Sunday, October 26, 2014

October 25, 2014

Thu. night was to be a surprise for Danae but it turned out differently than we had anticipated. Olen was returning from some Adventist Health International meetings in California Thu. to NDJ and was to return to Bere on Friday, but he decided to take a late evening bus to Kelo and we were to pick him up there and bring him back to Bere to surprise Danae. However we did meet him in Kelo but later than expected (the bus was going very slowly from NDJ). Mason went with me to pick up Olen and Zachary Gately that was coming at the same time. When we left Bere Mason asked if my fuel gage was correct. It was. Was there enough to get back from Kelo. Affirmative, I think. Actually I had thought maybe we could get more gas in Kelo. We found out there is no gasoline in Moundou or Kelo at any price. Stations are closed because of no fuel. We picked them up at the bus station and drove back through some deep mud holes where water is still crossing the road although most of the road is drying up but very rough with deep holes. The gas gauge was on the warning light about half way TO Kelo. It only takes about 1 1/4 hours to go there now from Bere. On the way back from Kelo the gauge was below empty and I kept praying that somehow we would make it back to Bere. We made it back without running out of fuel. The Lord must have added some fuel. We hear that gasoline is being sold to motorcycles for about $16 US per gallon if you can find it at all. Road side stands that sell it by the liter are closed. I found one place Friday that still had some and I was able to get 20 liters (about 5 gallons) for $40 (about $8 per gallon). Previously it was about $4 per gallon. I know that in Europe and Turkey it is about $2 or $3 per liter routinely. We hear that a pipeline had burst or maybe an explosion at the refinery in NDJ. The oilfields are in southern Chad. There is a lot less traffic now.  Diesel (gazoil) was still available. Have no idea how long this problem will last. With no fuel it may not be long until there is no internet or cell phone service if no fuel to run the generators at the towers. The oxcarts are the most reliable I guess. When we got back to Bere (about 0300 am) 

Danae was in surgery repairing a stabbing victim that had come in about 0200. The victim had intestines hanging out with some holes in the intestines that had to be repaired. So she knew we were gone and that Olen was coming with us. I also heard that there was tribal fighting in Lai (about 10 miles away) with some decapitations but don't know for sure if this is fact.

On Friday we had two c-sections. One was for placenta previa and mother was bleeding a lot and had a hemoglobin of 4 so was given 4 bags of blood and is doing ok post op. The other was prolapsed cord and transverse presentation of baby. Both babies had been dead for some time and the cervix on each was only about 4-5 cm dilation.

Dolores has a sore throat past few days after taking the Malarone for the malaria. Also had a cough but is feeling better. We are healthy otherwise.
Our emails are drbland@sbcblobal.net and dfbland01@gmail.com.

Love Rollin and Dolores

Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique
Blog www.weareamissionarybland.blogspot.com

Tuesday, October 21, 2014

October 21, 2014

Now we hear there is another diagnosed with Ebola in the USA. One
death and 2 alive. Lots of media coverage and not much about the
1000’s that die from other causes such as traffic accidents.
Apparrently not much media attention to Enterovirus D-68 that has
paralyzed some and killed some others. Not many die from traffic
accidents here in Chad because we have no roads that you can travel
fast enough to do much more than break bones when motorcycles collide
etc. One certainly does not want to travel after dark at any speed
because of ox carts, stalled vehicles, goats, cows, pedestrians, etc
that would be in the road.
We just have the usual malaria and malnutrition that kills lots of
people because they don’t get treated in time. Mike and Chris Kelley
are trying to get nutrition center going but money or lack of is a
problem. They are still trying to get oriented on how to run it for
which patients. You cannot give free food to everybody so lots of
screening has to be done.
We see about one intestinal perforation from typhoid per week and
lately averaging about one amputation of either leg or arm per week
from various causes. There are a few more hernias and hydroceles
than there were before. The census especially surgery should be
picking up more as we get into the rice harvest. They are harvesting
their peanuts (groundnuts) and millet and sorghum grain now.
Danae had fever probably from malaria and is taking Malarone now.
Says she is feeling better now. Addison is feeling better and her
abcess is healing. We are fairly healthy otherwise. Now Dolores has
aching all over and temp of 100.5 so probably beginning malaria so
will take her meds..
Mason and Kim McDowell are going down to Moundou being that word that
the container with some of their things maybe is released from customs
and needs unloaded and stuff sorted out being that some things are
theirs, some are for Mike Kelley and some for Moundou and some for
James Appel.
Dry season maybe is finally arriving as I see that the humidity is
down near 50% for the first time in several months according to my
hygrometer.
Ever looking upward and forward.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.
Love Rollin and Dolores

Sunday, October 12, 2014

Oct. 12, 2014

We hear about how bad it is in the USA. Ebola has killed one and
another tests positive even though the 2nd one was wearing the
protective gear when treating the first one. We also hear about
West Nile virus and now Enterovirus D-68 that is killing some and
several having paralysis from it like the old polio and several
hundred being infected with it from coast to coast. Also the
Chikungunya virus is causing “growing concerns.” Maybe the countries
should not take flights from the USA to them. Maybe you should come
to Chad. We don’t have any of those that we know of and malaria is
at least treatable. Have even heard rumors that the US is about to
declare martial law in force doing away with most freedoms.

