Oct 28, 2013

So glad to have Danae, Olen, Lyol, Zane, and Addison here with us.  Addison is so cute.  We drove to N’Djamena Wed leaving here about 0415 and getting to the edge of town about 1115 which was really pushing to get there that fast and then on to the airport at the opposite side of town by noon.   It is only 250 miles but part of it is through mud holes and water and much of the rest that once was paved now has huge pot holes about a foot deep in places.  One place on the main highway had two huge semi-trucks stuck in the mud and barely room between them to get on through.  We did get to the airport before their plane arrived and then waited for them to get off, clear immigration, customs and claim baggage and strap the baggage on the 4 Runner what would not go inside.  We got registered with the police and got a few things to eat and went out to the Lutheran mission hostel for the night and rested until almost noon Thurs.  They were very tired after the long ride with the kids on the plane and spending 2 or 3 nights packing before they left D.C.  Thur we did some shopping.  There are no refrigerators or air conditioners available in the country until the trucks can start bringing things in after rainy season which is ending now.  We left about 0715 Fri and got back into Bere about 1545 with our load. The road is drying some now.  Danae and Olen were happy with the new cement kitchen counter tops and the newly painted house that Dolores spent so much time doing.  

Sabbath was communion in church and then we visited in the afternoon.   Sun after rounds in the hospital we gathered the pumpkins out of their “garden."  Danae and Olen are still trying to get stuff unpacked and put away. They brought some new nice surgery instruments that was given to them from Brother's Brother in Pittsburg and a bunch of suture.   We still don’t have much Ortho plates and screws yet but hoping for some.   Dr.  Dirk Wunderlich from Germany is going to bring in December some intramedullary rasps that should be very helpful.

Monday we had a severe peritonitis from typhoid perforations (six of them) which we repaired and irrigated out her abdomen.  Hopefully she will do ok.  We also had another C-section for CPD and fetal distress and mother and baby appear ok.   We had another complication of Penn shot.  A little boy’s foot necrosed and so I did an above ankle amputation.   The shot was given apparently to close or in the femoral artery.  Previously we had had a little girl that lost her arm from a Penn shot with a dirty needle.  Our nurse “surgeon” did a C-section, 3 hernias, and drainage of an abcess in abdomen while we were gone to N’Djamena.   We have a huge breast mass mastectomy to do but she does not have enlarged axillary nodes.  She previously had a “lumpectomy” 2 yrs ago for a “fibroadenoma." We had another orchiectomy for a large testicular mass today.  

It is nice to have the kids around.  It makes life more interesting.   Also we will be having various volunteers coming in the next 3 months or so which hopefully will help get some things finished on the new buildings etc.   A nurse midwife, 3 or 4 doctors, 2 anesthestists at different times will be coming besides the Maranatha group.

Our emails are: drbland@sbcglobal.net and dfbland01@gmail.com  

Love, Rollin and Dolores

21 Oct 2013

We are in keen anticipation of the coming of Addison and of course Zane, Lyol, Danae, and Olen which will be later this week.  We are driving to N’Djamena Wednesday to pick them up from the airport (about an 8-9 hr from here).   They will be bringing with them lots of different things for the hospital as well as other things.  We will have lots of rope and strapping to tie bags and suitcases on to the car.  

Dry season is on with temps in the 90’s although the humidity is very high and not many days ago we had a good rain. 

The malaria and typhoid has been fairly steady.  Surgery has been pretty slow although have had two strangulated hernias in the past few days.  The ecclampsia lady with c-section twins last week is doing ok and the twins so far are ok so let them go home today.   Kids are like kids at home in that they put things in orifices such as nose or ears.   Took a peanut out of a nose yesterday.  I did a skin graft today over an area on a lady’s thigh that had had a deep burn.  The man that I did a cystostomy and dilation of urethra for urethra obstruction last week succumbed to his malaria and typhoid and apparent stroke.    Had a little boy with white hair probably kwoshiokor and said he only ate white rice with no sauce or anything on it except sugar.  

Hopefully we all have as much anticipation for the coming of Jesus as we do for our loved ones and family.   As you see events in the world especially the USA surely the Lord can’t delay much longer.  

Our blog is:  www.weareamissionarybland.blogspot.com

Our email is:  drbland@sbcglobal.net  and  dfbland01@gmail.com

Love,  Rollin and Dolores  

Oct. 15, 2013

Another week has passed and we are still getting big rains including today and Friday night.  I’m hoping dry season will get started pretty soon.   It is about 25 miles to the post office in Kelo but it takes 2 hrs to drive it if you hurry through the mud holes.   Of course when it dries up there will still be the holes and very rough road.  

