Monday, July 25, 2016

The life of a foreign missionary is often glorified in various stories and problems are not mentioned. Yes there are rewards sometimes but sometimes one does not see results that are good. Sometimes it just seems like "work". We see lots of interesting pathology in the medical work but after 100's of hernias and hydroceles, etc it becomes a blur. A "missionary" in a foreign country has to be adaptable, flexible, patient, and know why you are there. 

One has to deal with thieves that were people you had trusted. It seems that some think that foreigners are made out of money. Loans often become gifts because they usually are not repaid. Some steal from school accounts as parents pay for their kids school. Some try to take bribes from patients at the hospital. Often in the government hospitals patients have to pay extra to the nurses and lab people to get the care that is already paid for and we try to prevent that here. Since we computerized the med ordering here we think it has decreased some of the bribery and stealing. It seems crazy that they can sue you for lots of money after they were fired for stealing lots of money or not doing their work. 


One has to make do with equipment that does not operate properly. Many of the surgical instruments don't clamp or hold as they should. Many drapes have holes that we try to match with other drapes with holes in different places. The good drapes tend to develope legs. The autoclave sometimes will burn the cloth wrappings. The electric autoclave takes so much power to use so is not hooked up yet. One has to be inventive at times to get things done with equipment that was supposed to be for something else. We do have an operating room light now whereas initially we had to use a head light which gets very hot and uncomfortable. There is no public power so one has to hope that the generator keeps working but sometimes it does not. If no electricity then no water as the water pump is electric. It is difficult to get parts for generators and other things. Sometimes people send stuff that didn't work properly for them so "donate it to Jesus". "Junk for Jesus" which unfortunately costs good money to get shipped here. Our gloves often have seen too much heat or something on the way to Chad and tear easily or stick together or were defective manufacturing. Almost everything comes from China or France. 

Communication is a problem although now we do have some semblance of phone and internet service part of the time, but very slow. Some places in the cities have good phone and internet but not good here in the rural area. Not able to get on most web sites and not able todownload pictures unless they have been downsized a lot. Not being able to communicate with the many different languages here is a problem but I have not even learned well the official language French either, so I am handicapped.

Then there are the various diseases that you don't have to think about back home. Of course malaria is the big one in the tropics and can be fatal if not taken care of properly. Typhoid is common but there is vaccine for it but it is not 100% effective. Most of the locals have not had the vaccine. There are many different parasites and bacteria that can give diarrhea or many other problems. One has to take these awful tasting meds every so often for the various problems. HIV is very common so if one gets a needle stick may need to take the HIV meds for awhile which make you feel bad. 

Transportation can be a problem as there are almost no roads that have ever ever been graded here in Chad and central Africa. There are just ox cart trails and if there is much traffic the water holes in the trails get pretty deep especially in rainy season. Often in rainy season one cannot go on the "roads". The "moto" (motorcycle) is probably the most dependable to in some places other than ox cart especially in rainy season. Large trucks can go only in dry season. 

Getting meds is a problem much of the time. In Chad the government mandates that all meds come through the central government pharmacy which often does not have sufficient in stock and lots of meds not available at all. We are not permitted to import our own. Also the government mandates that all medicines that are past date or even short dated be thrown away which is crazy. Even though lots of studies including the US military show that most medicines are good for years past their dates. Lots of perfectly good meds have been dumped but they come around inspecting to see if you have any expired meds. There are very few blood pressure or diabetes meds even available. I've even heard that in some other countries perfectly good donated food was dumped because it "might be contaminated with GMO food" instead of giving it to people to keep them from starving to death. Ignorance kills so many people. 

Nursing is not what you would expect. They often or usually sleep on the job esp at nights. There is almost no communication between shifts. Hopefully, meds will be given the same day as ordered but often is not.  Knowledge is very basic or minimal. When a patient leaves the OR they are almost on their own but usually have relatives to help care for them. Basic math is lacking in many staff. 

But in spite of the problems it still is a great and challenging life and helps to develope your character . The Lord does truly take care of us through various problems. The Lord is good. 

