Is it worth it?

Fighting over 50 cfa (about 9 cents) resulted in large wounds in the abdomen in one man and I don't know what happened to the other man. One man owed 50 cfa and the other owed him 1000 cfa. Knives were involved, then treatment at another hospital before coming here 3 days later with large amounts of purulence coming from his abdomen wounds that were minimally closed. Not sure what was done inside the abdomen at the other hospital if anything so we opened it and did not find a perforation but lots of purulence. We washed it out and put in drains and he still is having some drainage but nothing that looks like bowel contents.


Reminds me of the story Jesus told of a man that owed a huge amount and pleaded for more time even though it was totally impossible for him to ever pay it (sort of like the US national debt) but he was finally forgiven the debt. Then he went out and would not forgive someone who owed him a small amount and had the man put in prison. That 50 francs will become quite large by the time he pays for his medicines etc although part of the treatment was gratis. So was it worth it to fight over such a small amount?


What if Jesus had said that it was not worth it to come down to this little speck in the universe to try to save these rebellious, very few of whom will just accept the great gift of His taking our place to die for our sins and save us if we will allow His grace to cover our sins and show it by our changed lives? As we consider this season to remember Jesus birth, are we giving to those less fortunate than we are? There have been times when I have wondered if it is worth it to come to Chad which is very far behind and a corrupt country. Some people spend their whole lives in difficult mission situations whereas we plan to spend only 5 years or so this time plus the 3 years we spent in Nigeria 45 years ago. So maybe sometimes I have the wrong attitude. Hopefully, we make a difference at least in a few peoples lives and a few will learn about God's love. But Jesus came to this corrupt world which is getting worse.


This past week we had a huge mass that was making her short of breath and not able to eat hardly anything. It turned out to be a 4 kg kidney that was mostly a hemorrhagic cyst. She is doing ok now. We also had a 9 year old boy with a large cancer in his pelvis and was unable to walk. We took out most of the mass that was even around his iliac artery. His strength to his legs has not returned yet. His prognosis is not good. He also had no testicle on that side. We only had two prostatectomies this week. We had a menopausal lady with a "prolapsed uterus" or a large cervical polyp that was actually an inverted (turned inside out) uterus so we did a vaginal hysterectomy on her. The man with a necrosed scrotum and testicles that we took off has finally healed and gone home. The surgery numbers are beginning to increase as people are getting their field work done.


Dolores is still doing some Christmas sewing. Our rat problem seems to be decreasing or maybe gone in our house but there have been some in all of the new buildings.


I think some volunteers will be coming next month to help in the building projects. We are looking forward to being able to use these new buildings that have been here 3 years but not finished. Of course we are looking forward to Danae, Olen, Lyol, Zane, Addison, and Juniper arriving back here next month. The compound seems empty without them.


Remember this season is to help someone that can not help you in return.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com

Rollin and Dolores Bland
Hopital Adventists de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique
Blog www.weareamissionarybland.blogspot.com

Dec. 13, 2015

I was notified Fri. that I was to preach for Sab. (yesterday) for Bere church. I also was singing a duet with Sarah Snyder (a new volunteer graduate nurse that will be here the next 9 months). We sang "O Shepherd Divine" then I talked about the parable of the lost sheep in Luke 15 and Matt 18. After the duet I had mentioned that it would be nice for the "choir" to learn harmony and sing different parts. I did not mention that presently they basically yell as loud as they can in competition with the terrible loud drums with no expression. There were several "amen" when it was mentioned. Olen and I had discussed this a little just before our "evacuation" in Sept.

One of the choir members came over Sat. eve wondering if she could have some lessons on singing so that was encouraging. I am not a music teacher so I don't know how that will go. In the talk I had mentioned that there are several members that have strayed and that we are all to be shepherds to care for them. The pastor was by here today and said he had heard several comments about how practical the talk was so that was encouraging. My translator was Favian, a new graduate finance person here for awhile to help with accounting problems and computer teaching whose mother tongue is French but education in English. Her father is the Health Ministries leader for the West African Division.

The brakes on the pickup have been making a noise for some time. Today I took the front disc brakes apart and put in new pads. One of the rotors or disc is really worn down and needs replaced. Apparrently the brakes were not releasing as they should. The mud and dirt and dust is really hard on vehicles here. I think the deep dirty water that I had driven through was what caused the alternator to go out on our 4-runner. We got the diodes replaced and it works ok now. We still have not been able to get the switch to move out of "lock" or the steering to move on Olen's '91 4-runner.

Our hospital census is staying 50-60 most of the time. We had more surgeries this past week with several hernias and hydroceles, 3 prostatectomies, a 6-kg spleenectomy (so big and heavy it was obstructing his gut and making him short of breath), a bowel obstruction form adhesions, a c-section for eclampsia (seizures, edema, pregnant) and she had twins, bladder stone in a 2-yr old boy, a hymenectomy for imperforate hymen, enucleation of an eyeball in a 18-month old child for huge infection from foreign body that destroyed the eye, etc. We have had several heart failure patients some with bad valvular disease and maybe some with cardiomyopathy from ? I think I have given more furosemide diuretic in the past 2 weeks than in the previous 2 yrs. More common is not enough fluid and not drinking enough fluids.

Dolores is busy sewing some shirts etc. No grandkids here to take care of right now. They are surely missed.
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
Blog www.weareamissionarybland.blogspot.com

After Thanksgiving

Yes we are safe here. The terrorist attack in Chad was a long way from us as it was north of NDJ on Lake Chad area. It may be more dangerous in the USA with the mass shootings and the Ebola. We have had no Ebola in Chad and we have lots of military check points to check for terrorists or whatever you reason is for going anywhere. We see drunks that have wrecks on their "motos" or pedestrians that get hit as they walk on the road after dark. It seems there are always pedestrians, ox carts, stalled vehicles, cows, goats, etc none of which have lights after dark It is dangerous to drive after dark. 

Even though Thanksgiving is not an observed holiday in Chad, we had a nice day with plenty to eat and no scheduled surgery but had a c-section about meal time.. We had invited some local people and some from another mission so we had about 27 together. Three days ago we had a c-section for a ruptured uterus with lots of blood loss. She almost died but is doing ok now. Last night we had motorcycle and car and pedestrian accidents. Six were brought in. One had a fracture knee femur which we put in traction. Some had lacerations and head injuries. One was brought in this morning with part of his foot cut off by a car. It had a lot of debris which we spent a lot of time trying to debride and trying to save part of his foot. The bones were even part cut off but we managed to salvage the heel so hopefully he will have a heel to walk on BUT a huge danger for infection and may have to amputate more later. A knife stab wound which barely missed his liver and did not perforate any intestine (we opened the abdomen to look) was last week and did well. 