The hospital keeps busy with the malaria and typhoid and occ snake bite and occ tetanus.   The lady with the ruptured uterus that got severely infected that we have had to pack her abdomen open is now beginning to progress and look better and probably will live.   The man with the gunshot to his mandible is doing ok and taking food and liquids and looks as if he is going to live, however there is a different story now as compared to last week.   Instead of being he defending his wife from rape, now the story is that he was a thief and a policeman shot him.  However the policeman had said that he would pay for everything and also that it was said that the policeman was going to prison makes me think the first story was probably more nearly correct but probably some money changed hands so who knows what the real story was.   Here it is who you know and there is little system of justice and women have almost no rights.  Maybe the policeman was trying to steal the woman…

We have had two strangulated hernias lately including today.   Both did not require bowel resection.   We had a c-section Fri night and again Sun night.  Fri night was previous c-section and suspect uterine rupture but was not ruptured but baby was dead but very small pelvis and minimal dilation.   Sun night was for ecclampsia with seizures and edema and increased blood pressure but the twin babies are doing ok so far.   Today we did a cystostomy on a severely tight bladder that was hemorrhagic and severe urethra stricture especially in the prostatic portion with lots of scarring that we were able to open and put in a large Foley.   

Both of the SIGN nail patients were sent for x-rays but they were able to walk and have not returned with x-rays so that I can report them to the SIGN people.   It is about 3 or 4 hours especially now with the bad roads to the nearest x-ray unit.   Hopefully someday we will have some sort of x-ray capability so that does not happen and so we can better serve the patients.   The one with a ovarian mass probably cancer that involved a loop of bowel that had to be resected did well and was discharged.   Not sure if it was really a cancer as it was quite well encapsulated and somewhat cystic almost like an old ectopic.  Our supply of misoprostol apparently got stolen recently.   Maybe someone is doing their own abortion clinic or ?  We were keeping it in the office as it would disappear from some other places but still happened.  We recently had an incident of a Foley coming out (somehow the bulb deflated)of a man then the nurse putting another one only part way then inflating the 30 cc bulb which caused severe pain and bleeding and obstruction.   I was able to get one in with a guide wire and it is functioning well now.   I hope the nurse got the point of my remarks that a foley should always be put in all the way before the bulb is inflated

We got the freezer lid straightened up using some clamps and hammer etc so now it seals and is working.   It was actually amazing that it came through the rough treatment on the way here as well as it did.   The electric lights are all in our house now but waiting for some things to be brought from USA by Olen and Danae when they come back next week.   We are planning to drive up to N’Djamena (about 8 hrs from here)to pick them up from the airport on Wed.  We will stay overnight in N’Djamena then come back to Bere on Thurs

The devil is working overtime.   Our school here needs your prayers to deal with a principal and a pastor. 

Several of the expats have been sick lately with malaria or typhoid but so far Dolores and I are well now. 

Continue to pray for us and the work here.

Love,   Rollin and Dolores

Oct 7

We are doing ok.  Dolores and I are not sick.  I had a problem with my shoulder for a while but doing ok now and I guess I strained my back but it is better now.  I got over my bronchitis and malaria finally.   Two of the volunteers that came 3 weeks ago now have malaria.  One of my helpers in surgery, Simeon, has malaria today.  Jamie had it a few days ago but is ok now. 

The hospital is still somewhat slow although it should be picking up soon as rainy season starts winding down and people start harvesting their crops and have more money but today Monday we had a huge rain for about 3 hrs.  They have harvested their millet and sorghum grain already but their main crop rice will be another month yet.  The “roads” are still very bad with deep holes and water.  Jamie went to Moundou thurs and water came over the hood of his pickup in a place or two.  Sabbath we had a man with a shattered jaw and most of his teeth missing on the left side from a gun shot.  He was trying to prevent his wife from being raped by a “policeman” and the policeman shot the man.  He was fortunately hit in the mandible instead of a little bit higher up.  The bullet entered at the angle of the mandible and went out through his mouth knocking out teeth and shattering the mandible on the left.  I don’t know anything to be done for him except try to prevent infection and we are keeping his mouth shut with a band around his head vertically.  Strangely the man who shot him was around today and said he would pay for whatever the hospital charges were.  Others say that he will be going to prison.
We also had two little girls age 9 or 10 in the past two weeks with large masses.  One was a dermoid cyst with hair and bone in it and the other was an ovarian mass maybe a cancer.  Each mass was about 7 inches or more diameter.  We have had 3 abd hysterectomies for huge fibroid uterus recently including one today.  All 3 were very obese also.  

The kitchen sink is hooked up in our new house and we moved some stuff from our container to our house yesterday including our freezer, bed frame, chest of drawers, dresser and mirror (amazingly it did not get broken).   The bathroom is not hooked up yet and still some wiring to finish but it is looking more and more like a house that we might be able to live in eventually.  There are always so many things to get done or things that need repaired etc. There was a man by here today looking for some glasses (about 5.0) we had only some 3.25 which he said helped some.  He said he was the one that planted the mango and Niem trees here over 30 yrs ago.  

Olen, Danae, Lyol, Zane, and Addison should be arriving here about Oct 23.  Of course we are looking forward to that.  They will have been gone from here for 3 months.  Olen and Danae’s wedding anniversary is tomorrow their 6^th.  They are celebrating in the Virgin Islands.   

It is a little different here to get a car license renewed.  We started the paper work 2 months ago and have paid almost $400 and still don’t have all the paper work and new tag yet.  The old one expired end of August.  

Our emails are: drbland@sbcglobal.net  and dfbland01@gmail.com   

Love,  Rollin and Dolores