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.
Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique