15 July 2013

Olen, Danae, Lyol, and Zane left on the bus this morning at 0630 to go
to N’Djamena. Fortunately it is a cool cloudy day (only in the 70’s)
with a little bit of rain (an answer to prayer) so maybe Zane would
not get too hot on the way. Danae has to get some special papers
filled out so she will be allowed to ride the plane home on Wed. It
involves paying some money to the right people. She is “27 wks” but
actually about 36 wks pregnant. She hopes to deliver this one in
Springfield, Ma and not on the way somewhere (ie Zane was born in New
Jersey). They were all in good health as they left here. It will be
awful quiet here in evenings without Lyol and Zane. We like their
noise a lot better than the roosters crowing under our windows every
4:00 am. Perhaps sleeping in their place will be quieter unless the
nurses want too much.

We have two freshman med students that will be
here two more weeks and a nurse practitioner that will be here another
month then it is just us and the Parkers here at Bere and the Roberts
down at Bendele and Bronwyn at the Nutrition center. Gary Roberts had
a severe cellulitis of a leg after a scrape on the shin from a motor
cycle. He is much improved now in spite of the fact that some had
heard a rumor that he was about to die from??? He apparently had
malaria at the same time.

Last week we did two vesico vaginal repairs. They were repeats.
Previous attempts apparently got ruined when drainage tubes got kinked
so this time we just put in the foley with NO connection tubing. I
understand that is the way some fistula speciality hospitals do it
realizing that poor nursing can ruin an otherwise good surgery. We
think we got a good repair on each and so far they look good. We
also debulked about 35 lbs of abdominal ovarian cancer mass and fluid. 

She looks good today. We lost a girl from probably perforated typhoid 

bowel a few hours after I had decided not to operate. Maybe I
should have anyway but she might have died on the table. I am not
perfect. The bowel resection we did after we got here is coming
along ok although quite weak. He had had 3 previous surgeries and
his problems apparently began with unable to urinate with a urethra
stricture but previous surgery had accidentlly cut the bowel and a
subsequent attempt to repair did not hold but praise the Lord he is
eating and improving now. We recently had a man with a bladder
diverticulum larger than his bladder. His main problem was a urethra
stricture and prostate hypertrophy. The med students were happy to
do a delivery past evening.

One good thing about the prolonged time here for therapy at the 

nutrition center for one of the fistula ladies is that she has learned 

about Jesus while at the hospital and the nutrition center and would 

like a church built in her village.

There are military or police check points along main roads. They say
that it is because Chadians helped get rid of Al-Queda in Mali and now
that group wants to get revenge in Chad> I don’t know if that is
true or not. If one travels anywhere much you need to have your
passport or ID card along even the locals have to have their ID along.
I have not heard of any uprising or problems in this country but
maybe the government is a little paranoid.

As always we covet your prayers.that Jesus will be glorified in all
the work that we do and that we will maintain good health.

Our internet is very sporadic so not sure when this will get posted
Our phone is 235 62674586
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com ,
Love, Rollin and Dolores