We have had 3 or 4 rains but it is as hot as ever and much more humid.   One has to drink so much water to keep up with the sweat and one needs some extra salt to keep up with what is lost through the skin.   One tries to sleep in the “sauna” but doesn’t get very rested.

Yes, I apparently had malaria this past week and I just finished my week of quinine treatment which makes you almost deaf temporarily and decreased balance and decreased appetite and no energy.   I’m feeling better today and the energy level is coming back as is the hearing and balance.  Now I know what the patients go through.  The malaria gives you terrific aching all over besides the fever which I had 102 a week ago.  Dolores has not had any problems thus far. 

Olen left  Tues. 26 April to pick up Danae and Zane in N’DJamena.   He also had some business to take care of.  He was at the Ministry of Health until late last night so not coming back here until this afternoon.  We have had problems with the local district medical officer trying to throw his weight around and prevent doctors from working.  I had all my paper work but had not registered with some national registry in N’Jamena.   He was going to ground me then he gave me 2 weeks to get it done which it is done.   Dr. Greg Saunders, a board surgeon that has also spent 10 years in Nigeria, has been here last week and this week helping do surgery but the MCD had him grounded for a day this week. But Olen was able to get some special permission from higher up in N’DJamena so now he is able to work.  He did not have a copy of his license and certificates with him but just a card showing his membership in the American College of Surgeons.  We have a Nigerian doctor here for 2 ½ months  and apparently he is cleared and a Chadian doctor or medical student that the MCD has not cleared to do anything yet until today.  Moral of the story:  volunteers that come, esp. medical, should bring copies of their license and paper work when they come to help.  Actually that is true no matter what country you go to. This MCD has made a nuisance of himself in many different way.  There are very few Chadian doctors that actually see patients but most are in “administrative” positions.  Nurses, some of which are very good, are the ones that see most of the patients in the country in the local dispensaries or clinics.  Sometimes they might even take vital signs like a bp on a pregnant lady but often they do not.    Women do die from ecclampsia.  We had one recently that was unconscious seizing.   We did a C section, the baby lived but she died even with the magnesium sulfate, etc.    She never was conscious during the time we saw her.  The family took the baby.  Maybe they found a relative to feed him. 

Thanks for the $100 that the Grand Lake Camera Club sent.   It is being used to pay for surgery on a 10 year old girl with severe contractures of elbow, wrist, and hand with thumb almost against the forearm.    The surgery was done today.   Her mother had died and the father has no  money.   Hopefully the surgery will enable her to have use at least partially of that arm and hand.      

Thanks again to the Jay Seventh Day Adventist Church for the $1000+ and to the Integris Grove General Hospital Medical Staff for the $1000 that they sent with us as we left home.   It seems there are always various needy projects.   There is a lady with no husband but has malaria getting meds for that.   She has a blind child that had both eyes removed because of retinoblastoma and another child that had malaria.   Dolores has been taking her something to eat the past few days.  Danae has paid for one or 2 vesicovaginal fistula repairs but it makes a woman a woman again.

Americans and Europeans always seem to be in a hurry and often do not even greet each other but Africans seem to be ahead on that point.  If they go to Europe or America they notice how “inhumane” we are.  Africans always have time to greet and find out how the family is, etc   As John wrote in the Bible,  “By this shall all men know if you are my disciples if you have love one for another.”   Do you love someone enough to let them know that Jesus is coming soon?   Or even to be their friend?

We are very glad for the safe and healthy return of Zane and Danae although they did enjoy their time back in the US getting checked over but fortunately nothing was found.  Now “Nana” can spoil the grand kids again.  Ha! J “Nana” has been making lots of mango sauce and dried mangoes.  

We went to the river today and saw about 9 hippos about 10 miles from here.  I also saw an African pied kingfisher, spur-winged lapwing plover,  Reed long-tailed cormorant,  cattle egrets,  etc.

It was over 100 in the church today and I guess my back side is not used to sitting on those hard benches with no backs etc..   

Our email is    drbland@sbcglobal.net   and   dfbland01@gmail.com    and our blogspot is    www.weareamissionarybland.blogspot.com    and of course link to  www.missionarydoctors.blogspot.com       Olen and Danae are much more gifted at writing.  

Our address is:    Hopital Adventiste de Bere, 52 Boite Postale, Kelo, Tchad,  Afrique.   

