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