Sunday, December 28, 2014

December 27, 2015

Most people here don't pay much attention to Christmas but we took the day off other than making hospital rounds. Thanks to all of you who sent Christmas notes to us. On Christmas Eve the expats got together and took turns reading the story in Matthew and Luke and sang Christmas carols. On Christmas morning we had "snow" (white paper cut outs on the front porch) and temperature down to "cold" 59F.  Dolores and I ate breakfast with Danae, Olen, Lyol, Zane, and Addison then watched the grandkids open their gifts. They get so excited. The afternoon all the expats had a potluck meal together then had a "white elephant" gift exchange. Each one brought one wrapped gift to put on the table then numbers were drawn for order of choosing as each one got to choose either one gift from the table or to "steal" one from someone who already had one. A gift could only be "stolen"no more than 3 times. 
Choir with new robes
 
Several surgeries were done the day before Christmas including two for ruptured uteri. 

Dolores spent the previous almost two weeks working most of night and day making about 25 choir robes for the church. She measured each person in the choir so the robe would be right for them. I made a closet 48 inches x 80 inches x 22 inches for the choir robes to be hung in. The wood boards are rough and crooked so require lots of trimming and planeing to get the boards to fit together to look decent. I sprayed some insecticide especially on the bottom hopefully to prevent termites eating it up quite so fast. They had a "concert" yesterday with their new robes and loud drums and steel guitar that you could probably hear for a kilometer with lots of joyous dancing in the church. I think they had religious words but I have not learned to appreciate their music style. 

The main holiday here is New Year which the "fet" lasts for several days. Often there is no internet or telephone about that time also.

May all have happy and prosperous new year. We are now one year closer to when Jesus will return to claim His children and take them home. Matt 24:14

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

Monday, December 22, 2014

Written December 14 (posted Dec. 22)

The "harmattan" dust blew in Friday night so now the air is brown but it is cooler. The "harmattan" is north wind that sweeps down from the Sahara usually in December or January with lots of a very fine dust that gets into everything but the dust shields out some of the heat from the sun so it is cooler now. We did not have much harmattan dust last year but did have a very cool spell about this time with lows down in the low 50's F. It isn't that cold yet this year. Dry season began a little earlier this year as last year we had a shower even the first weekend of December whereas this year the last rain was in October.

We are just beginning to get some papayas off the trees we planted about a year ago. We are letting them ripen on the tree (most locals pick them before they are ripe so someone else does not get them) and they are much sweeter when tree ripened. The mangoes, guavas, avocados, cashews, citrus, and pomegranites that we planted will probably need a few years before they produce. The bananas seem a little slow also. Maybe whoever comes; after us will get to enjoy them. 

Our Toyota 4-Runner runs much better now after Jamie showed me where to plug in the diagnostic tool I had which then gave a few options as to the problem. The place to plug it in was not to the left of the steering or of the dash as was told but sort of behind the ash tray about in the middle. We had thought the problem was the control module (computor) and even had one bought and brought out but we never used it or opened it. The problem turned out to be the MAF (mass air flow meter and sensor) which I cleaned carefully and now the car runs fine with no additional cost. 

Gasoline has become more available and is down to 750 cfa per liter or about $6.00 per gallon here in Bere. I understand it is down to 490 cfa per liter or about $3.92 per gallon in N'Djamena so maybe it will come down some more here.

We have had some unusual appendix presentations the past few days. One was a large appendix in an inguinal hernia. One was a retromesenteric presentation that had necrosed and part of the small intestine was obstructed and blood supply severely compromised to the point that we had to take out about 60 cm of small intestine after a lot of careful dissection. Another was ruptured appendix one or two weeks or more previous with almost the entire abdomen intestines all stuck together and obstructed and had to take out about 70 cm of small intestine also. We also had an elderly lady with very large masses about 10 cm diameter in her femoral and inguinal areas that I guess were lymph nodes filled with soft black tumor like material although did not find any other that this might have metastasized from. We had a boy with a mass (probably a cancer) right over his brachial artery of his arm but got it off without sacrificing his artery. We had an elderly man with a 6 month posterior dislocation of his hip which we tried unsuccessfully to reduce then tried to reduce it with; open surgery and still could not even after considerable dissection. The head of femur was very soft and osteoporotic and the acetabulum was almost flat so we cut off the head of femur, closed the wound and put in a tibial pin for traction and he is now in traction and amazingly this morning his legs are almost equal length. Oh yes we still have some hysterectomies for large fibroid uterus, some hernias and hydroceles and yesterday a strangulated hernia but was in time so did not have to resect any intestine. Danae even did a c-section on a woman that had just died and got a living baby. We have interesting lives to some people.
 
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com

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

Thursday, December 4, 2014

The Parkers leave, leaving us with big needs

It was a sad day Monday as Jamie and Tammy Parker said good bye to everyone and left for the USA and not planning to return. Actually they left Mar 31 and returned here about a month ago to pack and make various arrangements to return permanently to the US. They had been living here the past 5 years as volunteers on donations. They had helped a lot of kids and he had done a lot of maintainance and construction work. I guess we are the ones for maintaining now. We could certainly use some people to do construction especially plumbing and electrical work on our new buildings so they can be used. If you are interested send an email. We can use short term or longer term people. 

We have had 3 colon resections during the past week. One was a right hemicolectomy for obstruction because of a cancer of the ascending colon. Unfortunately he also has some metastasis in the liver. He is doing well eating and walking post op. Another partial colectomy was for an obstruction of the transverse colon because of a cancer but also had metastasis to the liver. He also is doing well post op. Both had palpable masses similar to walled off appendiceal abcess. The transverse colon was very redundant and was down low in the abdomen. Of course no CT or even x-ray so rely on physical diagnosis. Yesterday we had a right hemicolectomy for an intussisseption that we could not reduce. We also had another urinary obstruction because of much scarring and probable cancer of the prostate which we were unable to resect but was able to dilate the urethra enough to get in a 24F Foley which we plan to leave for a long time.

I was supposed to do a study for prayer meeting past evening but was doing the intussisseption case about that time so Olen filled in for me. Yesterday morning I took some photos of a Bible training group that is being conducted in a new church in Doubge about 6 miles from here. The 20 attendees then are expected to conduct outreach in their various villages. One man bicycled 75 kilometers to attend. 

Our emails are: drbland@sbcglobal.net and dfbland01@gmail.com.
Love, Rollin and Dolores
Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique
Blog www.weareamissionarybland.blogspot.com