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 firstname.lastname@example.org and email@example.com
Love, Rollin and Dolores