Nov. 21, 2014

"Fall is in the air". The mangoes are beginning new growth and blooming and the old leaves are falling off. There is more dust in the air and it is cooling down so now it is only low 90's day and low 60's early morning. The ground is dry and hard. Rice harvest is well under way and the millet and sorghum grain has been done. They should be picking cotton soon. Last year we had some rain in November but there has been none this year.

The fuel situation continues about the same. There is no internet or phone much of the time, perhaps related to lack of fuel for the cell towers so don't know when you can read this. The hospital has enough diesel to last for some time. I just bought gasoline 20L for 1100 cfa per liter or about $8.80 per gallon, so slightly improved.

The surgery schedule is still somewhat slow but have had some interesting ones. We had a torsion of a 12 lb ovarian cyst. Also two different ones with cancer of their mid thigh. Both were resectible. Both were anterior and medial so was difficult to remove but both have full function of their legs and feet now which was amazing. No pathology to send to so don't know what kind they were. One especially was deep inside the muscle. Took about 2 liters from a little girl's chest a few days ago. She still has the chest tube but seems to be breathing better. Probably related to tuberculosis. Her relatives say that some of their cows are dying with a cough and maybe have tbc. We have the girl on tbc meds now. We had a little 10-yr-old boy that was having vomiting after eating but could keep water down. We could feel a mass in his mid abdomen and at surgery his mesentery was full of tumor and partially obstructing his first part of intestine. We dilated the obstructed area somewhat but unable to resect the whole mesentery. Perhaps it will respond to cyclophosphomide which is all we have to offer.

Hope all of you enjoy your Thanksgiving weekend in the US with lots to eat and have family and friends and football. We all have lots to be thankful for especially all our gifts from our Heavenly Father.

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

Your tax deductible gift can be sent to the Jay Seventh Day Adventist Church, Jay, Okla.. 74346 or to Adventist Health International, Loma Linda, Calif 92505 Either should be marked "Bere Hospital Project"

Love, Rollin and Dolores Bland

Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique

Blog www.weareamissionarybland.blogspot.com

Gasoline shortage AND personnel shortage

The hospital has been somewhat slow although Danae seems to be keeping busy with Ob-GYN. There have been several prematures and several babies that were dead before the mother got here. One does not like to do c-sections for dead babies but sometimes it has to be done. Also has had several curettages for incomplete abortions or retained placenta fragments with lots of bleeding.

One big item now is lack of gasoline or very expensive if you can find it. They say there is rioting and people even being killed in NDJ and Moundou because of the lack of gasoline. If it can be found some places are charging up to 4000 or 5000 cfa per liter (about $32 to $40 per gallon). They say there is still diesel for some reason but lack of gasoline which really affects the motorcycles and small cars. My Toyota 4-runner takes gasoline. It is quiet here in Bere and I don't need to go anywhere. Some of the government employees are going on strike also some of the taxis are on strike. It has been rumored that war could break out if it does not get better soon. I think the military has pretty tight control. We are so far out that here should be no danger here. Hopefully they get their refinery or whatever repaired soon.

The REAL BIG item is that Jamie and Tammy Parker arrived back last week BUT they came only to pack their things and sell or give away almost everything and return to the USA. They will really be missed. Hopefully a replacement can be found soon so that construction and maintainance can be continued. They left here April 1 and just now are saying they are leaving permanently. He had back surgery while he was home this time and still is having problems. They had served here 5 years and had done a lot of good work. They had been serving as volunteers living on donations from their home church in Tennessee. They could not accept the salary and terms that AHI had offered. The Lord works in mysterious ways so maybe something will come of all this and the construction project etc. will continue.  Money is in short supply as well as personnel.

Tax decuctible donations can be made to Adventist Health International Bere Hospital Project, Loma Linda, California and 100% goes to the project. They get their operating expenses from other sources.

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

Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique

Look out for horned bulls!

Thur Oct 31 we had our 2nd penile denuding (the skin being peeled off). This one was from a bull horn that caught the man in his scrotum and peeled the skin but the meatus still seems intact. The previous one lost all his skin and his meatus from his penis when it got caught in a belt to a rice thrasher. The skin all necrosed when we tried to save it but I think this one has a fair chance of living as we put it all back together. We hope to do some grafting on the first one before too long or maybe create a flap from his scrotum to cover at least part of his remaining penis. Would a full thickness graft or split thickness skin graft work best? 

 Also Danae and I did a perineal and anus reconstruction on a lady that had had a 4th degree vaginal tear from her first baby 7 years ago and amazingly she had two babies since then. Hopefully there was still a little muscle remaining so tht she can have some anal continence. We had a c-section for placenta previa (placenta over the cervix) which was bleeding a lot. Danae picked her up by herself and carried her in a hurry from the delivery room to the OR. Everyone is doing fine now. 

We had a lady that died in spite of all the medicines for the infection. Danae had paid for part of the medicines. They had no money to pay for transportation of the body back to her village so Dolores and I took the body out to her village about 35 km out in the bush with some of her family members. We had to buy some gasoline (which is very scarce but we found some) for 1250 cfa per liter (about $10 per gallon). It was a nice trip although we got back after dark. They seemed to appreciate it. Did not have time to do any birding or much picture taking along the way as we left Bere too late. The trail was pretty narrow but the water holes were pretty well dried up. It was only about 1 1/2 hours each way. 

It is getting drier and hotter in the day time usually about 95-98F in the day but cools down in the 70's at night. Humidity is down in the 40% range now.

Fuel is hard to get or very expensive so business is slower at the hospital. Much less vehicle traffic.

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

Love Rollin and Dolores

Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique