I was listening to some Christmas music here at the house this Sabbath afternoon and played the Messiah done by the London Philharmonic Orchestra and choral. In my mind’s eye I was back in the community chorale in Grove, Oklahoma doing our Christmas program that we did each Christmas for several years. I especially remember one with our leader, Jim Boles. He was very patient with me as he gave me the tenor solo at least one year even though Mr. Wilhelm had a better tenor voice I think. I had problems counting or staying with the right timing with the orchestra, but Jim helped me with that and I made it through. I enjoyed the chorale each year made up of members from several different churches. We had to begin practice in September to be ready for the December program that was usually in the Methodist church. Nancy Lundgren had such a beautiful soprano voice and she also led the chorale a few times after Jim passed away with heart problems.
There were many very beautiful voices and wonderful people in that group. The chorale did not perform the past few years. It seems everyone was too busy especially leadership. Not everyone has the capability to conduct a music group. Back home in America there is lots of music and decorations everywhere but here in Chad there are none. The weather is cool (it might get down to 60 at night) so definitely no snow although this is the coolest time of the year. The people don’t have money to waste on things that are only glitter. They are more concerned with survival and where is the next meal going to come from and will the little child die from malaria or parasites. Almost half of children die before age 5. In the western world esp America we spend so much money for things that really don’t matter very much. Here children make their own toys from whatever they can find although most don’t have much of anything but helping to care for siblings or working in the fields as soon as they are old enough at all.
There was a first here last night. One of the student missionaries helped with Tammy Parker put together a Christmas program for the church school which they never had before. There are almost 300 in the school. Dolores spent lots of time making costumes for the program. The program was held outdoors and many of the community were there. Maybe some of them will get a little glimpse of the Christmas story and the Saviour that came to save us from our sins. There are so many in the world that know almost nothing of the good news of salvation and the Saviour.
Many of you will spend time together with families this holiday season. Our family met together except we were here in Chad and they were together in Oklahoma. Danae, Olen, Lyol, and Zane will be back here in a few days so we are looking forward to that.
We hear that the containers that you have been praying for will be coming in a few days. We hope that is a fact. It would really be Christmas if our container and the containers for the hospital construction arrive here this coming week. Our container was packed 1 year ago. We have lived out of our suitcases and what we could get here so maybe we didn’t need as much as we thought. There are a few things in it that is supposed to help with hospital stuff. There are some books and music and different kinds of food and a kerosene refrigerator and some other things for the house that is supposed to be built for us eventually.
May each of you remember this season what is REALLY important. We are certainly looking forward to the return of our Jesus when all this poverty and suffering will be no more.
Love, Rollin and Dolores
Our emails are drbland@sbcglobal.net and dfbland@gmail.com The internet here is very intermittent and slow.
Sunday, December 23, 2012
Friday, December 14, 2012
Death Angel stays close Dec 13
When a patient dies one always wonders what could have been done different to avert death. One died this am that was one day post-op prostatectomy that was uneventful and he was doing well at 0700 then at 0730 he suddenly got short of breath and died unexpectedly. Possibly a pulmonary embolus (blood clot to the lung) and I am still not sure what we could have done differently. We don’t have anticoagulants here other than aspirin but he was a low risk for problems. The other one was a large abcess and infection of jaw and neck and possibly the mediastinum. We had drained a large amount of purulence from the neck but she was not improving much then died this pm. I don’t know if a trach would have benefited or not but it is difficult to get good nursing for a tracheostomy. We have little children that die almost upon arrival from malaria fairly frequently.
We have had 4 ruptured uteruses recently but so far all have survived. But the death angel was really close esp for one of them that was having gasping or agonal respiration as we were beginning her c-section but with lots of IV fluids and blood and getting her bleeding stopped and emergency hysterectomy. She is doing well today. Not sure but we think all the ruptured uteri had been given IM oxytocin (medicine give to have the uterus clamp down to prevent bleeding) before they were referred here. One of the ruptured uteri even had a live baby. Miracles still happen. Another c-section for prolonged labor, dead baby, now has had some sloughing of her vagina and urethra. Not sure how much repair she might require later. We had also a severely necrotic (mostly dead) prolapsed uterus that was very very large. We had amputated it basically and it did not involve the bladder however the infection apparently ascended up the stump and inside the abdomen. We had to open her abdomen a few days ago and there was much purulence in the abdomen but no perforation of bowel so she was irrigated out and drained and so far the death angel is holding back.