Our surgery patients are starting to increase in how many we operate
on. Perhaps doing more hernias but also have had several leg
amputations for necrossed foot or cancer. Also have had several
orchiectomies for pyocele (pus filled testicle). I am amazed what
can be done without x-ray. We do have an echo ultrasound machine
that is helpful sometimes especially for the OB-Gyn cases.

Sunday we had a typhoid perforation of terminal ilium then had a
intestinal obstruction secondary to a Meckel’s diverticulum band and
some adhesions.

Monday we had an intussisseption of cecum and terminal ilium into the
transverse colon in a 6 year old.  Also had another BKA amputation for
a rotten foot. Also did a scrotal reconstruction. (His testicles
were in the open after losing much of his scrotum from an infection),
also a hernia in a 3 yrs old boy.

Tuesday we took off a huge (about 10 cm) keloid from a man’s ear that
involved taking off part of his external ear.

Wednesday we had a lady with a mass in her right lower abdomen that
was mildly painful but had been there for years. She had a history
of surgery in 2008 and in 2004 including a hysterectomy and “cancer
metastasized all over.” She was in with probable malaria but a mass
palpable in her abdomen. We did surgery and found a walled off
abcess that was able to be dissected out although had to repair some
intestine. We opened the mass after it was removed and found that it
was a walled off abcess around a sponge that had been left in the
abdomen from a previous surgery. Each day we have had hernias and
hydroceles to do. We have also had three pyoceles that involved the
cord all the way up into the abdomen so did an orchiectomy through an
inguinal incision.

Wednesday Oct 8 was Olen and Danae’s 8th wedding anniversary
celebrated by working all day and having fruit jello for dessert that
Dolores made for them.

Thur we did a SIGN intramedullary nail on a fracture femur from Jan
2011 that was plated Jan 2011 but the femur had refractured and the
screws of the 2 plates had come loose although the screws were not
what they should have been. It had been broken loose apparently not
too long after it had been plated. There was lots of scarring and
was quite difficult to ream out the bone but we were finally
successful. He is doing well so far. The SIGN that we did last
week is slow to get moving. Maybe was not very active before.

Friday about midnight we had a man brought in with his penis skin
completely avulsed including the glans. Also the scrotum was
avulsed. They said the belt from some sort of thrasher had broken
when he was near by and the belt somehow caught him between his legs.
We reconstructed his urethra and penis and scrotum with the skin that
was still hanging on and seemed viable. Hopefully it will all
survive. We will leave his Foley in for at least a month. Almost a
Bobbet procedure done!!!

Sabbath I went out to the branch Sab School at 7:00, as usual taught
English SS class then preached for the 11:00 service on “Are we the
devils helpers?” Then Sab evening we had a motorcycle accident brought
that had been in a head on. One had a fracture arm, clavicle and
rib, another had a fx of a femur and a tibia/fibula fx.  Two others
had abrasions and superficial lacerations. We hope to put in SIGN
nails if they don’t go to the traditional healers.

Addison has had malaria but also an abcess on her behind the past week
but she remains happy most of the time. Had to drain the abcess so
it should be getting better. Otherwise we are all healthy.

We welcome volunteers or visitors. It just might be safer here than
you think. We all look forward when there will be no more death or
deadly viruses when Jesus returns to take his friends and children
home with Him.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.
Love, Rollin and Dolores

Tuesday, October 7, 2014

October 3, 2014

No big rains this week and things are beginning to dry up somewhat.
Well, we had a quick 0.5 inch (about 12 mm) of rain today. Humidity
stays 80 to 90%. People are harvesting their millet and sorghum and
beginning to harvest peanuts (groundnuts). Water is decreasing in
the “roads” and business is picking up at the hospital especially the
surgeries. Classes are beginning this week at the school.
Temperatures have been nearly perfect in the 70’s F and low 80’s F.

One surgery was on a 16 yr girl with a bowel obstruction secondary to
cancer. We resected the obstructed part and put it back together
but she is going to die soon because the cancer was widespread
throughout the abdomen. There was a “moto” accident where a
motorcycle with 4 adults were riding on one and hit a pedestrian.
Lots of “road rash” and one had a fracture femur which we fixed the
next day with a intramedullary rod SIGN nail. The MCD brought them
all in. Apparrently the one with a fracture femur was somebody that
was supposed to be important as various chiefs were calling about him
but the MCD actually promoted us to do the surgery rather than they
going to a “traditional healer” or witch doctor.
 We have had 4
c-sections in the past 24 hours which is more than the previous 2
months. Maybe they were waiting for Danae to return but anyway they
were all indicated or necessary to be done. Danae did two during the
night. Had two orchiectomies for hard endurated testicles and cords
taking the cord also all the way into the abdomen doing the
orchiectomy through an inguinal incision.

We really enjoyed the DVD of our trip to Turkey in June that Ronnie
(Olen’s mom) made. We just got it and looked at it tonight. Maybe
some of the names of different places will help us remember what some
of our pictures were although we had taken a few notes.

Dolores keeps busy with the grandkids. They are very active. She
has also canned some more guava sauce which is very good. Addison is
so cute as she walks around all over. Of course Lyol and Zane are
everywhere also.

We hear that Ebola is in the USA now with one case in Texas and
perhaps 100 others exposed to him. We also hear about Enterovirus
B68 that has perhaps caused one death and some with paralysis. Of
course here they just die from malaria and malnutrition and some other
things also such as HIV.

We are in good health and hope to remain that way.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.
Love, Rollin & Dolores