Love,     Rollin and Dolores

Some more meandering April 3 and 7,2012

     It is beginning to warm up but they say it will get wamer. It was 110 in the shade and 100+ in the house. If there is a breeze it feels like a blast furnace. In the OR it gets down to a cool 85 with the air conditioner. One has to keep drinking water by the gallon to keep some semblance of hydration. One wets the bed but not peeing in the bed but perspiring even with the fan going, when there is electricity. It is still about 90 to 95 in early morning. In some of the huts where other people live and no fans etc. it is 100 even in the early am. The shower water is even hot by the time it is pumped into the hospital water tower tank and then through the hot ground to our houses. Some say the humidity is increasing although I hadn’t noticed it much yet. The air is still pretty dry. It is hard to study French or read or do much of anything when it is so warm.

     Update on Zane. He has been afebrile since he got to the airport in N’Djamena one week ago. He is undergoing lots of tests at University of Maryland Children’s Hospital. They say he may have a little infiltrate? in one lung and his WBC was 17,000 with high percentage of lymphocytes and his AST was elevated. He is being tested for all kinds of unusual thngs but all has been negative thus far. We should know more in a few days. But we are glad that he is feeling better and afebrile. Maybe they will figure out what it was. He has several different opinions from different specialists as to what the problem was or is. We are very thankful for all the prayers going for him. 

     Surgery is still busy and has some interesting cases. I took out a brachial cleft cyst a few days ago. I did a 5th ray amputation of a foot for a tumor of the 5th toe. Also did an amputation of front half of a foot trying to save his heel so he can walk. He had a very large tumor of his distal part of foot. Also a 1 yr old with a very large incarcerated inguinal hernia and another man with a strangulated inguinal hernia but the bowel was still viable and pinked up ok. Also a c-section today for fetal distress with bradycardia and much meconium but mother and baby are doing well. Another c-section was not soon enough for the baby even though we did it very quickly after she arrived. I drained a huge peritracheal abcess with probably 2 cups of purulence removed. Also chest tube in a man with an empyema that he had had for 2 yrs he says. He had been to other clinics but no one had stuck a needle in his chest to see what it was. I wish I was a better urologist with all the blockages from large prostates, urethra strictures including a 4 year old, bladder tones, also have testicular tumors, hydroceles, undesended testicles, renal cysts, etc. Actually we have taken care of most of those ok I think. I had two that looked like chocolate pudding when you cut open the testicle after we did the orchiectomy for some kind of tumor. We are somewhat short of some sutures but someone had sent lots of very tiny suture ie. 7-0 or 8-0 that we have very little use for. This was some donation in years past.

     Pray that we will have the gift of tongues or languages and learn French rapidly. Yes I know that it takes work or time concentrating on it and tryng to use it with the local people but there are other languages here such as Arabic and several others as well. The administrator’s son age 12 already can speak 5 languages including English, French, Arabic, Gombie, and Longerier sp?
     Glad to hear from anyone that sends us updates of back home esp. thanks to Gloria Ketcher, Cathi Spencer, and Lauren Upson and Κathy Keaton, Kendra Anderson and others.
     Thanks for your thoughts and prayers. Incidentally my email is drbland@sbcglobal.net in case this is copied on somewhere. Dolores email is dfband01@gmail.com . Our internet is sketchy and slow but we are getting through if we are patient.