Recently a liver abcess ruptured and patient was very ill and painful. The laparotomy for acute abdomen was done and the abcess was found and drains placed and now patient is doing ok and the death angel holding back.
We have 3 “in house” now with cancer of the bladder that could not have anything done. Today there was a 6 month boy with a huge mass in the upper abdomen (filled most of abdomen) growing rapidly past 3 months mass that is. Probably a large cancer. Parents decided against surgery which might not have helped anyway so the death angel will have that one soon.
Here in Chad almost half of children die before age 5 mostly from malaria, malnutrition, and parasites. So the death angel visits most families fairly frequently. Malaria especially can be very deadly.
We are all in good health except I recently had a “cold” but am recovered. Dolores is working long hours making costumes for a bunch of school children for their Christmas program which is next week.
We covet your prayers and emails.
Our emails are: drbland@sbcglobal.net and dfbland@gmail.com Our internet is operative only occasionally but we eventually get the emails. Unable to get on Facebook or Linkedin.
Love Rollin and Dolores
We have had 4 ruptured uteruses recently but so far all have survived. But the death angel was really close esp for one of them that was having gasping or agonal respiration as we were beginning her c-section but with lots of IV fluids and blood and getting her bleeding stopped and emergency hysterectomy. She is doing well today. Not sure but we think all the ruptured uteri had been given IM oxytocin (medicine give to have the uterus clamp down to prevent bleeding) before they were referred here. One of the ruptured uteri even had a live baby. Miracles still happen. Another c-section for prolonged labor, dead baby, now has had some sloughing of her vagina and urethra. Not sure how much repair she might require later. We had also a severely necrotic (mostly dead) prolapsed uterus that was very very large. We had amputated it basically and it did not involve the bladder however the infection apparently ascended up the stump and inside the abdomen. We had to open her abdomen a few days ago and there was much purulence in the abdomen but no perforation of bowel so she was irrigated out and drained and so far the death angel is holding back.
Recently a liver abcess ruptured and patient was very ill and painful. The laparotomy for acute abdomen was done and the abcess was found and drains placed and now patient is doing ok and the death angel holding back.
We have 3 “in house” now with cancer of the bladder that could not have anything done. Today there was a 6 month boy with a huge mass in the upper abdomen (filled most of abdomen) growing rapidly past 3 months mass that is. Probably a large cancer. Parents decided against surgery which might not have helped anyway so the death angel will have that one soon.
Here in Chad almost half of children die before age 5 mostly from malaria, malnutrition, and parasites. So the death angel visits most families fairly frequently. Malaria especially can be very deadly.
We are all in good health except I recently had a “cold” but am recovered. Dolores is working long hours making costumes for a bunch of school children for their Christmas program which is next week.
We covet your prayers and emails.
Our emails are: drbland@sbcglobal.net and dfbland@gmail.com Our internet is operative only occasionally but we eventually get the emails. Unable to get on Facebook or Linkedin.
Love Rollin and Dolores
Monday, December 3, 2012
Thankful Dec 2
It is a time of thanksgiving at least for the American holiday. All the expatriates had Thanksgiving meal together which was very nice. We are thankful for good health although I did have malaria last week but I am ok now. I began my quinine early so as not to miss any days work. Dolores had a “cold” and sore throat. How do you get that with 65 to 90 temperature weather and dry? As everyone in America gears up for the “holiday season” we don’t have a Thanksgiving holiday here but it is Chad Independence Day on Nov 28. Christmas is not much of a holiday here either. We will try to make it a little festive with some decorations around the house of Danae’s. We often think about how thankful we were born in USA rather than here. People here often have very little to look forward to but a short hard life with many episodes of malaria and parasites and loss of perhaps half of their children. I am thankful that I was not born a Chadian in some remote village with no knowledge of the outside world or of Jesus. Especially I am glad that I was not born a female in Chad as many of them are not given opportunity to be educated and have to look forward to just having babies and being a wife of some man that may beat her up every so often if she does not please him just right. Be thankful for your rights and privileges in America even though they are being eroded.
The French doctor that was supposed to be here for a week did not come but we now have a very nice German neurosurgeon that has come here for 3 weeks to experience “mission medicine”. Actually he has spent time in Rwanda about the time of the genocide, also spent time in New Guinea and 3 years in Australia. He speaks good English but not much French. His wife left him 2 years ago.