We have lots of patients on the Medicine service now with lots of different problems besides the usual malaria, typhoid, parasites, and HIV. We have had some with bad hearts  ie mitral valve disease, several with hepatitis and ascites, and various tumors.  We are having to put some on the veranda as not enough space inside. 

We are hopeful that some volunteers will come soon and help finish some of the buildings that had the shells put up 3 years ago esp for maternity and private wards which would give us more bed space.  Hopefully we can get the new OR done also.

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

Thank you for all your birthday best wishes and comments. We celebrated the Friday the 13th beginning the day before at 0400 with a c-section then driving to Moundou and doing 2 fracture femur intramedullary nails then driving back to Bere after dark through all the ox carts, stalled vehicles, pedestrians, goats, cows, etc arriving in Bere about 2100 and had an OB waiting that had a transverse lie presentation and baby had huge hydrocephalus so a c-section. Then Friday at 0400 had a difficult forceps delivery with baby with abnormally large head compared to rest of body and also a heart problem murmur and died some hours later. Friday was a normal day otherwise. Dolores made a birthday cake and supper and had invited some people over in the late afternoon. At midnight was called for another OB with breech presentation but her 5th pregnancy and by 0300 she had delivered twins normally. Sat morning at 0730 went out to a branch Sab School in the car then it would not start so had to call Dolores to come pick us up with the pickup. The alternator had quit so jump charged the car battery enough to get it back to Bere. (The alternator is now taken off to get repaired in Moundou hopefully) Then at about1000 did a strangulated hernia that required some bowel resection for some dead intestine. It has been relatively quiet since then. We had 3 bowel resections recently, one for intussisseption, one for a resectable cancer, and one for a strangulated hernia with dead intestine. We have had two nonresectable bladder cancers this week. Zach is in NDJ to pick up a new nurse volunteer from Walla Walla, Washington this weekend. Today they called from Moundou wanting me to come do 3 more fracture repairs. Don't know what they are yet. Maybe go there tomorrow Sunday. I don't like to leave Bere uncovered surgery wise. May Psalms 139:23,24 be the prayer of each of us. Our emails are drbland@sbcglobal.net and dfbland01@gmail.com. 
Love, 
Rollin and Dolores Bland 
Hopital Adventiste de Bere 
Boite Postal 52 
Kelo, Tandjile, Chad, Afrique 
Blog www.weareamissionarybland.blogspot.com

Juniper Belle Netteburg

It's a girl. Juniper Belle Netteburg 7 lb 14.3oz born 2:12 pm Nov 8 in Springfield, Mass USA to Danae and Olen Netteburg but we had to wait until now for the name. I think the pictures and comments will be well posted on Facebook. Of course she is beautiful.
We believe in equality of the sexes. Each one of our children has a boy and a girl except Danae now has two boys and two girls. Now we have 10 grandchildren with 5 boys and 5 girls ages new born to 22 yr.

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

We have been back in Bere a little over 2 weeks. All seems quiet and safe around here although a few days ago there was another Boko Harem attack north of Ndjamena by Lake Chad that killed one person. We are a long way from that. The main problem has been the rats that seem to have tried to take over our house while we were gone. They chewed through the mesh that was supposed to let in air ventilation along the roof which they somehow managed to get to. They don't seem to be eating the poison very much yet and they are pretty smart about traps although we have caught two or three. 

 
Halloween which celebrates the Devil's day was a busy night here. We had a strangulated hernia in a 2 year old, a urinary retention, a c-section for a very small pelvis. Then they brought in a boy that had an open fracture femur for 9 days that was infected and he had tetanus. We put in a pin in his leg for traction to try to stretch out his thigh muscles but the tetanus prevented that working very well. It was difficult to get enough diazepam and anti-toxin given so he still had tetany much of the time. Unfortunately the family decided to take him back home after 2 days and let him die there. Two nights ago was similar with a breech delivery at 2200 then a difficult forceps delivery at 0130 then an ectopic pregnancy with lots of blood in abdomen that came in and we did surgery at 0300. Actually these 2 early am patients were referred from another hospital. Another day we had a lady with preeclampsia that the 4 month fetus died so tried to induce delivery. She had some pain and also wanted a tubal ligation or hysterectomy. She was not progressing at all so opened her and found a ruptured uterus so a c-section and hysterectomy was done and she has done well post op. We had a bowel resection for dead bowel about 1 meter from the volvulus that was doing well next day then suddenly short of breath and died maybe from a pulmonary embolus or ? So not everything goes well. We have lots of hernias and prostatectomies.

We don't have any student missionaries or other volunteers since the US State Dept advisory in Sept that US citizens should evacuate from Chad because of increased danger but this changed after 3 weeks to the same advisory as before, to "avoid high population areas and markets," etc. We think it is as safe here as a lot of other big cities. We are hoping for some volunteers to come and do some plumbing and electric work. 

 
Pray that Matt 24:14 will be fulfilled here as well as the rest of the world so that Jesus can come and take His children home. 

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

Past few days in Bere

We are getting settled in although not quite adjusted to the time zone change yet. I went out this morning to two different branch Sabbath Schools under the mango trees then came back for church.

Things have dried up a lot so I think dry season has begun. The low this morning was 80.

I did a prostatectomy, an ectopic pregnancy with a lot of blood in the abdomen, a ruptured appendix that I thought initially was a perforated gastric ulcer but wasn't, 2 hernias, drained an abdominal wall abcess, took a grain of rice out of someone's ear, etc.  Samedi did 2 c-sections the morning we got back. One baby was dead from a prolapsed cord. Other baby lived .

I was surprised to find one generator missing when I was looking around Thurs morning after we got back Wed evening on the mission plane. Our baggage arrived here Fri morning. The generator apparently got its inner wiring burned so Isaac had taken it apart from the motor and had it taken to Moundou to get it rewired or rewound. So far the other generator is doing fine. They say the repaired generator sould be back this coming week sometime.

The dogs are fine.

James Appel is here this weekend going back to N'Djamena where he is working part of the time. He was at Moundou for a few days while Scott was gone. James was visiting the grave of his child this morning that he lost here to malaria a few years ago.  Scott is going to Europe next week for a month but Samedi will be covering Moundou during that time . I will covering Bere.

All seems quiet so far as Boko Haram or any danger is concerned. I have not heard of any further problems.

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

my brother and wife Reggie and Cheryl Bland with us

by our campsite Kebler Pass, Colorado

on Independence Pass, Colorado
After arrival in the USA we spent a week in Colorado mountains enjoying the  Fall color and spending  some time with my brother and his wife.   The color perhaps was not widespread as good as some years but still was very good.   We had rain in the Beaver creek South Fork area the first day or so but was nice after that other than freezing cold which was much different from 90F in Chad  
Rollin and Dolores

Oct 8 left Chad

 We are back in the USA arriving back in Jay, Okla early am Sept 19 after a 10 hr bus ride from Bere to NDJ then 4 hr flight NDJ to Addis then a 15 hr flight to IAD (Washington,DC) then a 3 hr flight to OKC then a 3 hr drive to Jay.   Of course there were some layovers etc.   On Sept 12 I came back to Bere from a branch Sab School and learned that the US State Dept had sent out an advisory that American citizens should leave Chad because of continuing government instability and danger from Boko Haram.   Although the last bombing in NDJ, Chad was June and July in a market and a police station.   We actually felt very safe in Bere as it is so remote.   That same day the General Conference (our church headquarters) sent out a note that we should leave "as soon as feasible".   We really think there was a mistake as we have not experienced any danger.   The US State Dept has since then sent out a travel advisory warning of possible danger areas but no mention of needing to evacuate.   A lot of expatriates have left Chad but there are still many who think everything is about the same and have stayed on.   Olen got permisson to stay to keep things together a little longer and thinking that Dolores and I would go back by the last part of October.   We don't know how soon the General Conference will give us the OK to return or if they will.   So we are sort of in limbo not knowing how to plan.   Danae and the kids, Scott and Bekki from Moundou and Dolores and I all came back on the same plane to DC.  We all have had malaria either during the trip or since arriving back here.   Olen also had it back in Bere but is better now.   James Appel is still in Chad.  
We are all safe and well but PRAY for us and the work in Chad that it can continue.   We have invested lot of time and energy as well as money there and would hate to see it go backwards by many years.  Of course the most important thing is all of our safety but we never saw any real danger except from malaria. 
refer to blog   www.missionarydoctors.blogspot.com
Our emails are  drbland@sbcglobal.net    and  dfbland@gmail.com
Love   Rollin and Dolores

August 26, 2015

Yesterday Olen, Danae, Lyol, Zane, and Addison arrived by bus to Kelo from NDJ and we picked them up there and brought them back to Bere. So good to have them back again. Addison is talking more and more even since we saw them just 3 weeks ago. Olen had to go back to NDJ to fly tomorrow to Abijan, Cote Ivoire for the Global Health Conference and returns in a week. Of course it takes some time to get adjusted to the time zone changes. Danae did some consults and rounds on medicine and peds this afternoon even though she was still tired.


Last week I did 40 surgeries but this week looks to be slower. I had another hemithyroidectomy yesterday. I also began an attempt to take off a large mass on a head which had to abort the attempt as it had a large connection to the aorta I think. Anyway it seemed to be some sort of cancer from inside the cranium so I managed to get the bleeding stopped and the wound closed. It was scary for a bit. Today we had a torsion of a large ovarian mass that was interesting. We have had 3 ectopic pregnancies in the past two days. Today also had a c-section and a vacuum delivery. Both babies are alive but they should have come in sooner.


The road from here to Kelo is pretty good by Chadian standards meaning it is still passable maybe even in a car if have high clearance. We did the 25 miles yesterday in about an hour although took longer coming back so as to not hit the bumps quite so hard with a load. The countryside is pretty and green now although the rice fields are not flooded as they should be at this time of year. The cotton is blooming and the millet and peanuts are maturing. Tonight is a beautiful moonlit night. 

Still no word if or when someone will be coming to finish our buildings esp the electric and plumbing, We still need your prayers and support.


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

August 20, 2015

We are back in Chad after having a wonderful vacation and 5oth wedding anniversary celebration.   We spent 2 weeks in Denmark, Sweden, Norway and Iceland.   We went to my 55 yr high school alumni weekend and then we went to two grandchildren's (Aaron and Avery) baptisms in Springdale, Ark.  We went to the General Conference in San Antonio, TX; also went to the Okla camp meeting, meeting lots of friends in both places.   

We had our 50th wedding anniversary celebration July 26 in Jay, Ok because that was when all the children and grandchildren could get together even though our wedding was Aug 22, 1965.   My brother Reggie and family came down from Denver.  Olen and Danae made a special trip from Chad with family for this.  They will be going back to the US in Oct to be ready for the next one coming.  We are very proud of our children and grandchildren.  They paid for the week get to gather in Branson afterwards which was very nice to visit together and see some of the shows.   All our children have at least a college or university degree as well as their spouses and all are active in the church work.   Of course all the grandchildren are “above average”.    They are all getting a Christian education.   The 10th grandchild is due in Nov 2015 (Danae is having her 4th child).

The sterilizer for Bere Hospital was bought for $4000 that some of you donated money for.  We brought back some of the baby shirts that say in French born in Bere Adventist Hospital.  We bought 1000 for $3500 which was a very good price imprinted and all at the vendor’s cost.  Donations accepted.  

It is rainy season here now BUT it has not rained as much as normal and may not be enough for the rice to mature properly.  The water table in the ground is normally about the top of the ground now and it is not  even close.  The millet, peanuts, maize, etc are doing ok.   Some say there is a possibly of a famine if we don’t  start getting more rain.   I don’t know what the minimum amount of water rice has to have.   Several sources say that the government is out of money and has not paid many government employees for several months and that some of the Chinese have pulled out of the oil works for a few months.    Oil prices too low.  
Surgeries have been slow but we have several that need done as soon as they donate some blood and pay about $100. I did a hysterectomy for a large fibroid also a laparotomy for a perforated gastric ulcer that someone else had operated but missed the problem several days before.   We also did some hernias and prostatectomies this past week.   

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

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

THE NEXT THREE ARE OUT OF ORDER

It does not seem possible that we are starting a new year.  Here the main cadeau (gift) giving is at New Year's. Another activity is also asking for cadeaus.  There was not anyone at our door like last year; singing then asking for cadeau.  Most of your good resolutions are already broken probably by now that we often make to begin the new year.  But we can still read our Bible daily and maybe I should be studying French more diligently. 

