Sometimes we dream of cool weather or of air conditioning but we felt “cold” the other morning when it dipped to 75 and needed a sheet or blanket to cover up in bed. Today it is more like 85 in the am. And the humidity in the 90’s with temp in the 90’s. The AC in the OR only works part time as the inverter for it keeps cutting out esp when it is so hot. The rains have started and many people are busy working ground with their oxen and plow and planting corn and peanuts and millet etc and soon will plant rice as it gets wetter. There are almost no tractors any where so I’m sure they dream of tractors so they can work more ground and better.
Sometimes we dream of nurses giving their patients medicines as they are supposed to be given but often are not. Maybe even dreaming of nursing that understands what they are taking care of and what they are supposed to do about it. I guess it is good to develop patience even if it is not good for the patients. Some nurses are very good and conscientious but then there are a few others. I suppose that is true somewhat back home too but we really need some oversight at least part of the time. We are dreaming of getting a nursing school started and in fact one nurse has just arrived to help make this dream a reality and plans to be here for the next 5 years. Her husband plans to get a radio station started here also hopefully with some good music and educational programs for the Bere community. They know French and there are another two nurses that just arrived but they need to learn French, but they are young so they learn it before us.
We are dreaming of a new OR and new maternity unit and more staff housing and building for the anticipated nursing school and some buildings for anticipated outlying clinics in some other villages with well trained nurses (hopefully) from our nursing school to staff them and refer patients to Bere Hospital, esp for surgeries etc. The Adventist Aviation plane plans to be back in service soon that might help some in transportation. We are dreaming of having a plan developed for long term future development of Bere Hospital and improving the health care of this country of extreme poverty.
I’m dreaming of a time when people won’t wait so long to bring their problems to be cared for. I have had to amputate a leg AKA for an injury of two weeks that had multiple open fractures of the tibia and fibula and extremely foul odor and maggots in the wounds. I recently had another leg AKA with similar issues but from large tumor of lower leg also a mastectomy for large tumor mass with larvae in the mass. Also two children with severe contractures of arm and hands from old burns. We did surgery on them and their arms and hands won’t be perfect but hopefully they will be functional. The amputees are learning to walk with crutches that are homemade in the village. We are dreaming of them with prosthetic devices someday.
Oh yes we dream of home at times and seeing and hearing from you. Some of you have never said anything so we don’t know if you are getting our updates or if you are interested in life out here. Some have been very helpful in keeping us updated on events there
We also dream of Zane being afebrile as he is still has a low grade fever. He has almost finished his Flagyl treatment for Giardia and is going to have an IV Ceftrixone treatment for 10 days for possible typhoid as suggested by a specialist back in DC. He has had some diarrhea and has decreased appetite. So continue your prayers for him.
We dream of quiet nights sometimes esp when the guineas are making noise and the fruit bats that make noise all night. The dogs bark under our window anytime and the rooster crows there also esp about 5:00 am. One would think that they could do their thing somewhere else. They belong to the neighbor administrator that lives in the house very close to our apartment. Hopefully our house will be built when the rest of the construction projects are done. They plan to build some other staff housing then also.
We had a good wind and thunder and lightning storm about midnight last night. It gave us a good rain also and cooler air. It is really greening up rapidly now that the rains have begun. Corn and okra and peanuts are starting to grow.
I went out last Thurs and Sunday to a village way out in the bush about 1 ½ to 2 hours away by motorcycle. Part of the way was just trails through the brush and around the water holes. It was a rough ride but “scenic." We have a dentist here that went along also. We both saw several patients. It also happens to be the village where they hope to start a Bible school. There is a nice government clinic building with plumbing but no water to run in the plumbing. They have only mebendazole, artermeter, paracetamol in stock for worms, malaria, and fever. So I had to write Rx for people to get meds from another town. The clinic personnel were very minimally trained but then the main problems are parasites and malaria. It is a village of about 5000 people. I saw a Fulani group moving their cows and their belongings. They are the nomadic cow herders. There were several different birds but didn’t have time to stop and look at them well. There were 8 of us on 5 motorcycles
We can dream of when we will get our container with our things and a vehicle. It has been finally shipped from Houston. We probably won’t get it here before Sept. partly because the roads will be impassable for a truck to bring it here before then. No, I’m not dreaming of a white Christmas.
I’ll quit dreaming but am dreaming of hearing from some of you.