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

July 17, 2016

It has been relatively quiet this past week. Although two of the volunteers were detained and had to pay 3000 cfa "fine" for riding as 2nd passenger on a moto. They had walked almost to the market then was offered a ride then was stopped at the market. Later Olen was talking to the commissair (head of he area police) and found out that the ones who collected the "fine" did not have authority to do so. The commissair was going to "talk to the prefet about it" Haven't heard any more. Incidentally the "prefet" is still around so the rumor that he was sacked was not true.

We had a man come in with a partial obstruction intestine with history of previous surgery elsewhere for a "cancer of the cecum". Not sure what surgery was done. Did not find any evidence of cancer anywhere even though he had been told it was in his liver and kidney also. But now he was obstructed at the cecum and had lots of adhesions. Probably was appendecitis and now was scarred down. We took out his cecum and terminal ilium short amount and reconnected his ilium to his ascending colon. He is doing well post operative. The other man with strangulated hernia and dead intestine that we had to remove is doing well. A man with a neck abcess that was actually improving just gave up and refused to eat and drink even with IV fluids and finally died. We had a thyroidectomy and some hernias and prostatectomies that are all doing ok. We had another 1.7 inches (about 42 mm) 2 days ago so over 3.3 inches this past week.

Dolores has an eye infection that has been painful but hopefully is improving. Addison and Juniper had some sort of eye irritation also.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.
Love,
Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique
Blog www.weareamissionarybland.blogspot.com
July 25, 2016

Monday the 18th we had a strangulated inguinal hernia (did not require intestine resection) and also had strangulated internal hernia that had dead intestine that had to be removed. Also had a sigmoid colon volvulus (colon twists on itself and shuts itself off) All that was besides a scheduled hernia repair. This past week we also had a parotid mass that was mushy and very vascular and we did not get it all out as too involved with other structures and probably was a cancer. We had done her thyroidectomy previous that was possibly malignant and she had done well with that. In general the hospital has been slow except Pediatrics but even that is not as much as some previous years. We have a Pediatrician from Brazil that is taking care of Pediatrics for the next 2 months. We have a couple (Eddie and Carolina Perry) here this past week that want to start a clinic in the Congo. She is finishing a FP residence with some tropical medicine and he is doing ER work. They hope to go in the next year or so. 

Our computor system has quit working so have had to go back to the writing out things on paper. Olen has spent lots of time with it and texting Zachri Jensen in Washington to try to get it going again. The computer that was using for server does not seem to cooperate. I am computer challenged so am no help.

Our generators all seem to be in good working order now. Had problems with a frequency sensor that was not adjusted right also a fuel filter problem but all seems ok now.
Everything is pretty and green now. Dolores' eye infection is much improved. 

Putin recently signed into law that no Christian Bible studies were to be allowed even in homes. The window of opportunity for Russia is almost closed. The USA recently passed laws that will make it difficult for Christian schools and institutions to operate. Many of the Moslem countries have laws against Christianity and so difficult to tell the story of Jesus. We hear various ones talking about possible world financial collapse. The end surely must be near. What are you doing to let people know about the soon coming of Jesus? "Even so come Lord Jesus"

We will be gone on vacation annual leave the next 2 months leaving July 29.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.
Love

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

Monday, July 11, 2016

July 10, 2016

Olen, Danae, Lyol, Zane, Addison, and Juniper all arrived back here Friday evening July 1. So glad to have them back. Addison and Juniper have had a fever. Not sure if malaria or just some virus. They are being treated and are doing ok. Our hospital census is up especially in Pediatrics which is usual for July. Lots of malaria and typhoid. We have a pediatrician from Brazil for 3 months so she is taking care of Peds. We also have a medical student from Loma Linda and an OBGYN from Texas (friend of Danae's) and a Family Medicine from California for a short term visit.