Our total surgeries for December was down compared to last year 145 to 128 but it seems we had more big cases including several bowel resections for various reasons.  Last week had a spleenectomy in a 3 yr old for a ruptured spleen from a motor accident.  He also had head trauma but after giving blood to him and doing the surgery he is doing ok. Also had a ruptured appendix that had abscess under the liver with his cecum there but incidentally his right kidney was down in the right lower abdomen feeling to palpation like a mass maybe a walled off appendiceal abcess.  We also had one with urinary retention with large prostate and another with urethra stricture.  Another little boy had a large stone in his proximal urethra which we were able to push back with difficulty into his bladder where we had opened it and removed the stone.  We also did a fasciotomy on the leg of a baby that had been severely burned.  Initially the foot appeared white and dead but after a few leg splitting incisions and one in his foot, the foot pinked up some and had a small amount of bleeding so hopefully save his foot although may lose his toes.  We had a bowel obstruction of the very end of the terminal ilium with a band that required a plasty to open the obstruction.  The little girl with arm amputation at the shoulder for cancer of the humerus is doing ok now.  We had a patient die from rabies that had been bitten by a cat a month before.  Cats don't normally carry rabies.

Our total census has been past full lately.  In fact on 30 Dec we had almost 90 in the hospital but bed spaces for less than 70 but we add beds to the veranda and they sleep on mats which some of them prefer.  We also have beds in the building that eventually is to be pharmacy and lab.  The new maternity is not open because it is not finished with electricity and plumbing which would add some bed spaces.  The new private wards have the same problem.  There was a run in maternity with 14 deliveries in one day.  Every service had lots of patients but today the census is down somewhat. 

We are heading into the usual busiest time of the year especially for surgeries.  Last year we had 200+ surgeries for Jan.  We have a new Chadian doctor here with us that is sort like an intern.  He needs lots of experience and guidance yet.  Hopefully eventually he can do a lot of the care.  He is supposed to be eventually in Abeche with Dr. Appel. 

Dolores is resting up a bit after her marathon sewing of all the choir robes for the church.  Now she is "just taking care" of the grandkids.  Danae has been very busy with maternity lately.  We are all healthy presently. 

We are almost out of medicines for malaria especially the pills, and there is none to be found in the entire country.  We still have some injectable quinine, injectable artemeter, and fansidar.  The head of the central pharmacy for the country probably did not order it in time from whereever and yet they won't let hospitals order or import meds on their own schedule.  There are almost no meds for hypertension except atenolol and HCTZ.  We have no ivermectin for filaria and some other parasites now either.  We do have lots of albendazole.  Different anesthetic agents are hard to get or impossible to obtain so we work with what we can get. 

The "harmattan" dust has really moved in with the north winds.  The visibility is less than a kilometer but it shields out some of the sun so it is cooler with only about 80F for high and in the 50's for lows.  One can wipe the dust off something and it will be covered again in not very many hours.

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
Blog  www.weareamissionarybland.blogspot.com 

OUT OF ORDER: Nov. 30, 2013

I thought I had posted them, but had instead placed them in the "draft" box. Sorry. Please note the dates.  Ronnalee Netteburg.

We hear of the snow and ice back in the USA and we shiver in the “cold” here. It gets down to 75 F in the mornings. It is pretty nice here with dry air and ground and highs only in the 90’s.

Hope each of you have had a happy Thanksgiving and “black Friday” holiday. On Thurs all of the expats got together and we ate very largely of all the good food that various ones had made. No TV or football or other things like that. Of course it is not a holiday here like there. In fact we did two surgeries in the morning.

Today Dolores and I went out in the bush for church and took a patient with us returning to her home there about 45 or 60 minutes (only about 16 miles) from here if you did not stop. The “road” through the brush is sort of hard on side mirrors on the vehicle but overall smoother than the “main road.” A one day church had been built there about a month ago and they now have 40-50 adults and about that many children that come to hear Bible stories. The church is not finished on the floor and besides it is cooler under the mango trees now in dry season. They have no medical care or clinic in that village. We may start an occasional clinic there to try to help them. Gary Roberts is marking out an air strip there and they are favorable towards that and hopefully any government officials are ok with it then it would be only a few minutes away even in rainy season whereas we could not drive there in rainy season.

Have repaired two meningoceles in the past week. Yesterday (Friday) was one meningocele, a strangulated hernia, vesico-vaginal fistula, mastectomy, hydrocelectomy, prostatectomy, and an ordinary inguinal hernia. This past week we drained a liver abcess with about 2 liters of pus. Last Tuesday I did a SIGN nail (intramedullary rod) on an open fracture of a lower leg but also the knee was totally messed up and laying open for 3 days with lots of gravel and dirt in the wounds. The lateral tibia plate was partly absent and little small pieces and fracture patella and the ligaments all torn apart. Hopefully it is repaired somewhat and hope for a good stiff leg without too much infection. Putting in the nail was the easy part. Tomorrow I have a bilateral femoral fracture to repair but the accident was one year ago. One side is loose and the other has healed together but much shorter so have to take it apart and will put in SIGN nails in both. Both SIGN cases are in Moundou as I am covering for James Appel for those while he is in the US for a month. Tonight we had a man with fracture of tibia and fib about 2 or 3 inches above the ankle but was refusing treatment at first but finally let us cast it I think in fair position and it had no skin breaks. We had one other vesico vaginal fistula this past week. Both cases were redo that had not quite held with the previous surgery. No one wants to pay for those fistula repairs as the woman is sort of an outcast with leaking urine and can’t have sex etc and chronic urine smell. If the repairs work it gives the woman a new lease on life. We need a large fund to cover the cost of those repairs.

I think it is official now that Dr. Scott Gardner (Olen’s uncle) will be coming to Moundou. He previously was going to be in Koza, Cameroon. Dr. James Appel is going to Abeche, Chad to get some work going there that has been minimal thus far and Dr. Roger (Congolese doctor) is moving from Moundou to Bature in southern Cameroon.

We love to hear from any of you. Our emails are drbland@sbcglobal.net and dfbland01@gmail.com

5- year pregnancy????

August 15, 2015

What is a urologist? Is it a doctor that primarily takes care of male patients? Is it someone that mainly takes care of the urinary system? Does he/she have to be a doctor? Does he/she have to have boards in urology? Does he/she need to know surgery especially of the urinary tract? We have a janitor nurse "surgeon" that does prostectomies quite well as well as some general surgery procedures In fact he is probably as good at many procedures as most of the Chadian doctors. 

