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