I have been busy with hospital rounds and surgeries. I have done about 120 procedures since Oct 26. I did two SIGN nails or intramedulary rods on open fracture tibia last week. One of them has no x-rays yet. The other had one preop before arriving here a few days after the accident. We had another bladder stone and another mastectomy recently.
We have had no internet service most of the time the past two weeks but are thankful when we can get on for a few minutes and perhaps send email or read one of yours. Even when it works it is very very slow. We appreciate your notes when they come through like a breath of fresh air with your news bits.
Love, Rollin and Dolores
Our emails: drbland@sbcglobal.net and dfbland@gmail.com
The French doctor that was supposed to be here for a week did not come but we now have a very nice German neurosurgeon that has come here for 3 weeks to experience “mission medicine”. Actually he has spent time in Rwanda about the time of the genocide, also spent time in New Guinea and 3 years in Australia. He speaks good English but not much French. His wife left him 2 years ago.
I have been busy with hospital rounds and surgeries. I have done about 120 procedures since Oct 26. I did two SIGN nails or intramedulary rods on open fracture tibia last week. One of them has no x-rays yet. The other had one preop before arriving here a few days after the accident. We had another bladder stone and another mastectomy recently.
We have had no internet service most of the time the past two weeks but are thankful when we can get on for a few minutes and perhaps send email or read one of yours. Even when it works it is very very slow. We appreciate your notes when they come through like a breath of fresh air with your news bits.
Love, Rollin and Dolores
Our emails: drbland@sbcglobal.net and dfbland@gmail.com
Muder??? Dec. 2
Last week we had two ruptured uteri with dead babies. Both had been given large doses of oxytocin (medicine to make uterus contract) IM by someone in a village clinic before arriving here. The first one was her 9th pregnancy so it would have been easy to have missed the diagnosis but the uterus just didn’t feel right. When we opened her abdomen there was lots of blood and baby and placenta through the ruptured uterus in the abdomen. The bladder also had a large tear in it way down by the cervix. We repaired the bladder hopefully not getting the ureter. The urine cleared and she is doing ok now. The second one was similar but no bladder involvement but the uterus was split open vertically. We tied the tubes of the first one but the husband would not let us do the second one as it was only her 3rd pregnancy with one living child.
Apparrently some of the “midwives” have been told by some Chadian doctors that it is ok to give IM oxytocin. Danae was recently in a conference about OB care before she went on annual leave and there was discussion about this practice. She tried to point out the dangers of this practice but apparrently they get away with it part of the time but here were two dead babies and could have been dead mothers because of this practice. We might call this murder or manslaughter if we did this at home. What does it take to get better medical practice going? How many die that we never hear about that ruptured and bled out and died before arriving here? We don’t know. Meaningful statistics are nonexistent here as they don’t put down true numbers at all and some of the people doing them are not able to do basic math.
I have had at least 14 C-sections and 4 vacuum extractions since Danae left on annual leave Oct 25. We also have had 3 molar pregnancies and a vaginal hysterectomy and abdominal hysterectomy during that time and have a very large tumor prolapsed uterus for tomorrow and a mass about 7 months size that maybe is a large ovarian cyst.
Life is interesting for OB-Gyn. Continue to pray for our patients.
Love, Rollin and Dolores
Our emails: drbland@sbcglobal.net and dfbland@gmail.com
Apparrently some of the “midwives” have been told by some Chadian doctors that it is ok to give IM oxytocin. Danae was recently in a conference about OB care before she went on annual leave and there was discussion about this practice. She tried to point out the dangers of this practice but apparrently they get away with it part of the time but here were two dead babies and could have been dead mothers because of this practice. We might call this murder or manslaughter if we did this at home. What does it take to get better medical practice going? How many die that we never hear about that ruptured and bled out and died before arriving here? We don’t know. Meaningful statistics are nonexistent here as they don’t put down true numbers at all and some of the people doing them are not able to do basic math.
I have had at least 14 C-sections and 4 vacuum extractions since Danae left on annual leave Oct 25. We also have had 3 molar pregnancies and a vaginal hysterectomy and abdominal hysterectomy during that time and have a very large tumor prolapsed uterus for tomorrow and a mass about 7 months size that maybe is a large ovarian cyst.
Life is interesting for OB-Gyn. Continue to pray for our patients.
Love, Rollin and Dolores
Our emails: drbland@sbcglobal.net and dfbland@gmail.com
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