 
I don't claim to be a urologist even though I wish I was one many times here in Chad. I am not board certified in anything although I have had many years experience doing almost anything to the urinary tract and other things. Today I had 3 prostatectomies plus a reconstruction of a man that had had "3 surgeries by urologist" in Ndjamena, Chad according to his record for urinary retention and left with a suprapubic foley drainage the past 6 years although his main complaint was pain in his proximal right thigh which I could not relate to his other problem. I was finally convinced that I should try to help this man with his problem of the urinary tract and was able to reconstruct his urethra or dilate making a new tract through a terrible scar and closing his suprapubic wound. It all seemed to go quite well and hopefully the poor man will have a semi-normal urinary tract after he heals from all this. I had almost refused to try to do surgery on him but as I had done a few other similar ones, decided to tackle this one. I also did a torsion of a testicle surgery today but it was too late to save the testicle so had to do an orchiectomy. 

Today we had a very large hemithyroidectomy and all went well. Not sure if malignant or not. We also had a posterior dislocation of an elbow from an accident 4 months ago and reduced with general anesthesia. He will have severe arthritis but hopefully it will be functional as it was totally immobile before. 

 
Dolores misses taking care of the grandkids but they will be back next week.

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

Mary 29, 2015

Rainy season is trying to start but has not really rained very much. We have had 2 rains that maybe were an inch. Mangoes are about finished. 

 
The next 2 weeks we will be in Denmark, Sweden, Norway, and Iceland. We have had problems with our flight from NDJ to CPH Copenhagen. The original Air Moroc was leaving here and arriving in CPH June 3 for $400 each but that flight was canceled. Ethiopian Air is almost $800 but have to leave June 1 to get there in time for all our other reservations (that is the one we are taking at last minute). Turkish Air was available for $1300 with nice schedule and Air France went from $1700 to $2900 as it was being checked. All this for the same destination CPH. Thank you Cathi Spencer and Kermit Netteberg for getting this and the credit card problems all straightened out hopefully. 

 
This week we had another intussisseption requiring resection of terminal ilium and ascending colon. Also had a man with a strangulated hernia for 6 years (that's right 6 years). It had necrosed through and he had an iliostomy through the hernia defect. We resected the bad area of intestine and put it back together. Both patients are doing well. Also another mastectomy for cancer. Our total hospital census is down in the 40's from near 80. People want to be working in their field but we seem to be getting more from long distance. This past evening we had a lady that was horned in the cheek by a bull giving a puncture wound and loosening some teeth. There was another ectopic pregnancy with lots of bleeding. Two more prostatectomies today. Also another 13 yr girl with vaginal tear "from a fall." Don't believe that one for a minute. 

 
Thanks to all who donated for sterilizer. Still negotiating on price.

Be sure to read the blog at www.missionarydoctors.blogspot.com about an interesting story how the devil is very involved in every day life and the legal system in Chad.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Love, Rollin and Dolores Bland

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

May 17, 2015

We finally got our first good rain of this rainy season. It was a good soaker perhaps 25 mm (about 1 inch). I think it is enough so that everyone can start plowing with their oxen etc and get ready to plant their crops. We should have about 5 months before next dry season. The humidity is very high like being in a sauna. Maybe it will start to green up a little before we leave on annual leave June 3. At least now we don't have the dust like before.   But now we have the flying termites and ants attracted to the lights at night and can get through almost anywhere. Locals like them as a delicacy to eat.

Dolores is making a lot of baby clothes as we are out of little things to give to the babies born here in Bere Hospital. She is tired of doing mangoes.

Today I had a well dressed grateful patient drive down from NDJ to give me and surgery crew a goat and a bag of rice (75kg or 175lbs). I had done a surgery in Dec on him a bowel resection for intussisseption and he is fine now. I gave the gift to Ndilbe our head of OR and who is getting married in 3 weeks.

Today we had a term pregnant lady brought in that a "house wall fell in on her" Was referred here for her large vaginal "hematoma" she also had some head injuries The vaginal injury was an avulsion of her bladder so must have had a full bladder when the wall fell on her pushing her fetus down very hard or something. She delivered normally here although she was being prepared for a c-section because of her "hematoma" then Danae did a repair of the vaginal wall and bladder injury. Did not believe the story at first as we thought it was another case of vaginal violence but with the other injuries maybe it was true???

This past week we had another strangulated internal hernia with about 2.5 m (about 8 ft) of dead upper intestine which had to be resected. So far he is doing well. Also a perforated gastric ulcer that was almost moribund on arrival to OR. We cleaned out large amount gastric contents and repaired the ulcer but he died 2 days later.

May is supposed to be slower but so far about same as Feb and Mar.

We are all healthy now.

Our emails are drbland@sbcobal.net and dfbland01@gmail.com
Love. Rollin and Dolores

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

May 3, 2015

We had a terrific wind and dust storm last night then we had a few sprinkles of rain today but it rained mud. For awhile the visibility was perhaps only a 100 meters. One could see the dust in the air inside the house and the dust accumulated on everything very quickly in just a few minutes. A few tree limbs were broken down especially the mangoes. They got a good rain over in Cameroon. At least today was quite a bit cooler not quite 100 F and low down to 85 which had been only down to 90 the past few days. According to the forecast it is going to warm back up the next few days.


We went to a wedding yesterday. The preacher talked for over 1 1/2 hours. The couple sat during the discourse. There was "music" and dancing afterward even though it was at least 110F in the meeting area. The bride is supposed to be sober and maybe shed a tear but I did see her smile once when I took a picture she with her pastor. The bride wore a nice white dress which I understand they often do not. Dolores took some people in our car and got there more or less on time. But Danae, Olen, and I and Ndilbe (surgery tech who is getting married May 29) were quite late as we had to do a c-section before going. They fed everybody rice, goat, chicken, "gatos" (sort of like doughnuts), and a sweet crepe and a few potatoes for us. We were among the special invited guests so we got served first. We passed on the goat and chicken but the other things were actually quite good. I don't think they know what a "honeymoon" is. The wedding was supposed to begin at 0930 and it went to afternoon The groom was one of the employees of the hospital. One of the gifts to them was a big ram sheep.