Our address is: Hopital Adventiste de Bere, 52 Boite Postale, Kelo, Tchad, Afrique.
Love, Rollin and Dolores
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Thursday, May 24, 2012
Tuesday, May 15, 2012
14 May 2012 Showers of blessings
Praises for some cool days and nights. Maybe rainy season has begun. We have had two real soaker rains this past week and it is much cooler. This morning Dolores thought she needed a blanket because she was “cold”. The temperature was 78. At least now we are not wetting the bed with sweat. The generator and invertors seem to like the cooler temps and are functioning better now.
Zane is better now and has been afebrile past two days. He is being treated with Flagyl for Giardia Hopefully he will continue to do well. Olen and Danae have also been taking meds for Giardia.
Apparently our container with our goods has finally been shipped from Houston. I’m still not sure what is happening about the battery situation. I don’t think they were put in our container.
I did a mastectomy today on a lady but did not get all the tumor but at least it was debulked and cleaned up where there had been fly larvae. I have an amputation tomorrow of a leg with a tumor involving bone and has fly larvae in it. Yesterday we had a ruptured appendix (doing well today) and a ruptured uterus with much loss of blood and baby floating in the abdomen We did a Cesarian and hysterectomy on her. She is still alive at least for the present. Also we had a knife stabbing in the abdomen and testicle that came in with omentum coming out the abdominal wound and much clots around the testicle and much dirt and sand all over. We explored his abdomen and apparently had no other injuries. Last week we did a AKA (above knee amputation) on an old man with necrotic infected tumor of leg and he his feeling much better now. We had another boy with an injury to abdomen by a cow horn but fortunately did not damage anything major. Also had another little boy age 2 with a bladder stone size of hen egg. Bladder stones are fairly common probably related to Schistosomiasis and chronic dehydration especially in the heat.
What are complications of C-sections? I have seen several and heard of a few others around since I have been here such as vesico-vaginal fistula, high recto-vaginal fistula. Vesico-uterine fistula, even a vesico-uterine fistula with a pregnancy placenta in uterus and baby in bladder that died in bladder, ureter involvement in various ways, various sorts of infections, severe blood loss, evisceration because of not closing abdomen well, etc. When surgeries are done by people with minimal training even in basic anatomy in some of these places with just a nurse or minimally trained “doctor” it is still better than dying.
Of course there are the complications of ignorance. People that refuse to do certain things even after it has been explained to them such as a lady past week that had a crushed index finger that had been crushed 2 weeks before and was severely infected and needed amputation but she refused. The big problem is that people that come in to have things done until it is too late such as tumors or malaria or other things. Most acute appendicites are ruptured before they come in or they have a large appendiceal abcess. The knife stabbing wasn’t until the next day. Sometimes there is the frustration of dealing with nurses that have little knowledge or are wanting to care for patients properly. The “Oh well” attitude is too common when some medicine is not given as it should be. Sometimes the patient has not bought the medicine which they have to do before the nurse will give it. Sometimes the nurse has not signed that she has or has not given a certain med or given a reason for such. So rounds is not just checking the patient but checking to see if the patient has bought their meds and if the nurse has given it or not and if the paper is done properly etc. There is also the problem of thievery and bribery. I’m glad that Olen has good knowledge of French so can deal with the politics and administration issues, firings, hirings, etc. I’m very proud to be his father-in-law as he does such a great job. Danae gets quite frustrated with some of the nursing issues at times. One has to remember that many people are not that far removed from “dark ages ignorance” but some of our staff are very good and compassionate and want to help people all that they can. It is hard to get some to plan ahead and order meds and supplies on time etc. Currently we are short on suture esp. 0 Chromic and Vicryl and similar things and we have almost no antihypertensive meds. What do you do for preeclampsia and eclampsia if you don’t have anything to treat them with but we do have some magnesium at least. Then there is my ignorance of the French language and maybe my slowness to catch on to some of the cultural things. I have learned some but I seem pretty slow after all we have been here 3 months and should know more than we do.
The pomegranites and figs that Danae brought back from Janelle’s are putting out shoots and looking like they will survive. I have planted papaya seeds and currently have 24 transplanted to their places where I hope they will grow well around the edge of Danae’s yard. We also have about 20 mango seeds (from large mangoes) germinated and starting to grow. Not sure where we will plant them yet as some fences or walls are not built yet.
