Going to the river 28 Oct

One week ago on Sabbath afternoon we decided to drive to the river with Olen, Danae, Lyol, and Zane in our 4-Runner.  We were following the Parkers in the Land Cruiser.  Both have 4 wheel drive.  They drove through just fine but I got off the road about 6 inches in one place and suddenly went axle deep in the mud and 4 wheel drive would not make.  Our winch was able to be connected to a small palm tree and we winched ourselves out of the mud and drove the rest of the way without any problem even though part of the trail was a foot deep in water.  This way we got to try out our new winch that we had put on before we left home.  It worked great.  The trail was solid under the water.  The Land Cruiser never had any problems. The kids enjoyed the river which was still bank full.  

     Along the way we saw where they were beginning to cut the rice and shock the rice bundles.    All the harvesting is done by hand of the rice, millet, corn, peanuts, or whatever.  The dogs, Sheba and Midnight, really enjoy the water and swimming in the river.  

     Wed eve before Danae left  for furlough, we drove around a few trails south of here and saw some areas we had not seen before even though it is close by.  Actually we had not been anywhere until now.  Now we have a possibility even though we may not have time to do much esp the next two months.  At least the “roads” are getting drier and better so that some villages may actually be accessible.  It is pretty lonely here with Lyol and Zane gone and don’t have Danae to do surgery with her.
     

     They say the main “road” is not under water anymore.  Where the road was under water was also the area where there are hippos at least in dry season.  One place on the main “road” there is a large tree across the road and one has to go around it off the road.  There are not many chain saws and it is difficult to cut a large log with a machete.  It would make someone a lot of firewood if they could cut it up.   

Our emails are  drbland@sbcglobal.net  and  dfbland@gmail.com  and sometimes we even answer . 
Love  Rollin and Dolores

Oct 28 Update on prayer needs

     Keep praying for us as the hospital containers still haven’t been released yet and if they aren’t released very soon the whole project will be postponed at least a year apparently. Olen spent most of last week as well as one day the previous week in N’Djamena trying to influence the right people to help the situation.  It is hard to get appointments with some of the officials. They want to charge an unrealistic amount of import tax.  We simply do not have the funds to pay the exorbitant tax.
     The weather should be drying up the mud fairly quickly as the temp is in the 90’s and only cools down in the mid 80’s at night. I see on the news that Nigeria also had floods from the excessive rainy season.  I don’t know how far west the rains went, such as Niger, Mali, etc. No appreciable rain the past two weeks. We are out of sacks of cement for the building projects but hope to get more tomorrow.  The “roads” are getting more passable.  The “road” from here to our post office in Kelo only takes about 1 ½ hours to go the 25 miles now. The bus goes over it every day now to go from here to N’Djamena which takes about 10 hours on the bus.  
     One week ago I went to Moundou in our car (about 2 ¾ hrs) to get some supplies.  It was Friday so one has to have business done by noon as many of the businesses close at noon on Friday for the Moslem sabbath.  At 12:30 Danae called wondering how soon I would be back as there was a baby that needed a colostomy because it had no anus or rectum so I rushed back and we did put in a loop colostomy.  Imperforate anus are fairly common here. We also had a 7-month pregnancy in the abdomen with placenta attached to bowel and end of tube.  The uterus was very small.  The woman said she had felt movement until 2 months ago when someone had hit her in the abdomen and then no movement afterwards.  There was minimal old blood in the abdomen.  Perhaps it would have gone on to become a calcified fetus but she saw someone who thought it was a molar pregnancy and needed attention. I had seen two calcified fetuses about that size when I was in Nigeria 40 yrs
ago. Read more in Danae’s blog under “misdiagnosis” at www.missionarydoctors.blogspot.com 
     Danae left here with Lyol and Zane early Thurs morning on the bus to N’Djamena to leave that night with Olen to go to Paris for the weekend then on to the USA maybe arriving there before Hurricane Sandy in the D.C. area.  They are to be back here the end of December.  They deserve a good vacation but they will be missed greatly.
     It seems that OB has gotten busy since Danae left.  I have already done 4 C-sections and a normal delivery.  There was another normal delivery done by the nurses also.  One C-section was for transverse presentation with hand sticking down and unable to change it as the uterus was very clamped down.  This was because the lady had oxytocin elsewhere, clamping down the uterus which resulted in a dead baby.  Another C-section was for a footling breech and previous c-section with nice live baby.  Another was for CPD (lack of room in the pelvis) and failure to progress and dead baby.  Another was for a previous C-section and head very high and live baby.  I had another lady with a large (about 25 cm diam) mass in her right broad ligament with the round ligament over the top of it.  The mass was multicystic and some cartilage like material in it but no hair.  I’m not sure what it was but at least it came out fairly easily once I incised the peritoneum and peeled it off.  
     I had a visitor today who was a governor of another state.  He brought a patient-friend of his with some x-rays wondering if I could fix his hip.  Dr. James Appel had referred them here.  The patient had had a fracture of his right hip 7 yrs ago and had had a surgery of some sort apparently removing part of the proximal femur at least the trochanteric area. The x-ray was not the best quality so difficult to tell the condition of the head and acetabulum.  We have some endoprosthesis here of varying sizes but don’t have a good intramedullary rasp to prepare the bone for the stem of the endoprosthesis. The slide to put the head into the acetabulum would be nice also. It would be difficult to make it work at best. The leg is about 2 inches shorter.  He really needs a total hip.  I wish we had more orthopedic equipment to work with.  A good fracture table would be helpful at times.  Hopefully we will have new OR tables  etc. when we get our new OR and OB maternity built and continue to pray that it will be soon and not a year from now.  