It is a little difficult to work on vehicles without all the tools you need. Am replacing the brake shoes on the hospital pickup (one side down) but one rear wheel bearing was making a noise and is very loose so pulled the wheel and axle but don't have what we need to get the old bearing out. Am sending it with someone that says they can do it as well as find a new bearing to put back in then we will put it all back together.
We went to Moundou in our 4-runner Thurs to bring back 3 volunteers from there. One is a Danish medical student. On the way we blew out a tire but had a spare to put on then drove into town and was able to find a new tire to put on for 130000cfa (about $260 US). Thankful we could get one. Our A/C had not worked for a time and we found a place to recharge it but it also needed to have replaced a pulley that had locked up but they were able to replace it so thankful that now we have A/C so if we drive someplace it is much cooler.


Had a strangulated hernia to repair Fri night. This past week we had a large prostate abscess although we did not know it was that until we were doing a prostectomy for "large prostate". Had another prostate with a large stone within the prostate which we took out. We also had another ruptured spleen which came in about 30 hrs after an accident. We opened her and cleaned out all the old blood but fortunately the spleen had sealed itself, no bleeding so closed her and she is doing well 4 days later.



The mangoes are getting less on the trees by our house so not so many fall on our roof but there are still plenty from other trees.



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

Happy Mother's Day

Happy Mother's Day to all the mothers. Some will be happy and some will be sad. Did you tell your mother that you loved her? Danae did a c-section 0200 today and mother and baby are ok. Dolores has been a good mother as we have 4 very fine children and 9 grandchildren with number 10 on the way. Of course all are above average.

It has threatened rain but still no than a few sprinkles and higher humidity with the hot air. If rainy season does begin soon it will be worrisome for the local people and their crops. Usually they are already planting by now. Dry season began earlier than usual this time also.

We had another ruptured spleen but did not have to remove the spleen. We also had another intussisseption with a mass in the mid intestine that pulled the intestine down inside the part more distal. We removed about 1 m (about 3 ft) of mid small intestine. She is doing well 2 days post op eating and walking well. All our vessicovaginal fistulas are doing well except one that has redeveloped a leak. I saw one boy with a huge cancer of his leg but his father refused any surgery as it needed AKA amputation so they went home with his huge leg. Had another incarcerated inguinal hernia and another that I thought was a strangulated epigastric hernia but was actually a large nonresectable stomach cancer with nodules throughout the abdomen.

Danae is busy trying to get together her case load for a year until June 30 to present for OB-GYN oral boards that she hopes to take sometime this winter. She has previously passed the written part. I'm glad I don't have to do that.

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

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

The one who manages the blog was out of internet this past week.

Heat and mangoes

It is still hot here with highs about 110F and lows of 85F. We had a few sprinkles of rain so now we have increased humidity. Rainy season should be beginning within a onth in fact usually is starting to green up a little by June.

On our way home in June we will be going through Denmark, Sweden, Norway, and Iceland. It never gets very warm in Iceland so we will probably have to wear all our clothes to keep warm maybe in Norway also. we are planning a trip to Runde Island off Norway coast to see puffins and other birds. We are looking forward to seeing several scenic fjords etc. of Norway. 

 
The number patients in the hospital and surgery has really slowed down now. There are always some malaria patients. We had a little boy with pleural effusion and pericardial effusion which was drained. We plan to take out the chest tube today maybe. We also had a little one year boy with malaria and typhoid being treated for 3 days then had something protruding from his anus and he could not defecate and he was vomiting. He had an intussisseption protruding from his anus that we could not reduce. We took him to surgery and found an intussisseption within an intussisseption partly necrosed so had to resect his terminal ilium and ascending colon and reconnect his intestines. He had high fever pre and post op but I was somewhat optimistic that he might live but he died the next day. Malaria, typhoid, and all this surgery was just too much. We had another leg amputation this time for necrosed diabetic foot.

Dolores is tired of doing mangoes for drying and canning etc. Mangoes are still falling on our metal roof and make a terrific noise when they hit. Now she is making some fruit leathers with mango pulp that she lends up. We have more shade with our house by the mango trees but have to endure the mangoes hitting the roof in mango season.

Our internet is barely functional so hardly ever can get Facebook and things like that but can usually eventually get simple emails.

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
Sent from my iPhone

April 15, 2015

It is tax time and in the stock market the bulls have been running for some time and the US dollar has been enjoying high value but we have bulls running here in Chad also. The dollar will get about 600 francs now instead of 500. But we have real bulls. We had two men that had their scrotum and penis almost pealed about 2 months ago one of which was from a bull goring. Now that same man is in with a goring in his chest with a fracture rib and a sucking chest wound which is now repaired and a chest tube in place. His previous injury has healed although quite a bit of scarring but I think his penis will still be functional. We have had gorings in the abdomen but more commonly in the extremities. The bulls and cows here have very large long horns and they are main beasts of burden pulling ox carts and pulling the plows for plowing the fields etc. They tell me that a good bull or cow is worth about US $700 maybe more so a team or yoke of oxen is valuable. 

We have had 3 more vesicovaginal fistula repairs. A large area skin graft of one week ago on a hip and thigh is looking good so far. Maybe I'm learning more about how to make them take. Also about a week ago we had a man with a necrosed sigmoid colon and about 3-4 meters (10-12 ft) of terminal ilium which we took out and reconnected him. Apparently a strangulated internal hernia. He is doing ok now but long term prognosis is not good with that much intestine absent. We have had two empyemas in kids reqiring chest tubes recently. We have a lady with very large central facial enduration so that can hardly see and nose and upper lip very large. It is not just edema as it is quite firm. Inside her mouth is normal. Is it yaws???? (yaws is a tropical disease same family organism as syphilis) We did an AKA amputation on a boy with a huge tumor probably malignant of his knee. His amputated leg weighed about half as much as the rest of him. It probably is not curative but hopefully help him for awhile.

Dolores is still doing mangoes, drying and freezing and cooking them etc. besides watching grandkids and writing emails to a few that write us consistently.

We are also planning our trip home leaving here June 3 and arriving in Copenhagen the same day. Perhaps spending a day or two there seeing castles in Denmark then a bus trip through Sweden to Oslo, Norway spending about a week in Norway then flying from Bergen, Norway to Rekavik, Iceland and a few days in Iceland then on home June 16. Then we have several appointments with doctors such as the oncologist and ophthomologist, dentist etc. Dolores is getting her cataracts done while we are home and of course getting checkup for her CLL.

Thank you to all who have sent money for our autoclave project.
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

29 March 2015

I made a mistake or I was a fool on the previous blog about getting an autoclave for $2000 US. It was a very small 20L one which is not big enough for a hospital. There is a 70L for $10000 US which is automatic all electric 220v European. We are trying to negotiate for a lesser price but don't know how promising that will be. Everything is very expensive here in Chad. Motor oil 15-40 best grade is $24 per 5L.

