Sometimes I wonder

We read the commands of Jesus that we are to go into all the world and
preach repentance, teach, baptize, and make disciples everywhere.
Matt 28:19, 20; Mark 16:15; Luke 24:47; John 20:21; Acts 1:8.
Sometimes I wonder if I am really doing mission work for the right
reasons.  Is it because we have been commanded to do so?  Is it
because it is my “duty”?  Is it some sort of penance to go where life is
dangerous and uncomfortable and to do surgery and other hospital work
or other types of mission work?  Am I doing it just because of all
the different and interesting pathology that one can see out where
there is little medical care?  Do I endure loneliness and maybe lack
of appreciation just because I want to “earn” some kind of merit?
Would I give my life for someone who does not appreciate what I am
doing?  Sometimes it seems there is no one who is honest, and
everyone wants to get all they can from the “nasara” or white person.
Taking things or not returning things that have been “borrowed” is a
way of life for some but I see some of that back home too.  What are
we really here for?  Is God expected to make things easy just because
I claim to be one of His children?    On the other hand Jesus has told
us that His followers will have hardship and even persecution so does
that mean if things are going well and easy that maybe I am not
following Jesus as closely as I should?  Or conversely if there are
problems does that mean that I am a follower of Jesus or just reaping
the results of my bad choices?  Most of the world’s major religions
such as Islam, Budhism, Hinduism, Catholicism, etc teach about doing
various things to earn merit for the after life.  Some times I wonder
if maybe we get into the same mental attitude.  I am thankful that we
serve a God that is full of forgiveness and grace and has promised
eternal life with Him if we repent, believe, and accept His
forgiveness and then serve Him because we love Him so much for what He
has done for us.  Jesus gave His life for a bunch of nonappreciative
people even some that claim to be His followers but do not do His
commands.  I am thankful that He has given us the privilege of
communication with Him and with each other.  Continue to pray for us.
Our emails are  drbland@sbcglobal.net and  dfbland01@gmail.com
Love,  Rollin and Dolores

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

22 May 2013

It has been quite busy this past week.   We have done about 4 surgeries per day including today and Pediatrics has been almost 60 patients so a total patients about 80 on Friday but a lot were discharged over the weekend so it is down today to less than 60 total.   Almost all Pediatrics have IV ‘s going with Quinine.   I hear the MCD (our local district medical officer that has given us trouble in the past) is to be looking over Pediatrics tomorrow.  Was to be today but did not show.  Another officer was to be here with him.   Our two kids with perforated intestine from typhoid that we repaired are both doing well.   The boy with a leg contracture and extruded piece of tibia from an old fracture is doing very well.   The relatives are doing a great job of doing the stretches on his knee so that it extends to about150 degrees now.   The area of his lower leg that has no skin I hope to be able to do a skin graft on soon, maybe tomorrow.   Another lady has large denuded areas on both legs but not quite granulated enough yet for skin graft.   The old man that had had 4 surgeries on his abdomen with the last one being a bowel resection and reanastomosis is eating well and walking some and went home yesterday.   I did a prostatectomy and urethra dilation on a man that I had temporarily put in an IV canula into his bladder to keep him comfortable over the weekend draining it through the IV canula.    I wish we had some more suprapubic temporary drains that one can just stick in quickly and drain the bladder until a surgery can be done.   We still have not had any one that will submit to a vasectomy even for free.   The women have to have a tubal ligation instead.   We had two C-sections for transverse lie one day apart. 

For those of you that received emails and others for special prayer last week for Olen, we thank you for your prayers.   He was very sick vomiting with malaria and had IV fluid and quinine running until he went to the airport and got on the plane.   He had no more vomiting and was able to keep down medicines and they all got back to Washington, DC without further complications and are doing well now.   The next big event is for Danae to have her baby.  They plan to have it in Massachusetts at Bay State Hospital where they did their residencies.  

The weather here has been very nice with rain every 2 or 3 days and temps in the 70’s and 80’s F.   So far no floods like last year.   We had lots of thunder and lightning and rain Sat. night. 

The mangoes are gone and there are not tomatoes yet and only a few cucumbers.   Most vegetables etc have not had time to grow since beginning of rainy season. 

Tomorrow is the last day for the two medical students from LLU then they start back to the USA.  They say they have learned a lot and enjoyed their stay here.   They definitely have seen things that they would not see back in the USA.    They have been taking turns alternate days assisting in surgery or doing rounds with our NP on Peds.    Our NP is scheduled to leave in about 3 wks I think.   She will be missed.   Most of malaria is treated by protocol dosage according to weight so hopefully we can get by and hopefully the malaria season will begin to decrease.   There is also quite a bit of typhoid.

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

Our phone is   235 62674586

Continue to pray for us and that volunteers can come finish some buildings including our house.   Lots of cabinet and shelves need to be built in each of the buildings. 

Love,   Rollin and Dolores  

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

Blog July 6, 2013

We arrived back in Chad Wed July 3 and took the long bus ride (about 8 ½ hrs) back to Bere. The road was dry but we have had a rain today that is very refreshing and temperature about 80. It is muggy when not raining. They had had some severe winds while we were gone that blew off some roofs but they have been repaired.  Some of the buildings maybe were not braced sufficiently.  Even part of  a brick wall was blown over.  It is nice and green and the corn and other crops are coming along.  Lots of plowing with the oxen is being done.  But up at Ndjamena it was barely beginning to green up.  Apparently not much rain there yet. 

Yesterday we did a bowel resection (took out about 20 cm small intestine) on a man that came here from CAR (Central African Republic). He previously had had surgery for urethra stricture through the bladder but apparently had cut into the intestine in the process so he had draining intestinal material coming through a drain.  We took out the involved intestine that was very adherent to the abdominal wall and cleaned it out as best we could then reconnected the small intestine. He was very skinny but hope he will do okay now. He had had 3 previous surgeries.  I’m glad Danae insisted we do the surgery that I was considering postponing for a time.  We also did an eye enucleation for an eye that was blind and bulging out greatly. Possibly was retrobulbar tuberculosis with white cheesy material there.  Don’t think it was a cancer. Also did a removal of a parotid tumor yesterday.  His facial nerve still functions. Last night did a C-section for a shoulder presentation that I was unable to get the position changed. It was a second twin. The first is fine but the second one was dead. I let Danae rest last night. 

We left Jay area last Sunday afternoon and drove to Janelle’s in Oklahoma City and repacked some things there and left there Monday morning. Our flight from DFW was cancelled to IAD in Washington DC so had to get another flight arranged but still got there by 3:30 pm.  Kermit and Ronnalee Netteburg picked us up and we stayed the night at their place and packed in some more things that had arrived there for us such as our new SIGN orthopedic equipment  and some ureteral stents.  We left DC on Tues and arrived back in Chad Wed.  We had to pay for some extra baggage but we expected to. 

Sometimes one wonders why one would leave all the comforts of home and the family and friends there but when one sees the need here and the friends here it becomes more evident. Of course we also have family here although they will be back in the USA the next 3 months.  Another family member will be coming about Aug 12. Danae and family will be coming back here in Oct.  

Thanks to everyone for their donations and prayers.

Pray for our health and everyone here.

Our blog is:    www.weareamissionarybland.blogspot.com  

Danae’s blog is:   www.missionarydoctors.blogspot.com

Our email’s  are   drbland@sbcglobal.net    and   dfbland@gmail.com 

Love,   Rollin and Dolores