danae and Juniper are back here now as is Zach Gately.   They all seem to be in good health.  Danae still cannot see part of visual field right eye in bright light but otherwise ok.   She did surgery today with no problems.  The problem affects only the cones of the lateral part of her right eye.    All the big specialists and tests in the University of Maryland in the US did not find a cause or treatment "possibly a virus".  Anyway we are glad it was not a tumor or aneurysm or anything real serious.   Not enough problem for disability.  Ha!!
Last week we had a ruptured spleen from a moto accident that we did a spleenectomy on but now is doing well in fact eating and drinking and walking on 2nd post op day.   He lost a lot of blood.  The man with two gun shot wounds through his left chest now has a severe infection draining lots of purulence but I think he will survive.   Today Danae and I had a hysterectomy also a myomectomy (taking out large fibroids from her uterus so hopefully she can have a baby being she has not had one).  We also had another mastectomy for cancer last week.   Today we had a child with severe respiratory problems with wheezing etc. that would not respond to steroids, ceftriaxone, magnesium, albuterol, oxygen, ketamine, IV fluids, etc.  Don't know if she will survive but appears doubtful.
  
Have a happy Thanksgiving and don't watch too much football or spend too much on "black Friday".   We do have a lot to be thankful for. 
 
Our emails are  drbland42@gmail.com and  dfbland01@gmailcom.  
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  

Friday, November 11, 2016

9 Nov 2016
Danae and Juniper left early Sunday on a bus to  NDJ to catch a flight to DC, USA because Danae noticed a medial visual field defect in bight light Sat in her right eye.  
Olen and I did not detect anything unusual in her fundiscopic exam but it was non-dilated exam.   They arrived in DC early yesterday Tuesday morning and appointment to get MRI of head.  She is to get results today Wednesday and see a neuro ophthamologist today(Thursday).   Meantime Juniper is sick and was admitted to the hospital with fever,  possible malaria  They are at the University of Maryland hospitals  (later: MRI is normal, no evidence of MS or tumors)
Since Sat night we have had lots of Gyn cases here.  I have done 2 ectopic pregnancies, 2 c-sections (one for ruptured uterus and completely open bladder and one for transverse lie), 4 curettages (one for one of the largest molar pregnancies with over 4 liters of material), 2 for incomplete abortios, one for retained placental fragments ).  
The for 3 day post partum superior artery part of intestine volvulus that was necrotic and was resected is not doing well.  
Recently we had a man with left chest gunshot entrance and exit wounds x2 (somehow missed his heart) with pneumothorax and lots of subcutaneous emphysema (air under skin)   A chest tube was placed and he is doing well.  He was shot by police when he was "in a fight with someone".  
We recently had an AKA amputation above knee on lady that had just had bare bone below her knee.   She had gotten her leg caught in a belt on a power thrasher a few months ago and had been in another hospital.   Also recently had a ruptured gall bladder that had a very thin wall but necrotic part of wall that at first thought was from a perforated gastric ulcer but could find none and patient did well post cholecystectomy.  We did have a perforated gastric ulcer yesterday.  We have an ileiopsoas abcess to drain. 

Today we saw a boy with a hernia from a bicycle handle bar jabbing him in the abdomen.   
We have had a lot of abcesses lately in various places including neck, chest, thigh, labia, leg, arm, etc.  One boy died today with abcess of arm and thigh that began bleeding various places apparently septic in spite of antibiotics.
   
Dolores has had pain in her right knee that extends into her thigh and inner lower leg almost the whole time since we have been back here.   It gets better with rest and less pain if standing.  It seems muscular but sometimes it seems to be joint.   Is taking ibuprofen and paracetamol to rest.
Today our computer system has totally quit.  Olen has tried different things but no avail.  Zachary Jensen maybe can help via phone as he helped install it and to fix problems before.   He is 9 time zones away.
Today is a bad day with computer system failure, Juniper and Danae not well and long way distant, and Trump elected president of USA.  He seems to me to be the most vulgar, anti-religous freedom, bellicost, isolationist, anti-minority, non loyal to international friends, etc. man ever to be in that position.  
The "last day movements will be rapid ones" 
 
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  

Wednesday, October 26, 2016

Blog 23 Oct 2016

We have been back in Chad over 2 weeks and have been busy although not sure what has been accomplished some times.   Our hospital census has been 80-90 esp this past week.  The government employees have not been paid all their salaries so post office, hospital and health care, courts and various government offices are on strike.   Of course the military is getting paid so they are not on strike and there are still many military check points.  Some of our increased census from that and some from this time of year when they are harvesting their crops and have a little more money to spend.   Some of you saw some of our pictures from Europe on Facebook that Dolores posted.  
It has not rained more than a few drops this month and we don't expect any until next May.  It has been in the 90's most days and 80's at night.   The rice crop does not look very good as rainy season was not as much as usual.   Everything is drying up rapidly.  
A few days ago we had a lady with acute abdomen 3 days post partum and resembled a ruptured uterus but when we opened, the entire intestine appeared dead at first but more exam revealed that it was a volvulus (twisted bowel so no circulation) involving the entire superior mesenteric pedicle.   We took out the dead intestine and reconnected the jejunum to the terminal ilium (upper intestine to the lower part).   So far she is doing well but not sure what will happen with the "short bowel syndrome".   We had a 10 yr girl with 3 typhoid perforations and abdomen full of bowel contents.   We repaired and irrigated a lot and so far it appears that she will live.   We have had some bladder stones one that was 6-7 cm (about 2.5 inches) diameter.  We took out a prostate that was same size as my fist and so far doing ok.   We did a BKA (below knee amputation) on an old man that previously had a partial foot amputation but now foot all dead.   He has given up and refuses to eat or drink.   We have had a ruptured uterus recently.   Danae and I did a vesico vaginal fistula (hole from bladder to vagina) repair that was quite challenging.   We always do those together.  
The brakes went out on our Toyota pickup Sab while I was driving back from branch Sab School.  Today I took it apart and found that the wheel cylinder and caliper are bad.  The sandy much and water really does a number on vehicles.  IT only has 45000 km (about 28000 miles)   I need to check all the other wheels also.  
We have two family practice doctors here from Juneau, Alaska for this week.   They were in Moundou last week.  One of them had been here before.  
Our emails are drbland42@gmail.com and dfbland01@gmail.com  
My yahoo account got messed up and can no longer access it.  
Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com