We had another ectopic pregnancy today and yesterday (Sat nightd) we had a c-section hysterectomy for SEVERE bleeding from abruptio placenta and dead baby. We had to give her 7 units of blood and today her HGB is 6.4 and she looks pretty good now. Our anesthetist Mason left this morning on their annual leave but he helped us last night about midnight but he can sleep on the bus or plane.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Thanks to all of you

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

27 March 2015

We got our first rain since early October. It was almost enough to settle the dust a little but made it more like a sauna with high humidity but today the humidity is back down below 20%. The low this morning was 89 F. One wakes up in the night because he is dry and need a drink of water rather than needing to go to the bathroom. 

 
Dolores has been slicing and drying them lots of mangoes besides watching the grandkids. She had a birthday Wed the 25th. We had cake and watermelon. Danae made the chocolate cake. Dolores got a lot of "happy birthdays" via Facebook etc. There are not many tomatoes now as it is just too hot. Our papayas are about all gone now also. The mangoes are later this year and are just now coming on good.

A cluster of baby mangoes in mid-February.

Hospital is staying fairly busy esp with maternity and surgery.  Peds and Med is actually down somewhat now.  Had a boy yesterday with a large bladder stone and then a boy that had a bladder stone before and had a surgery in NDJ that left him with a suprapubic fistula and a penis that was almost completely closed. We were able to redo his penis and dissect out his fistula and close his bladder. Also had a BKA leg amputation for a large cancer of her ankle. This week we also had a vessicovaginal fistula repair that was easier than most of them in that it had more tissue to work with. Danae and I do all the vaginal fistulas together. Did a gastrojejunostomy on a lady with stomach outlet obstruction with nonresectable cancer of her antrum of stomach that was also in her periaortic nodes etc but maybe help her for a while. Also did a mastectomy for cancer of breast except this was primarily just a debulking not curative. We have presently 4 in hospital patients that are post op vessicovaginal fistula repairs, two of which we reimplanted the ureters and stented them. So far they all seem to be holding and dry. 

We had a bus accident a few days ago. One person was brought in with minor injuries, one had fracture femur and forearm but stable otherwise and one had a fracture femur, fracture humerus, fx ribs and head injury with blood from ear and divergent eyes. They were brought in by the MCD but both were taken out by the local "traditional healers" witch doctors which seem to have a lot of power and influence. I'm sure the one with head injury would be dying soon.

Our autoclave has been not functioning very well. Sometimes it burns holes in the wrapping and towels and other cloth things. A new one is located in NDJ for about $2000 US. I have sent the money to get it hoping that some donations will cover. Of course we need other things also so money will be well used. Also helping malnourished kids. Any donations can be tax deductible if sent to the Jay Seventh Day Adventist Church, Attn: Gail Hill, 13717 East 390 Road, Jay, Oklahoma 74346 marked "Bere Hospital Project".

We are thinking of going through Denmark, Sweden, Norway, and Iceland on the way home in June. One of our SM's here has a grandmother in Norway who has offered to help make various reservations for us once we figure out a schedule. The airfare is only about $300 more per ticket but of course there will be hotel, bus and train fares but we thought this was as good a time as any for us to do it and will be home by June 15 so Dolores can get her cataract surgery done. Plan to be at the General Conference in San Antonio the first weekend of July also part of the Oklahoma campmeeting in July then of course our 50th celebration July 26 in Jay. Plan to be back in Chad the first part of August. Hope to see some of you along the way.

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

March 13, 2015

It seems as if everything keeps going about the same except the usual problems. It is still dry season and quite warm now. Today the dust which infiltrates everything has increased again but that shields out some of the sun so maybe will be a little cooler. Visibility is less than 1 km (about 1/2 mile). The dust makes the voice more raspy especially if you are trying to sing. 

We are just now receiving Christmas cards and letters which we always enjoy. We especially enjoy all your emails and just knowing that you know and care about us out here. Linda, Gail, and Tina we hope you can email us as we don't have your email addresses. 

It has been challenging putting in a computer system. It has taken a lot of time to teach employees how to use it. It is used primarily for prescribing medicines, hopefully to prevent some of the theft problems. Patients are to pay for their meds as they get them, also pay for surgeries (maybe $100) before surgeries are done at least the elective ones. The software was created and donated by Dr. Dirk Wonderlich from Germany. Olen and others have spent quite a bit of time getting it initiated. We have a SM from Walla Walla University that has helped a lot. 

We had one day that we had 3 mastectomies besides some usual hernias etc. We did another mastectomy today. One lumpectomy was fibrocystic disease but others appeared to be cancers. We also had a little boy that was full of some sort of retroperitoneal cancer. Also had an AKA leg amputation for an infection that had necrosed his foot and leg yesterday. Last week we did a thyroid mass which about 10 cm diameter. Also we had a hematocolpos with imperforate hymen (Her menses could not get out because the vagina was obstructed) We are doing surgeries side by side in one small OR so that we don't have to work quite so late at night and yet get most of the waiting list done. Have not seen increase in infections with that arrangement.

Three munchkins enjoying life

Dolores has not had any more chest pain problems since coming back from her check up in the USA. She is quite busy keeping up with the grandkids:  Lyol, Zane, and Addison.
We still plan to be back in the USA June and July perhaps going to at least part of the General Conference and the Oklahoma camp meeting.  Our 50th wedding anniversary celebration on July 26 in Jay, Oklahoma. We would like to see some of you there.

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

March 1, 2015

Dolores was having chest pain Jan 24 and 25, but no more until Jan 30 Friday morning when she awoke with it a sharp dull pain in the left chest so she even agreed that it needed checked out; and she is past 70. We flew in the mission plane Fri afternoon to NDjamena and got a flight on Air Morocco early Sat morning to New York and then US Airways to NW Arkansas where our daughter Danita works in the ER at Washington Regional Hospital arriving there by midnight Sat night and was admitted to the hospital early Sun morning. (Thanks to Olen for spending lots of time with a travel agent etc working out the details) She had the full workup with blood work, CT's, EKG's, nuclear med; cardiac stress test and found no evidence of ischemia and had an ejection fraction of 73 which is very good. She does have an elevated WBC with 80% lymphs so had a flow cytometry which was not fully diagnostic, then had a bone marrow but found nothing that requires any treatment so was given all clear to go back to Chad. Chronic lymphocytic leukemia sounds bad but usually requires no treatment for years, maybe decades. We had told the various doctors etc that we had a return ticket to Chad on Feb 18 so they did the work up as rapidly as they could. There was a lot of ice and snow but fortunately the hematologist did not close her office and we were able to get to her office on Feb 15 through the ice to get the reports that everything was ok. We have another appointment June 24 for a check up when we go home on our "annual leave". We don't know yet if this trip is "medical leave" or part of our "annual leave" as it seems there is not a clear policy on that for IDE's (interdivisional denominational employees). 