Last time I mentioned the "prefet" was here with his military and guns snooping around the hospital looking for expired meds that he said we were killing people with. In fact there is no evidence that any expired med has killed anyone and previously we had gotten rid of expired meds but he also calls short dated meds the same way. But the next day he went on the local radio and then national radio in NDJ saying we were killing people by selling expired meds. For whatever reason he does not like "Adventist". Then the same week the regional Delegae (government doctor over this region) came with his entourage looking everywhere in the hospital even in some back dark corners and said he found some expired meds and "verified" what the "prefet" had said. The Delegaie's visit, including 2 hours of meeting after the exploration, lasted most of the day. The local MCD (government medical director for the area) accompanied both visits and only referred to me as "the old man" or "that old man". The Delegae never acknowledged that I was even present even though I accompanied them most of the time. They were very negative about Olen and Danae about them "not being cooperative" and telling the MCD when they were coming or going etc which actually was not true at all. They knew Olen and Danae were not here then so they came then. The Delegae kept saying that Olen and Danae or the administrator were not in charge of the hospital but the MCD is to be. Today I hear that the "prefet" was sacked and he is not in his house. I don't know if this is true or not.

Today we had a strangulated hernia with dead intestine (terminal ilium, cecum, and part of the ascending colon) that we had to take out and reconnect the intestines. The maternity has been fairly quiet since Danae returned. We had plenty before. We had 4 different patients with bladder stones this past week.

We have had no rain the past 2 weeks and some of the grass is starting to wither or turn brown. It is supposed to be heart of rainy season now to bring up the crops especially the rice. It could be bad if it does not start raining although it is nicer for the "roads". Tonight we got 1.6 inches (40 mm) of rain so better now.

Is it true that Donald Trump states he would make all who claim to be Muslim register in some sort of national data bank? Could it be extended to another minority group also? It sounds dangerous in America.

Jesus will soon come to take His people home. The signs are all around us. Pray that it will be very soon. Pray for our situation here in Chad.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.
Love

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

Tuesday, June 21, 2016

June 20, 2016

It is pretty and green with grass greening and needing lawn mowed, and most people are out plowing and planting rice, millet, cotton, beans and peanuts etc. We had about 4 inches (about 254 mm) last week. The "roads" are with deep water holes and mud. So far most of the water holes are only 12 inches deep but that will increase with more rain. 
 
Some days we are busy and some not so busy with surgeries, consults, and maternity etc. We were having generator problems everyday for awhile but that seems to have straightened out somewhat now. There are quite a few on medicine service now. Friday eve I picked up Zach at Kelo after he had returned from NDJ on some hospital business. The drive to Kelo is about 1 1/2 hrs even though it is only 45 km (25 miles) The bus from NDJ was late so we got back from Kelo about 2200. Then at 0200 had to see an OB with previous c-section x2 and a small pelvis in active labor so did a c-section and got back to bed about 0500. Then got up at 0630 to go to branch SS at 0700 then to church at 1030. I slept some before and during potluck lunch and in the afternoon. I was feeling weak. In the evening we had a retained 2nd twin with arm presentation in a 18 yr old that delivered 1st twin at home. I finally managed to change it to a footling breech but she was having no contractions and the cervix had clamped down some. Finally delivered with lots of pulling but the retained head took a lot of time. Of course the baby was dead. Sunday morning at 0500 we went to Moundou as I had agreed to do some surgeries there (probably a mistake). I did 4 ortho cases that were very difficult. Fortunately Zach drove the vehicle for which I was very thankful as I was not feeling well and came back in the evening 3 hours each way. By then I was aching all over and had headache and no appetite. It seemed like malaria so began the Malarone and some ibuprofen and wet the bed with sweat. I feel a little better today. I rested this afternoon. No surgeries today or complicated maternity although an incarcerated hernia came but I was able to reduce it so it can be done later. 
 
