Sunday, December 1, 2013

Nov. 30, 2013

We hear of the snow and ice back in the USA and we shiver in the “cold” here.   It gets down to 75 F in the mornings. It is pretty nice here with dry air and ground and highs only in the 90’s.  Hope each of you have had a happy Thanksgiving and “black Friday” holiday. On Thurs all of the expats got together and we ate very largely of all the good food that various ones had made.  No TV or football or other things like that. Of course it is not a holiday here like there. In fact we did two surgeries in the morning.  

Today Dolores and I went out in the bush for church and took a patient with us returning to her home there about 45 or 60 minutes (only about 16 miles) from here if you did not stop. The “road” through the brush is sort of hard on side mirrors on the vehicle but overall smoother than the “main road." A one day church had been built there about a month ago and they now have 40-50 adults and about that many children that come to hear Bible stories.  The church is not finished on the floor and besides it is cooler under the mango trees now in dry season.  They have no medical care or clinic in that village.   We may start an occasional clinic there to try to help them.  Gary Roberts is marking out an air strip there and they are favorable towards that and hopefully any government officials are ok with it then it would be only a few minutes away even in rainy season whereas could not drive there in rainy season.  

Have repaired two meningoceles in the past week.  Yesterday (Friday) was one meningocele, a strangulated hernia, vesico-vaginal fistula, mastectomy, hydrocelectomy,  prostatectomy, and an ordinary inguinal hernia. This past week we drained a liver abcess with about 2 liters of pus.  Last Tuesday I did a SIGN nail (intramedullary rod) on an open fracture of a lower leg but also the knee was totally messed up and laying open for 3 days with lots of gravel and dirt in the wounds.  The lateral tibia plate was partly absent and little small pieces and fracture patella and the ligaments all torn apart. Hopefully it is repaired somewhat and hope for a good stiff leg without too much infection.  Putting in the nail was the easy part. Tomorrow I have a bilateral femoral fracture to repair but the accident was one year ago.  One side is loose and the other has healed together but much shorter so have to take it apart and will put in SIGN nails in both.  Both SIGN cases are in Moundou as I am covering for James Appel for those while he is in the US for a month. Tonight we had a man with fracture of tibia and fib about 2 or 3 inches above the ankle but was refusing treatment at first but finally let us cast it I think in fair position and it had no skin breaks.  We had one other vesico vaginal fistula this past week.  Both cases were redo that had not quite held with the previous surgery.  No one wants to pay for those fistula repairs as the woman is sort of an outcast with leaking urine and can’t have sex etc and chronic urine smell.  If the repairs work it gives the woman a new lease on life.  We need a large fund to cover the cost of those repairs.  
I think it is official now that Dr. Scott Gardner (Olen’s uncle) will be coming to Moundou.  He previously was going to be in Koza, Cameroon.  Dr. James Appel is going to Abeche, Chad to get some work going there that has been minimal thus far and Dr. Roger (Congolese doctor) is moving from Moundou to Bature in southern Cameroon. 
We love to hear from any of you.   

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