With the first rains the ants do their flying and come to lights etc and get in the house etc. The farmers are getting out and working their ground by hand of course and planting peanuts and guinea corn and beans and will plant their rice later when it gets wetter.
Your emails are more than welcome. Our address is: Hopital Adventiste de Bere, Boite Postale 52, Kelo, Tchad, Afrique. For snail mail or care packages which take about 3 weeks to get here.
Love, Rollin and Dolores
Monday, May 7, 2012
“The Worm” 5 May 2012
Sometimes we have wrong impressions of what we perceive to be the facts. Remember the story of Jonah in Jonah 4 how he got angry at God because a worm came and made his plant wither that had been sheltering him from the “vehement east wind and the sun beat upon Jonah’s head so that he grew faint”. We took out a long angry appendix from a young lady then later we heard that in the village it was being said that her sickness was from a big worm that we took out. The family was shown what was taken out. Usually we have appendiceal abcess rather than acute appendicitis. Sometimes we have impressions of people that are not correct. First impressions are not necessarily correct ones. We all have had impressions of people that after we got better acquainted turned out to be absolutely wrong. We need to know people and be their friends so that we know what the “worm” really is.
Sometimes I think I can relate to Jonah and the extreme heat especially when the AC does not work in the OR. Apparently one inverter gets too hot then shuts off the electricity to the AC. The OR has no outside air source and becomes extremely hot and humid. One has to drink plenty of water between each case because one will sweat it out during the case and all the clothes or gowns will be saturated with sweat. So maybe I get upset when the “plant” (AC and inverter) withers and dies or quits. God was kind to Jonah in spite of his recalcitrance and saved him from the storm, the fish, and the heat. God will take care of us also. The low temperature today was about 90.
Our internet withers and is non functional part of the time but we should be thankful that it works at all and beats snail mail most of the time.
So far as we know our container with our goods etc. is still in Houston after sitting in Grove for some time. They are still trying to figure out how to ship the battery packs for the hospital because “hazardous materials” can’t be placed with other things but some say they could be if the batteries were shipped with no acid in them but apparently there is disagreement about that.
We are all doing relatively well other than minor GI upsets sometimes. Zane still has a fever at times even though he was said to be all ok. We appreciate the prayers of everyone. Sometimes the thermometer has to cool down to take a temperature if the room temperature is 102 which it sometimes is in the hospital. Often the patients are out under the mango trees because it is cooler there.
Love, Rollin and Dolores
Friday, May 4, 2012
April 2012 More reflections of an old missionary trying to learn new things
It is another hot and dusty day as we try to function but it is hard to think or accomplish much when it is this way but they say it will get warmer in the coming month maybe to 110+. The sandy soil dries out very rapidly and soaks water up like a sponge but they say in July and August everything around here will be covered with water and rice grows wel l here. Now is mango season and are they delicious. We get a few papayas and bananas and even had a coconut the other day. There is plenty of food but one still loses weight when it is so hot. Dolores made some granola that was really good the other day.
They are just concluding some meetings here at the little hospital church and about 12 or so are wanting to be baptized. Even after they are baptized they still have a lot of maturing to do sort of like the Israelites when they came out of slavery in Egypt to be God’s people. They need our prayers and support.
Ron, Dolore’ brother, certainly needs everyone’s prayers. He has stage IV cancer of the throat with nodes in his chest apparently. He has been getting tests and staging at the Univ of Okla Health Science Center since Dec 2011. It was noted that he had a mass in his neck in Nov 2011. It may or may not be related but he has had recurrent tonsillitis for years. He also is a knapper (makes arrowheads) probably not related either. He has postponed chemo for 2 weeks and has been told that radiation is not indicated for him. Won’t it be wonderful when we get to heaven and don’t have to worry about cancer, pain, and all the heartache we have here. We see quite a bit of cancer here especially bladder and prostate cancer.
We recently had a young man with a strangulated small bowel around a ompholomesenteric band or Meckel’s diverticulum but this was released and he is doing well now. So far all our vesico-vaginal fistulas and vesico-uterine fistula are doing well and are still dry. The 3 day old with no anus died the next day after we tried to recreate an anus. A lot of gas and stool came out when we opened the rectum but had minimal nursing care. Ruptured ectopic pregnancies are fairly common.
Internet service is very sporadic and has been none past few days.
Love Rollin and Dolores
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