     Pray more than ever for our situation that the officials will do what they are supposed to do soon.

Our emails are  drbland@sbcglobal.net and dfbland@gmail.com  
Love, Rollin and Dolores

15 Oct 2012 Problems

The devil is still actively trying to delay work here at Bere. Maybe the rainy season is about over. The rains have lasted longer than normal so the “roads” are still with large water holes and very, very rough. We drove towards Lai on the main “road” for almost 10 miles 2 days ago in the afternoon which took over an hour each direction.  Some of the holes are 3 foot deep. It is impossible to get the containers here for at least another 2 or 3 weeks.  BUT we need everyone’s prayers besides praying for roads to dry up, we now need prayer for the government people to let the containers through with the building materials for the hospital. Apparrently the duane (customs) is trying to get 40 million francs ($80,000.00) for that which is supposed to be no charge or at most very minimal.  The donor states that if it can’t be cleared properly soon he will divert the material to Zambia for a building project there. There is supposed to be a contract with the government to let it go through because we are a non-profit, non-government organization trying to help the people of Chad but so far they don’t want to honor their word. The Chad government is known as one of the most corrupt in the world. We need the OR, surgical care area, maternity and private ward beds.  Also housing is needed for volunteers to stay in. Some of the concrete slabs for the various buildings have already been poured and work has been progressing in spite of the difficulties. Some of the Chadian workers were laid off today as they were caught trying to steal some of the cement powder.  Pray that the devils road blocks would be overturned and that the work can proceed. Olen may have to spend a few days in N’Djamena seeing various government ministries such as the Minister of Health, Minister of NGO’s, Minister of Finance, etc. Olen is optimistic that some higher up official can turn it around.  

Also the customs people are trying to get more money for our container which supposedly had been cleared as we got our vehicle out of it already but we are unable to move the container to Bere because the trucks are unable to get through yet especially the big semi that would be required to move the 40 ft container. Olen and Danae are supposed to leave on annual leave next week for 2 months.  They both have not been well lately but are improved now.  Dolores and I feel inadequate but I’m sure the Lord will provide.  Olen is so good with languages and we seem to be very slow.  Pray for our situation in all your prayer circles. Thanks.

Love,  Rollin and Dolores
Our emails are: drbland@sbcglobal.net and dfbland@gmail.com
Our blog is: www.weareamissionarybland.blogspot.com  

3 Oct Wheels

     We have wheels!!  Our container has been released from customs and we have our Toyota 4 Runner 4-wheel drive with heavy bumper and winch on front. Jamie Parker went to Moundou, got supplies and our vehicle. Tammy (his wife) drove it back through a back “road” about 4 hours to get it here.  We really won’t be driving it a whole lot but it is nice to have when we need or want to. The stuff that was in the vehicle and the vehicle made  it through just fine.  Hopefully the roads will eventually dry up so that our 40-foot container can be moved to Bere. I’m not sure where we will put stuff when we unload it. Our house is just starting to get foundation etc.   There is no way to off load the container here in Bere except by just pulling it off the truck so probably has to be emptied before taking the container off the truck. There is a lift in Moundou that can load the container on the truck. It is beginning to dry up some now. 
     Ron (Dolores’  brother) made it to his knap-in this past week end.  We did not know if he could make it but some of his knapper friends put him in a motel for the week-end and had a raffle for him.  His cancer has been growing pretty fast but we are glad he made that.  That was one of his final things he wanted to do.  

Our emails are  drbland@sbcglobal.net  and  dfbland@gmail.com 
Love,  Rollin and Dolores