This trip certainly was not what we would call a vacation although we did tour Casablanca for a few hours during a layover on the way back to Chad. Air Morocco only flies 2 days per week to NDJ so we were fortunate but they don't seem to partner with anyone so we had to pay domestic baggage fees in the USA for our baggage especially on the way back. We barely made the connection in JFK as we had to claim our baggage then recheck it in each way. It involved getting our baggage and going to another terminal but an angel (an operations officer of Air Morocco) was also going to this other terminal and helped us to get to check in with only 3 min before closing the check in and we were the last onto the plane as they even helped us get through security to the head of the line. Otherwise we would have to layover either in New York or in Casablanca for 5 days for the next flight to NDJ.

We are safely back in Chad and back to work doing lots of surgeries etc. We had a lady that we took out a 17.4kg (38 lb) ovarian cyst last week. 

Boko Haram so far is quite a distance from us and has been repelled by the Chadian army thus far. Ebola seems to have quieted down. It is very dusty and warm here with high of 100F and low of 70F.

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

January 18, 2015

It is still "cold" with lows down to 50F but the dust is clearing so maybe it will begin to warm up a bit. The humidity is very low so things dry very rapidly. 

 
The busy season has finally struck for surgeries. We did 51 Monday through Friday which involves some long hours. Most of them are hernias and hydroceles but a few hysterectomies and appendix, etc. Had another with calculi in his bladder and penis. We had an intussisseption, a strangulated hernia, and a ruptured liver abcess today (we thought it was a bowel perforation at first but could find none anywhere). 

 
Danae and Olen have been busy trying to take care of some thief employees. It is amazing that the hospital has been able to stay solvent with so much that was being stolen. One main person was one that had helped catch the previous administrator with his large amount of stealing but now this one was doing just as much. I guess he let the devil get into him as he had said almost a year ago that someone had put a curse on him and he was afraid.  He was acting strange many months ago but thought it was anxiety which maybe it was in that he was afraid he would be caught then. The Lord has blessed this hospital in spite of all the problems. The stealing was from patients not from donations. When Jesus was here on earth he cleaned out the temple which had been made into a "den of thieves" but was to be a house of prayer. This is God's institution. Maybe we are not praying enough. Paul says to "pray without ceasing" which of course mneans to be in an attitude of prayer and talking to God all the time as our closest friend. "Resist the devil and he will flee from you". The devil has lots of power and control of many peoples lives. Many here wear some sort of amulets to keep the "evil spirits" away. Back home in the USA the devil just works in different ways but comes into most homes through the "one eyed monster" in the living room or he just keeps us so busy that we leave out God in our daily lives. 

 
Continue to pray for us and God's work. When are people going to be truly converted and be ready for Jesus soon return both here and back "home"?

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
Blog www.weareamissionarybland.blogspot.com

Cadeus

It does not seem possible that we are starting a new year.  Here the main cadeau (gift) giving is at New Year's, also asking for cadeaus.  There was not anyone at our door like last year singing then asking for cadeau.  Most o your good resolutions are already broken probably by now that we often make to begin the new year.  But we can still read our Bible daily and maybe I should be studying French more diligently. 

Our total surgeries for December was down compared to last year 145 to 128 but it seems we had more big cases including several bowel resections for various reasons.  Our last week had a spleenectomy in a 3 yr old for a ruptured spleen from a motor accident.  He also had head trauma but after giving blood to him and doing the surgery he is doing ok.  Also had a ruptured appendix that had abcess under the liver with his cecum there but incidentally his right kidney was down in the right lower abdomen feeling to palpation like a mass maybe a walled off appendiceal abcess.  We also had one with urinary retention with large prostate and another with urethra stricture.  Another little boy had a large stone in his proximal urethra which we were able to push back with difficulty into his bladder where we had opened it and removed the stone.  We also did a fasciotomy on the leg of a baby that had been severely burned.  Initially the foot appeared white and dead but after a few leg splitting incisions and one in his foot, the foot pinked up some and had a small amount of bleeding so hopefully save his foot although may lose his toes.  We had a bowel obstruction of the very end of the terminal ilium with a band that required a plasty to open the obstruction.  The little girl with arm amputation at the shoulder for cancer of the humerus is doing ok now.  We had a patient die from rabies that had been bitten by a cat a month before.  Cats don't normally carry rabies.

Our total census has been past full lately.  In fact on 30 Dec we had almost 90 in the hospital but bed spaces for less than 70 but we add beds to the veranda and they sleep on mats which some of them prefer.  We also have beds in the building that eventually is to be pharmacy and lab.  The new maternity is not open because it is not finished with electricity and plumbing which would add some bed spaces.  The new private wards have the same problem.  There was a run in maternity with 14 deliveries in one day.  Every service had lots of patients but today the census is down somewhat. 
We are heading into the usual busiest time of the year especially for surgeries.  Last year we had 200+ surgeries for Jan.  We have a new Chadian doctor here with us that is sort like an intern.  He needs lots of experience and guidance yet.  Hopefully eventually he can do a lot of the care.  He is supposed to be eventually in Abeche with Dr. Appel. 

Dolores is resting up a bit after her marathon sewing of all the choir robes for the church.  Now she is "just taking care" of the grandkids.  Danae has been very busy with maternity lately.  We are all healthy presently. 

We are almost out of medicines for malaria especially the pills and there is none to be found in the entire country.  We still have some injectable quinine, injectable artemeter, and fansidar.  The head of the central pharmacy for the country probably did not order it in time from whereever and yet they won't let hospitals order or import meds on their own schedule.  There are almost no meds for hypertension except atenolol and HCTZ.  We have no ivermectin for filaria and some other parasites now either.  We do have lots of albendazole.  Different anesthetic agents are hard to get or impossible to obtain so we work with what we can get. 

The "harmattan" dust has really moved in with the north winds.  The visibility is less than a kilometer but it shields out some of the sun so it is cooler with only about 80F for high and in the 50's for lows.  One can wipe the dust off something and it will be covered again in not very many hours.

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
Blog  www.weareamissionarybland.blogspot.com