Love to all,
Rollin and Dolores

Surgery - and more surgery   March 28, 2012

     If you don’t like surgery descriptions then skip the next paragraph. Dolores says that most people wouldn’t want to hear about that but some do and that is what I have been the most involved with.
     This weekend a little boy was brought in that had fallen out of a mango tree two days previous. His abdomen was tight and resonant and tender. At surgery his abdomen was full of old blood, his small intestine was twisted around its pedicle and strangulated and there was much retroperitoneal blood and a tear in his spleen that was not bleeding. He almost died on the table and did expire a few hours later. Nearly his whole intestine had a poor blood supply and was greatly dilated. We think we had the bleeding stopped but he died anyway. Another case was a young lady that delivered a live baby 2 weeks previously and stated a painful mass began afterwards but at surgery there was a huge retroperitoneal mass (about 18 cm diam) somewhat overlying the left kidney and aorta and vena cava etc. It had huge veins all around it and the left ureter went over part of it. I think it was the most vascular mass I had ever messed with. It obviously had been there for quite a while. By careful dissection, clamping and tying etc we finally were able to extract it. It was a semisolid mass and we still don’t know exactly what it was. I hope she appreciates the nervous energy it took to do the case. The mass appeared slightly like a kidney but no definite structure. The lady is doing well. We also removed a large goiter under local anesthesia and IV sedation which so far is doing well. I saw a lady today with a huge mass left mandible and extending into her mouth. We had to tell her that there was nothing we could do for her. She said that it had been coming on for 5 years.
     I heard about another strange case. Some boys picking mangoes heard a baby cry in a nearby pit toilet. The baby was somehow recovered from the worms and excrement in the pit and was brought to the hospital where it is doing well. Apparently the young mother did not want the baby and put it in there although I don’t know for sure if this is true as I understand she is now breastfeeding the baby and the grandmother who also recently had a baby is able to breastfeed the baby. The baby is getting antibiotics now . I think there will be more to this story later.
     We had a baptism this past Sabbath with 31 precious souls which is an almost unheard of event for Chad. They were baptized in the river that is about 7 km away. There are supposed to be about that many more that will be later from this set of meetings that just concluded.
     Zane is getting IV quinine for his malaria also getting zithromycin for possible typhoid as suggested by a specialist back at Harvard. It is not the most fun thing trying to keep an IV in a 9 month old but he is fairly tolerant. Danae was getting stressed out and is watching him almost continuously along with Dolores and Olen but I think he is getting better. He had a course of oral quinine before but did not seem to respond to it. He has also had other antibiotics and antimalarials.
     We hear that Ron (Dolores’ brother) is starting his first round of chemotherapy then they will reevaluate him and go from there. We are praying for a huge shrinkage of the tumor.
     Our container has been shipped from Grove to Houston but is waiting there for some special batteries (about a ton) for the hospital electrical system so that the generator does not have to run all the time. They say we could have plenty of electricity for the whole hospital and doctor houses if we had an extra $1000/month. Donations anybody? We recently got another generator, a big 30 KW Hollinsworth diesel that once was from the US Army. Our regular generator has been a Catapillar diesel 20 KW which has been about maxed out part of the time esp if the OR AC and the water pump are running at the same time. We get by ok as is although it would be nice to have more than 5 or 10 watt bulbs for light. We do have good light in the OR now. Recently got a good light given and put in place which makes surgery a lot easier. Headlamps just don’t work as good.
     We had a birthday cake with candle and got Dolores some cloth for a wrap around for her birthday so now she is as old as I am again. No, there are no fancy restaurants or something nearby to take her to. Besides that you need wheels to get anywhere much. It does not matter much when you are our age but just be thankful that you still have birthdays. We are already older than almost everybody here although a lot of people here don’t know their age or birthday. There are some around that have gray hair at least.
     One has to learn to sleep with various noises. The neighbor’s dogs bark under our window esp about 0300, also the fruit bats make noise almost all night. The guineas and chickens are awake at the first sign of daylight. Also there are loud bumps on the roof when fruit from a large tree fall, but the fruit is not edible and is about 1 inch diameter. The lady next door sweeps the yard and starts cooking on her charcoal stove about 0500. The dust is everywhere including in the bedding by overnight although it isn’t quite as bad now. But it is getting hotter as no dust to shield from the sun. If you wash clothes they will dry almost instantly in the dry heat.
     My biggest problem still is learning French. To me it sounds as if they re talking through their nose with a mouth full of mush. Maybe it’s the gray hair that is keeping it out of the brain so maybe if I would cut the gray hair off than it would be better ha :-) Yes I know that the real problem is that I haven’t spent enough time with the books and Rosetta Stone and Pimsleur, etc., but still I just don’t soak it in as fast as I once could which of course means that I need to spend even more time.
     Surgeries should start slowing down and the hospital work in general begins to slow down in April when it is over 100 in the shade so they say. So far the 90 and 100 weather has bothered too bad.
     We appreciate emails and will try to answer when our internet is functioning.


Love to all,
Rollin and Dolores

Night sounds   19 April

     One does not appreciate the various sounds until you can hardly hear.  We have lots of night sounds but since I began my treatment (quinine) for malaria my hearing ability is markedly decreased the past day or so and I have severe tinnitus.  

