Mar 17, 2014

This past week has continued to slow down so that we actually have some empty beds. There are always some malaria patients and some that we don’t know for sure what is wrong. Even the maternity area is slower now. I guess 9 months ago everyone was busy planting their crops in beginning of rainy season.

The devil is still active trying to take away from the story of love. We had a man brought in Sabbath that had a fractured tibia and fibula from a car accident; also a big laceration that we stitched, then he was told that he could stay on the gurney that was padded and we would fix the fracture with a SIGN nail the next morning (Sunday). Sunday morning when I was starting rounds I saw that there were a lot of people in this little “private” room and that there was no one on the gurney but the patient was lying on the floor so he could be in the private room. There were a bunch of “native healers” (witch doctors) doing their sticks around his leg and several beside bowing and doing some sort of incantations (maybe prayers) and the patient is now refusing surgery. He was a big chief and had all these followers that thought they were above hospital rules or anything else. I told them they had to leave if that was what they were doing. They did not, so I got Danae involved as her French is better than mine; but they would not pay any respect or attention to either one of us. We got the guard involved and finally they did leave and the patient left on the ambulance and said they would be back to get surgery but he had to do some business at home. Of course he has not come back yet. I’m sure that he never paid anything for hospital or the ambulance. Maybe they will come back after it is all infected or healed in bad position. One would think that a chief if he is so important would want the best care possible, but such is not the case.

There has also been some sort of mass hysteria among the school age girls in school. They would have “convulsions” but not lose consciousness and one would touch another girls then she would have these spells also. Olen saw some of them in the “Urgence” and everything was normal except they way they acted. When told they would be admitted to the Peds ward they would be all right and walk home on their power. I understand that there were so many involved that they closed down the schools in town. Some were suggesting that it was demon possession or some manifestation of Satanism. It is possible but they would also respond to painful stimuli appropriately.

We had another perforated gastric ulcer Sat night which seems to be doing ok so far post op. We also had another cancer of the bladder a few days ago. We continue to have the usual hernias and hydroceles and abcesses. We may not get much over a 100 procedures for this month.

Kermit (Olen's dad) is here for a week helping Olen with administrative stuff.

Addison and Zane both have malaria and are taking meds ok and doing ok.

Phone is 235-914-532-26
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Love, Rollin and Dolores

Mar 10, 2014

On Monday we had another patient that had severe necrosis of neck
almost down to trachea and esophagus but also around her mouth and a
large area of her scalp and her breast. I debrided a lot of it on
Tues. I don't know if she will live or not. The "fly index" was
pretty high. "Fly index" is the number of flies around a patient
that is very bad or has a lot of rotten tissue such as rotten leg or
other areas. The chance of survival is not very good if the "fly
index" is very high. You may remember a previous patient that had
necrosis so badly that air came through his neck and water came out if
he tried to swallow and we had placed a stomach tube. He finally
went home basically to die; but 2 or 3 wks later he walked back in
appearing much improved and eating and swallowing. Miracles do
happen. This lady needs a miracle also. The fish bite man of last
week that had so much rotten tissue of his hand may actually lose one
or two fingers although part of the hand has no skin. The last two
nights we have had a strangulated hernia each night.

We had Rich Carlson from Union College, Lincoln, Ne. He came in Fri
and left on Sun. He was visiting during Spring break some of the
student missionaries from Union that are in Africa. We have one here
from Union. From here he was going to Guinea then to Zambia. He is
a coordinator for the SM's and just visits some of them. He was a
classmate of my brother Reggie at Union graduating in 1973. He got
to observe and participate with a strangulated hernia surgery on Sat
night.

There is a lady out in a small village that we had thought might be
helped with some l-dopa for her neurological problem that seems to be
perhaps from basal ganglia or cerebellum with her poor coordination
but she is alert and oriented. We have been seeing her each Sabbath
afternoon and giving her some medicine that was suggested by Dr. Dirk
Wonderlich, a neurosurgeon from Germany when he was here but it has
not helped. The medicine is not available here but Dr. Reinhard
Wonderlich (Dirk's dad) brought some when he came recently. We
also told Bible stories while there. They don't know anything about
the Bible such as who was the mother of Jesus but one did know that
Jesus was the Son of God.

Dr. Reinhard W (a Ob-Gyn) brought a bunch of equipment and some
hardware for orthopedics. It is very useful. A wound vac and a
bipolar and monopolar coagulator. Dr. Wolfgang (a hand and foot
surgeon in Germany) also came with Reinhard and Hanne, his wife.
Wolfgang is even considering becoming a long term missionary.

Dolores has been busy drying some mangoes. We have a large screen
that is sitting in our house and with the high temps and low humidity
things dry very rapidly. There is an overhead fan to circulate the
air. Lyol and Zane like to snitch fruit off the screen. Everyone
is healthy except I have a "cold" with a runny nose and some aches but
that is the way my malaria started last time so I'm starting malarone.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
phone is 235- 91453226
Love Rollin and Dolores

March 5, 2014

Less than five weeks from now we will be seeing some of you at the Union College alumni weekend. I notice it is being extremely cold in Lincoln, Nebraska lately. Where we are now it is cold if it gets down in the 60’s F. 

For the first time in several weeks or months our surgery backlog is caught up. Dec was 145, Jan was 202, Feb was 174 procedures. That is including some minor procedures. Hopefully it slows down at least after March so Danae does not have it too rough while we are gone on annual leave. The numbers have been increasing each year over the previous year.

We had to amputate a little 8 yr old boy’s arm at the shoulder because it was dead from the mid humerus down. It apparently had had a tourniquet tight around the arm; I’m not sure what the initial injury was. The same day as the boy came in we had a lady come in with a dead baby with only the head out. It had been dead some time as it was smelly and material oozing out of its head. Danae was able to manibulate while I pushed etc and we finally got it out. We have another man with severe infection and lots of dead tissue of a hand and forearm after a fish bite a few days before. He may need an amputation at least part of his hand or mid forearm. I’m not sure yet. It had pumping artery from a finger which I had to ligate. We had another bladder stone and another cancer of bladder. Another man had severe infection of scrotum and necrosed testicle that had to be removed. We had a large abcess of liver that presented as an acute abdomen after it had ruptured. We cleaned it out and drained the abdomen; it is doing well one week post op. We had two perforated terminal iliums from typhoid this past week but they are doing ok except one has a wound infection which is not very surprising.

There is a lady in a village way out in the bush that has some strange neurologic problems but not sure what. Our German neurosurgeon was here in December and thought maybe related to Parkinsonism or some other basal ganglia problem. She has problems with balance and twitching and getting into grotesque positions. We have tried some l-dopa not max dosage yet but no change yet. The med was brought from Germany as it is not available here. The lady was found by Gary Roberts on one of his outreach trips. Danae did a nice story about Moses while we were at the village. They had questions about a few Bible names. They did not know who the first woman was, nor who the mother of Jesus was, nor His father. One person knew that Jesus was the Son of God.

Many people are very needy physically and spiritually. Pray that somehow the knowledge of Jesus as Saviour and soon coming King and Redeemer can be spread into all the world so that Matt 24:14 can be fulfilled.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Our phone 235 91453226
Love Rollin and Dolores