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