     One listens to the cicadas and frogs at night back home and maybe a cricket or a mouse stirring (hopefully not in the house but they are sometimes).  Of course at home there are sounds of motorized vehicles and sirens and perhaps a cow mooing for her calf or because they are hungry.  Perhaps one hears the sound of a door opening and closing or the hinge that needs oiled.  Sometimes one hears the neighbor’s loud sound system or tv.  Hopefully some will hear the sounds of music and the word of God some evenings.  Probably one hears the sounds of airplanes flying over during the night.  Perhaps you hear that good sound of your loved one breathing close to you or their voice.

     Here we hear the chirping of the fruit bats during the night and the dogs barking just outside our window.  The administrator lives in a house very close to our apartment.  He has goats that cry at night and chickens and guineas that make noises at night especially about daylight.  There is a rooster that crows loudly outside our window each day about break of daylight.  One also hears the donkey braying during the night.  The sheep and goats outside the wall around the compound make noises at night also.  Occasionally there is a moto (motorcycle) that runs down the nearby street.  Sometimes there is a phone ringing from Olen or someone else needing a surgery or ob at the hospital.  Perhaps there is the knock on the door that someone is needing help.  At the hospital at night there are sounds of newborn babies but also occasionally sounds of mourning for another person that died.

     About 5:00 a.m. I hear the pounding next door of the large pestal grinding the peanuts or rice.  Also about the same time I often hear the sound of sweeping with their brush broom the leaves etc that might fall from the trees.  There is no lawn, just smooth dirt.  One does not hear the sirens of ambulances because they don’t exist in Bere.  Occasionally someone is brought from another town in an “ambulance” to our hospital but no sirens as they would only confuse people and slow them down and besides the roads are so rough that one can not go very fast anyway.  One does not hear the sound of vehicles racing as that would be too expensive and there are very few except motos and they are used as transportation and taxis.  One does not hear the sounds of airplanes flying over here.

     There were the night sounds of Zane, esp for Olen, but Zane will be returning next week all healthy and apparently all the tests were negative so we are thankful for all the night prayers that were for Zane. 

     I have been told that some do not like hearing about surgeries so nothing this time except that we have Dr. Greg Saunders (board surgeon from Oregon that also has spent 10 yrs in Nigeria) here this week and next and he speaks a little French as he previously spent one year in Haiti.  

     Local Chadians should be great philosophers as they have a long dry season after the crops are harvested and also most do not have lights at night so they should have time to do lots of contemplation.  So far I haven't heard much philosophy but then I don’t seem to be learning French or Arabic very fast either.  

     We have had the sound of rain on the roof two times in the past week.  It has cooled down somewhat so one does not sweat so much at night.

     So one should be thankful for all the night sounds and not just ringing of the ears.  Tell your loved ones that you appreciate them and of course continue the prayers for all and that Jesus will come soon.

