August 8

When one thinks of acute pain in abdomen you usually think of
appendicitis, cholecystitis, perforated gastric ulcer, aortic aneurysm
and things like that but here it is more likely to be perforation of
distal intestine secondary to typhoid.  Yesterday we had an acute
abdomen secondary to bleeding in the tissue all through the abdomen.
He had a history of snake bite on the foot 5 days previous but no
swelling  or reaction of the foot.  We opened the abdomen and closed
it after we saw what it was.  We gave antivenem and fresh blood even
though the antivenem probably is of no value after 5 days.  His
prognosis is not good.  We do occasionally have perforated gastric
ulcer and appendicitis and ruptured ectopic pregnancy and tubal
infections with abcesses.
Every bed in the hospital was full yesterday including the extra beds
in the building that is supposed to be eventually lab and pharmacy.
Surgery, Peds and medicine beds were full.  Perhaps a few empty beds
on maternity.  We have a neonatal tetanus that is finally looking
like he might live.  He has been fed with NG tube but yesterday he
was sucking a little from breast.  The little boy that we grafted
skin on his leg after previously taking some extruded bone off is now
getting stronger and trying to walk and his family is very happy on
how good he looks.  The graft looks good so far.  He had not walked
since his fracture leg 2 yrs ago.  We also released some of his
contracture but he still has somewhat deformed leg but useable.  We
have several in the hospital that are somewhat long term with various
abcesses.  We had a 5 yr old boy a few days ago with a lodged stone
in his urethra at the base of his penis.  I could not get it to move
so had to excise it from there and repair his urethra.  Apparrently
he had a bladder stone that tried to pass but could not.  He is doing
ok now.
Aug 9 next day.  The man with hemorrhagic abdomen after a snake bite
died last night.  Not suprising!  We did another laparotomy for acute
abdomen today that was full of blood but he was oozing blood from
cancer all over his upper abdomen.  His liver was full of tumor so he
won’t live long.  Two more people with huge abcesses and necrotic
areas on their leg are looking better now.  We debrided them and they
are beginning to granulate somewhat.  Maybe they will be ready for
skin graft end of next week.    We had another C-section this am for
severe small pelvis and baby was having some meconium(we found when we
opened).  Mother and baby are doing well so far.  WE also did an
orchiectomy and hernia repair on a man with a large hernia but also a
large tumor of his testicle.
This afternoon I gave a basic talk on pulse and blood pressure (how to
do)  to some people from some other villages that wanted to be able to
help their people some.    Then we went to a “fet” given by our night
watchman for us.  He is a Moslem but a very nice man and more honest
than a lot of other people.  Yesterday was end of Ramadan (the Moslem
fast for a month and don’t eat during the day but can at night).
Mohammet, our night watchman, has a new young wife so was giving the
“fet” for us.  He fed us some Chadian food that was very delicious.
His new wife is age 14 and Arabic and petite.
A lot of people have gone home the past 2 days esp from Peds.  The
Peds census is down in the 20’s.  The surgery ward is still pretty
full.
Go to www.parkers4bere.blogspot.com for an interesting story about a
chained man.
We are still “hurriedly waiting” for the Netteberg baby that is due
almost any time now.  Still no progress on that from Massachusetts.
I am always glad for Fridays and Sabbath for more time for reading and
getting together for “potluck” and theoretically less work in the
hospital.  Although often it makes up for it on Sat night.
Our emails are  drbland@sbcglobal.net  and  dfbland01@gmail.com
Our phones are    Rollin      235  62674586        Dolores    235 68824768
Hopital Adventiste de Bere,  52 Boite Postale,  Kelo, Chad,  Afrique

Some have asked about how to get donations to our project.    One
option is to send to :
    Jay Seventh Day Adventist Church
    13717 E. 390 Road,  Jay, Ok.  74346

Earmark for the “Bere, Chad Project”
Thanks for all your prayers.
Love,  Rollin and Dolores