29 July 2013

We are seeing lots of typhoid including typhoid perforations of
intestine.  Usually there is only one hole in the intestine but one
at 0200 this morning had 5 perforations in the terminal ileum.  So
far the ones with surgeries are recovering.   We have had two
C-sections for shoulder presentation last week.  One was for twins
that the first one was dead but the 2nd twin is fine.  At the time of
surgery she did not want tubal ligation “ligature de trump” but today
she says she would like the ligature de trump.  But she may take the
Depo Provera injections for awhile unless she decides to have a 2nd
surgery now.  We had one this past week that was having “seizures”
or ecclampsia but her pressure was normal and she was completely
dilated but would thrash around terribly with contractions.  One could
not reason with this psychotic little 13 year old.  We gave some
diazepam and did a forceps delivery of a normal baby boy.  Mother is
doing ok but she low mentally and seems to have taken several days to
learn to breast feed her baby but she finally is doing ok with help of
relatives.  
We did a skin graft on the leg of the little boy that had 
a previous fractured leg and some of the bone extruded but the leg is
solid.  It still has some contracture of the knee but it has been
straightened enough so that perhaps he can eventually walk.  He had
not walked for a long time so his legs are very weak and not much
muscle but he is finally developing an attitude that maybe he can
develop muscles and walk and he is trying now.  He is smiling today.
Our malaria epidemic among the kids seems to be subsiding.  Maybe
everybody was treated. Ha!  The hospital census is way down from what
it was (perhaps 35-40 instead of 80) although there is plenty of
typhoid and malaria.  Martha, our NP, is taking good care of the kids
but she will be here only about 2 more weeks.  We also have a young
man, Kaleb Storzringer, from Germany that just arrived for 5 weeks to
help Jamie in construction.  We need someone who is skilled in
cabinetry or wood working to help with putting in shelves or cabinets
in the new buildings.
The weather continues to be quite nice with high humidity and frequent
rains but temperatures in the 70’s and 80’s.  We had a deluge a few
days ago probably 3 inches in less than an hour and almost filled a
wheelbarrow that was setting out but it is pretty well soaked up now.
We miss the grandkids playing but they will be back in October.  Of
course we miss the grandkids back in the US also.
Our emails are  drbland@sbcglobal.net  and  dfbland01@gmail.com
Love,  Rollin and Dolores