Love to all,

Rollin and Dolores

3 Feb 12 At Mission Institute  3 February, 2012      It seems that time flies but we have been kept busy at the Mission Institute with classes 8 hrs/day and about 500 pages of outside reading to get done and make reports on, etc.  There was lots of good reading material so some read up to 1000 pages.  We appreciate the notes that some have sent via email.  Oh yes, we are making new friends among the participants here from 13 countries and going to 14 different countries.  It would be helpful to know Spanish, French, Portuguese besides English but we get by.  We have had to take the Keirsey Temperment scale test which is more revealing about yourself than you might think.  We have also had to write up an 8 page report about the country we are going to and its dominant religion, ie. Chad and Moslem.  We have studied about security issues and how to handle conflicts esp if different cultures where something might mean one thing in one culture and very different in another culture.  All missionaries will be cross cultural workers and must be very adaptable.  There are 5 areas that especially are talked about during these 3 weeks.  They are growing spiritually, thinking Biblically, reasoning missiologically, serving incarnationally, and living wholistically.      They have fed us very well with 3 large meals daily and plenty of mango, beet, and passion fruit juices.   The internet service is slow or not at all but manages most of the time if you keep trying to get on.       I keep watching the weather for home and it looks as if winter forgot to come this year.   I’m sure the spring flowers are beginning to bloom by now.   Here in Nairobi it is nice all the time on the equator and about 6000 ft elevation.        Last weekend we went to Masai Mara to see lion, elephant, gazelle (Grant’s and Thomson), baboon, sassaby, impala, cheetah, zebra, cape buffalo, giraffe, dik-dik, water buck, hippo, warthog, rhino, black backed jackal, spotted hyena,  ( got pictures of all except rhino that was too far away).  Also saw many different beautiful birds.   Got good pictures of some   In fact was able to identify some after I got back and loaded on the computer.    I won’t bore you with the names (Dolores says you wouldn’t know what they were anyway) ie. Heuglin’s bustard, Kori bustard, gray crowned crane, superb starling, sacred ibis, flamingo, hammerkop, African spoonbill, African wattled lapwing, lilac breasted roller,  and many others.      We miss all of you and appreciate emails.   We will be in Chad after Sunday Feb 5.   There is supposedly a threat of a coup in mid Feb by part of the military but most people don’t think it will materialize,.    Pray that it will remain calm.   Once we get out to Bere Hospital it shouldn’t bother us anyway as it is a long way from N’Djamena (the capital).   Our big hurdle will be learning to communicate in French.   We haven’t had time to spend on it yet.   We have Rosetta Stone but one needs to spend time with it.       The most important thing is that there are many people that still don’t know Jesus especially in the Moslem world.   We all need to pray passionately for break throughs and mighty outpouring of the Holy Spirit on the many unreached people of the world.  All the various branches of “Christianity” put together is still only a small segment of the World’s population.   Pray for us that we can used of God.       We had a very nice Agape feast and communion service tonight and rededication to God.  Tomorrow there is a dedication service at the church for all of the mission institute attendees.    Love to all, Rollin and Dolores

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Thursday, April 26, 2012 10:27 AM

Zane Returning to America   March 31, 2012      Pray for us.   Danae and Zane left early am of 30 Mar to go to N’Djamena to try to get tickets to go back to the US.   They are going as a medical evacuation because Zane has not gotten over his recurrent fever so are headed back for more tests to see what is causing the problem.   He has been treated for malaria adequately as well as for possible typhoid etc.   The few tests that we have here are not very reliable.    They were possibly to get on Air France at midnight and arrive back in the US in the p.m. of 31 Mar .     One complication was that their passports were at the mission office to get visas renewed for the past 8 days and they had not done anything about it yet and their visas were expired or about to expire.    Danae finally got someone to unlock the mission office to get their passports but may have to bribe their way at the airport being their visas were expired.   Then they can worry about getting a renewal visa when they get to Washington, D.C.          Olen had mentioned about possibly just taking their annual leave now instead of Sept when they had planned.    Also the Parkers (maintainance man, builder etc) are leaving for 3 months leaving 3 April.   I don’t feel very competent in terms of managing the hospital especially with my lack of French to be able to communicate.     I can sort of get by in Surgery, but general medicine and pediatrics and hospital management  etc. is different.   Olen will make further decisions after we hear more about Zane.    Gary Roberts (pilot) is gone with his wife Wendy for a while.   The airplane motor had problems and so it had to be taken apart and sent back to the US for some parts.   Joanne fell from a horse past eve and broke her ankle and we casted it.   We have an x-ray machine now but unable to find some developer yet (not digital here but lucky to have any kind of xray but no good if you can’t look at the film).        This evening we (Olen, Dolores, and I ) took a girl home to her village about 7 miles out in the bush.   She had been in the hospital many weeks recovering from burns but is doing ok now.   She will eventually need some contracture release and z-plasty  done on the neck and one arm.   Today was the first that we had been out of Bere since we arrived here.    It was a nice break.     We had been to the river about 5 km away for a baptism last week.   Love to all, Rollin and Dolores

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March 9, 2012

Reflections of a old new or new old missionary  

     We have been here just past the end of the earth in the country of Tchad since February 5, after being in Kenya since January 11 when we left Tulsa.  Contrary to appearances we are alive and well but we have almost no internet connections (only through Olen and Danae).  Apparently our modem is defective.

     Sometimes I wonder if I am too old to learn another language, i.e., French and Arabic and other languages that are spoken here.  But then I should be experienced by this time.   After all, we were in the mission field of Nigeria 40 years ago for three years and have been in various countries on 2- or 3-week mission projects, mostly building churches with Maranatha.  The fact remains that I need to spend more time with Rosetta Stone and various books, as it just doesn’t soak in real fast.  It takes WORK!  But that is what we are here for, to work for the advancement of the cause of Christ.  French and Arabic are the official languages of the country so we have to learn French at least.  Danae and Olen (our daughter and son-in-law here) are doing very well with language but they are younger (excuses and I just gave a sermon about excuses not too long ago at Jay).
     But some more excuses, i.e., electricity only part time and the voltage fluctuates quite a bit, or no wheels but our vehicle and container might arrive by October if we are lucky.  It is difficult to tell others about God and what He means to you if you can’t communicate.  The weather is hot and dry and dusty but actually cooler when the dust shields the sun somewhat.  So be thankful for the dust storms.  They say it gets hotter and muggier next month just before rainy season should begin.  Presently, clothes will dry in the sun about as fast as if they were in a dryer.  The humidity is below 10%.
Fast food has not invaded this country yet, so no Wendy’s, McDonald’s, KFC, or any chain stores, i.e., no Walmart either, so that part is good.  There are very few smokers.  (It's too expensive if you live on $2 per day).  Maybe they should charge two days wages per pack of cigarettes at home.
     We are fortunate in that we live in an apartment with a bed with mosquito net around and a small gas burner to cook with and a flush toilet (no float valve but otherwise it works).  The student missionaries live with the locals in huts and have latrines and eat like the locals and shower by pouring water over their heads.  (At least there is water out of a well, so don’t complain.)  We are fortunate that we have two of our grandchildren here.  In fact Dolores takes care of them during the day most of the time while Danae works.
     The culture is definitely different than we are accustomed to.  The idea of borrowing and returning something ... probably not happening.  (Just if the lender needs it worse than you do.)  The “music” even in church has no harmony at all, or tune either most of the time.  Maybe even a high pitched shrill thrown in at times and the drums.  Whatever happens is the the will of Allah.  For some reason they want to give water instead of breast milk for the first three days of life.  So many are malnourished and 21% die before age 5.  One does not shake hands with your left hand because that is the hand that you clean your self with.  They farm by hand as they have done for many many years but they have cell phones, although internet is very minimal.  There are very few vehicles other than motorcycles and bicycles and ox carts.  In a town of 60,000, there is no need of stoplights but neither are there paved roads nor streets.  If you need some electricity for something, you better have a generator.
     Medical has been interesting although a lot of work.  I am in “charge of surgery” and have done about 150 cases so far.  We had two ectopic pregnancies back to back and two appendiceal abcesses back to back and today three strangulated hernias, including a bowel resection and reanastomosis for necrotic bowel.  We had a necrotic left colon that had been operated on at another hospital and was allowed to remain for three days and finally came here unsure what the original problem was.  We did a left colon resection and colostomy.  We had eye enucleations for retinal blastoma bilaterally.  This week a little girl age 8 with bilateral ovarian masses, one 20 cm and the other 10 cm.  We had a ruptured uterus that lived.  We had a very large thyroid mass, about 15 cm and underlying the carotid and jugular, that had to be trached but appears he is going to survive.  Also a very thick imperforate hymen with actually almost no sign of vaginal opening but she is doing well now.  Also a z-plasty for stricture from burns on a neck in a 3 year old.  One died post op with miliary tuberculosis throughout his abdomen, which we had only opened enough to look to see what was going on.  We have no CT or x-ray or EKG, and lab is minimal.  We do have a little portable ultrasound that we donated and brought over a year ago when we visited here.  We have done three vesico-vaginal fistulas so far which were very difficult technically because we don’t have everything we need or the right needles and sutures but so far they are holding.
     Working with our daughter and son-in-law is a real privilege.  I’m not biased but they are very sharp and are doing excellent work.  One has to keep in mind that if you can’t help the patient, probably no one else in the country can either.  There is no one to refer difficult cases to.  In fact, some are coming here from the capital city as referrals although mostly patients come on their own.  In church this past week someone said they were hearing in Moundou (the second largest city in country and two hours away) that Bere Adventist Hospital was the best place to go for care.  I want to get acquainted with some of the doctors from other places, especially when I learn language better.
Love to all,
Rollin and Dolores