Today we had the prefet (chief) come by the hospital with a bunch of military and the MCD etc. They went through the whole hospital I think then had an assembly to talk which was another 2 hours. He talked about how bad expired meds were and lack of compassion and not sure what all. Some say he is quite deranged. The MCD gave a power point on free meds and some history of such in Chad. As best as I could tell as I could not understand the prefet's speech very well. Previously they made us throw away a lot of perfectly good meds because they were short dated or past date. Olen has previously presented many studies including some by the US military that show most meds are good for many years beyond their expire date. A lot of this is gimmicks by the drug companies so they can sell more meds but unfortunately ignorance costs lots of money and lives. 
 
We are looking forward to the return of Olen, Danae, and the kids July 1. They have had a nice deserved vacation which one needs after working here awhile. 
 
We recently had an email from someone in Australia that reads our blog. We appreciate emails. It makes life a little easier. 
 
Love,  Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique

Tuesday, June 14, 2016

June 14, 2016

There are people searching for something better in life, people who want to learn more about Jesus and the Bible. "God Pods" are an easy way to give the Bible to people that you might not reach otherwise, and a high percentage of people here in Chad are illiterate. However, they can listen to these devices that have recorded much of the Bible, and have their friends and neighbors listen as well. With heavy usage these God Pods last about a year. Some have solar panels on them so they can recharge the batteries. People have come to know Jesus through these $30 devices. Maybe it’s a project that you can donate to. These God Pods can go where you cannot go. They can be recorded in whatever language.

It is very difficult to get Christian literature into this country, with lots of hassles and expense to get it across the border from Cameroon. Everything imported has to come through the country of Cameroon. If we had our own printing press here in Chad it would be much less expensive, and literature could be more available. Jonathan Dietrick here has been working on this project and researching options and cost. Initially maybe a small digital printer (about $3000) could be used until a larger one was needed or replace it. Unfortunately most of them say they should not be used in heat over 90F, so a room would require A/C which would require a generator to run it and the press. There is no reliable public power in the country although some public power is in N’Djamena (NDJ) and Moundou but not reliable. Probably need about $10000 for that.

A window of opportunity is open now for a Christian 1000-watt FM radio station in NDJ. The paper permission work is promised without cost now and the equipment for it has been promised from a donor. That power would reach about 100 km (about 60 miles) radius which could cover NDJ and some of the surrounds. We need a suitable piece of property maybe on the south edge of NDJ. Don't know cost of that yet. Maybe a suitable 1 or 2 hectares in edge of NDJ that could have the printing operation, the radio station, and maybe the mission headquarters together to create more efficiency. Of course need money for the buildings also. The radio station would need A/C also. The main thing that is needed is a person with communication and radio skills to operate the station until maybe a Chadian could be trained to do it. (Maybe a year or so.) The person needs to know French.

Maybe The Lord will impress some of you who read this to help Contact us for further details.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique

Monday, June 6, 2016

June 6, 2016

It was beginning to get a little dry since the last rain one week ago but today we got 0.9 inches very rapidly with strong wind. Everyone is busy working ground and planting. It has really greened up in fact some lawn is needing to be mowed. "Roads" are full of huge water holes now. Mango season is about past. 
 
The hospital has been slow EXCEPT for maternity. I have done c-sections for shoulder presentation (today), ecclampsia, previous c-section for various reasons and prolapsed cord all within past two weeks. Have done a few vacuum extractions in fact one each night past 3 nights. Also have had an ectopic pregnancy, tuboovarian abcess, also hysterectomy for 2.5 kg fibroid uterus. Surgery otherwise has been slow. 
 
Our phone and internet has been totally nonfunctioning part of the time ie. 3 days after the last rain storm but only a several hours today. It is never very good.

I had the talk for church this past Sabbath on "Two Lost Boys" also the story is known as "The Prodigal Son" Those that knew the languages better than me said my translator was not very accurate and sort of had his own version part of the time. 
 
Dolores is on "vacation" now!!! Anyway she misses the kids a lot. They will be back July 1. She is trying to do some sewing and some house cleaning and reading. We are healthy presently although I had vomiting and diarrhea 2 weeks ago and some diarrhea today but seem ok now. 
 
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Love, Rollin and Dolores
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique