Dec 25, 2016

Merry Christmas to one and all.   Hope each has had plenty of good family time and great feasting.   
Today we had a laparotomy for a man that had been stabbed two times in back and flank so lunch maybe waited a little then we had a white elephant gift exchange which was interesting and fun.   Olen got Danae a donkey which she wanted.   I hope she likes it when it does its morning braying at 4 am.  The camel is at least quiet.  .   Also got a little hedge hog which is quite cute.   I hope it survives the dogs and cats and kids.  Two days ago we also had a man stabbed in flank which we examined under anesthesia and his wound just went through a lot of muscle but not enter the peritoneum.  The one today went just posterior to the colon and along the edge of kidney and did not penetrate any intestine or stomach or spleen.   Possibly could have injured the tail of pancreas not sure.   Both are doing ok so far.   

Have recently started another group in a farther out village Moundala that has a good group of adults and children that are attentive and interested in the Bible stories and studies.   Some of them can read and want a Bible so hoping to get a few for them by next week.   Pray for them that the interest will continue.   
Yesterday there was a campmeeting at Bendele and also a baptism for 43 at the river.   One was a Fulani man and also two of his nephews  He has been through a lot to become a Christian including being ostracized from his family.   It is difficult for a Moslem to become a Christian but some take that step anyway.  He is strong and energetic and will be a good worker for God.  
We need to be thankful for the freedoms that we still enjoy as many do not have them and even in America many are being lost.   Pray for our country and for those that want to become a follower of Jesus.  
Have a happy and prosperous New Year as we are one more year closer to Jesus soon coming.  

Our emails are  drbland42@gmail.com and dfbland01@gmail.com.

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

Dec 22

Dolores has been busy baking and cooking different things for this coming weekend to try to make a little Christmas cheer for all of us especially the grandkids.   We are not traveling anywhere (no where to go to)  as many of you will be doing.  
Danae and i have done 2 vessico-vaginal fisutula repairs this week.  We have had a few other minor surgeries and some usual things such as hernias and hydroceles.   I did a flap reconstruction covering for a penis  that appears to be doing ok.  He had lost almost all of the skin of his penis and most of scrotum from a severe necrotizing infection.  We also did a pinch skin graft to a leg that had been severely burned on an exhaust pipe of a motorcycle.  Overall it has been slow lately as far as surgery is concerned but probably will pick up in a week or two.  
We are all well..  The camel and dogs and cats are well also.  The grandkids of course are excited about Christmas gifts that they might get.   
Out here there is almost no commercialization of Christmas as there is back in the USA.  There is more to do about New Years than Christmas.   Many people know nothing about Jesus and the plan of salvation.  
Our other children and grandchildren are getting together today at Janelle's in Oklahoma City.   At least last year we were all together for our 50th wedding anniversary.

Our emails are  drbland42@gmail.com  and  dfbland01@gmail.com.  

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

Blog 12 Dec 2016

It is cooling down here so only in the 90'sF highs and in the 60'sF lows.   It is somewhat dusty but will be more later when the "harmattan" moves in from the desert up north.

  
Danae is doing ok today but had severe vomiting and diarrhea a few days ago requiring a lot of IV fluids. (see Olen's blog   www.missionarydoctors.blogspot.com)    Her vision is about same and with dark glasses does not bother her very much in bright light.  Vision ok in dim light.   I think they came up with "Acute zonal ocult outer retinopathy" as her diagnosis from all her super specialists etc at the Univ of Maryland which they really don't know what it is or cause or treatment or prognosis.   It has not gotten any worse so far.   Several of us have had the gastrointestinal upset with nausea or diarrhea probably a virus but nothing like Danae had.   Dolores had the malaria last week but is ok now except for a headache today.   The kids are all fine now.   
We have been enjoying the papayas from our trees in our yard almost more than we can eat but goes good in fruit salads and for the kids also.   The mangoes are blooming a lot now.  The guavas are past.   They are still bringing us fresh tomatoes to buy which are quite good.  
The hospital census has been variable mostly 60-80.   The surgeries have not increased as much as normal for this time of year although had 22 the first 3 days of last week.  Had a large 2 cm perforation of intestine from typhoid last week that we had to repair but he is doing ok now.   Also had two appendectomies which is unusual especially one that was not ruptured yet.   Most have already formed an abces.  We had a fistula repair bladder to uterus-cervix.   We have one man that had a severe infection of penis and scrotum losing skin of penis and part of scrotum.   I plan to do a reconstruction of his penis with a flap of skin from scrotum and another flap to cover that area.  
We have no student missionaries this year.   I guess they are afraid of possible danger from Boko Harem although we think that is very minimal.   It is probably more dangerous in some of the most dangerous cities in the USA such as St. Louis, Kansas City, Springfield,Mo, Detroit, etc.

  
Our emails are drbland42@gmail.com and  dfbland01@gmail.com.   
Have a great Christmas and New Year!

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

It is holiday time back in USA with Thanksgiving tomorrow and Christmas in a month but it does not feel like holiday time here.   It is about 100F in the daytime and dry and dusty although we had a 0.3 inch shower a few days ago which it is not supposed to do in dry season so for a few days humidity is high.   We are going to have a Thanksgiving meal about 1500 tomorrow with several local people invited.  
Danae and Juniper are back here now as is Zach Gately.   They all seem to be in good health.  Danae still cannot see part of visual field right eye in bright light but otherwise ok.   She did surgery today with no problems.  The problem affects only the cones of the lateral part of her right eye.    All the big specialists and tests in the University of Maryland in the US did not find a cause or treatment "possibly a virus".  Anyway we are glad it was not a tumor or aneurysm or anything real serious.   Not enough problem for disability.  Ha!!
Last week we had a ruptured spleen from a moto accident that we did a spleenectomy on but now is doing well in fact eating and drinking and walking on 2nd post op day.   He lost a lot of blood.  The man with two gun shot wounds through his left chest now has a severe infection draining lots of purulence but I think he will survive.   Today Danae and I had a hysterectomy also a myomectomy (taking out large fibroids from her uterus so hopefully she can have a baby being she has not had one).  We also had another mastectomy for cancer last week.   Today we had a child with severe respiratory problems with wheezing etc. that would not respond to steroids, ceftriaxone, magnesium, albuterol, oxygen, ketamine, IV fluids, etc.  Don't know if she will survive but appears doubtful.

  
Have a happy Thanksgiving and don't watch too much football or spend too much on "black Friday".   We do have a lot to be thankful for. 

 
Our emails are  drbland42@gmail.com and  dfbland01@gmailcom.  

Continue to remember us in your prayers.

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

9 Nov 2016

Danae and Juniper left early Sunday on a bus to  NDJ to catch a flight to DC, USA because Danae noticed a medial visual field defect in bight light Sat in her right eye.  

Olen and I did not detect anything unusual in her fundiscopic exam but it was non-dilated exam.   They arrived in DC early yesterday Tuesday morning and appointment to get MRI of head.  She is to get results today Wednesday and see a neuro ophthamologist today(Thursday).   Meantime Juniper is sick and was admitted to the hospital with fever,  possible malaria  They are at the University of Maryland hospitals  (later: MRI is normal, no evidence of MS or tumors)

Since Sat night we have had lots of Gyn cases here.  I have done 2 ectopic pregnancies, 2 c-sections (one for ruptured uterus and completely open bladder and one for transverse lie), 4 curettages (one for one of the largest molar pregnancies with over 4 liters of material), 2 for incomplete abortios, one for retained placental fragments ).  

The for 3 day post partum superior artery part of intestine volvulus that was necrotic and was resected is not doing well.  

Recently we had a man with left chest gunshot entrance and exit wounds x2 (somehow missed his heart) with pneumothorax and lots of subcutaneous emphysema (air under skin)   A chest tube was placed and he is doing well.  He was shot by police when he was "in a fight with someone".  

We recently had an AKA amputation above knee on lady that had just had bare bone below her knee.   She had gotten her leg caught in a belt on a power thrasher a few months ago and had been in another hospital.   Also recently had a ruptured gall bladder that had a very thin wall but necrotic part of wall that at first thought was from a perforated gastric ulcer but could find none and patient did well post cholecystectomy.  We did have a perforated gastric ulcer yesterday.  We have an ileiopsoas abcess to drain. 

Today we saw a boy with a hernia from a bicycle handle bar jabbing him in the abdomen.   

We have had a lot of abcesses lately in various places including neck, chest, thigh, labia, leg, arm, etc.  One boy died today with abcess of arm and thigh that began bleeding various places apparently septic in spite of antibiotics.

   
Dolores has had pain in her right knee that extends into her thigh and inner lower leg almost the whole time since we have been back here.   It gets better with rest and less pain if standing.  It seems muscular but sometimes it seems to be joint.   Is taking ibuprofen and paracetamol to rest.

Today our computer system has totally quit.  Olen has tried different things but no avail.  Zachary Jensen maybe can help via phone as he helped install it and to fix problems before.   He is 9 time zones away.
Today is a bad day with computer system failure, Juniper and Danae not well and long way distant, and Trump elected president of USA.  He seems to me to be the most vulgar, anti-religous freedom, bellicost, isolationist, anti-minority, non loyal to international friends, etc. man ever to be in that position.  

The "last day movements will be rapid ones" 

 
Our emails are drbland42@gmail.com  and  dfbland01@gmail.com
Continue to remember us in your prayers.

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

Blog 23 Oct 2016

We have been back in Chad over 2 weeks and have been busy although not sure what has been accomplished some times.   Our hospital census has been 80-90 esp this past week.  The government employees have not been paid all their salaries so post office, hospital and health care, courts and various government offices are on strike.   Of course the military is getting paid so they are not on strike and there are still many military check points.  Some of our increased census from that and some from this time of year when they are harvesting their crops and have a little more money to spend.   Some of you saw some of our pictures from Europe on Facebook that Dolores posted.  
It has not rained more than a few drops this month and we don't expect any until next May.  It has been in the 90's most days and 80's at night.   The rice crop does not look very good as rainy season was not as much as usual.   Everything is drying up rapidly.  
A few days ago we had a lady with acute abdomen 3 days post partum and resembled a ruptured uterus but when we opened, the entire intestine appeared dead at first but more exam revealed that it was a volvulus (twisted bowel so no circulation) involving the entire superior mesenteric pedicle.   We took out the dead intestine and reconnected the jejunum to the terminal ilium (upper intestine to the lower part).   So far she is doing well but not sure what will happen with the "short bowel syndrome".   We had a 10 yr girl with 3 typhoid perforations and abdomen full of bowel contents.   We repaired and irrigated a lot and so far it appears that she will live.   We have had some bladder stones one that was 6-7 cm (about 2.5 inches) diameter.  We took out a prostate that was same size as my fist and so far doing ok.   We did a BKA (below knee amputation) on an old man that previously had a partial foot amputation but now foot all dead.   He has given up and refuses to eat or drink.   We have had a ruptured uterus recently.   Danae and I did a vesico vaginal fistula (hole from bladder to vagina) repair that was quite challenging.   We always do those together.  
The brakes went out on our Toyota pickup Sab while I was driving back from branch Sab School.  Today I took it apart and found that the wheel cylinder and caliper are bad.  The sandy much and water really does a number on vehicles.  IT only has 45000 km (about 28000 miles)   I need to check all the other wheels also.  
We have two family practice doctors here from Juneau, Alaska for this week.   They were in Moundou last week.  One of them had been here before.  
Our emails are drbland42@gmail.com and dfbland01@gmail.com  
My yahoo account got messed up and can no longer access it.  
Rollin and  Dolores Bland 
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile,  Chad,  Afrique
Blog  www.weareamissionarybland.blogspot.com

Arrive

We have arrived in Bere. The rainy season is about over and the roads are drying up although we did have one water hole in the road that the water went over the hood of the pickup. 

It is 95 today. It probably got down to 90 last night in NDJamena. We left Jay Monday afternoon and drove to OKC and stayed at Janelle's place; then Bob Schaefer took us to the airport in OKC Tues. We arrived in WDC 9:00 pm stayed in Holiday Inn and left Wed on Ethiopian Airlines arriving in NDJamena via Addis Ababa Thur noon. We stayed overnight in NDJ after changing some money to cfa (francs) and doing some shopping.  We took the bus today Friday Oct 7 to Kelo where Olen met us, and brought us to Bere.   

The trip was unremarkable other than TSA (probably the one in WDC) went through at least two of our suitcases spilling nuts out of a double bagged sack etc all through the clothes and did'nt close the duffle bag properly. Not sure if much is missing but seems like most things are present. Of course we had to pay for extra baggage (two each allowed for international) $200 each for two plus $200 for the extra 16 lbs that one was overweight. 

We are in good health and Olen and Danae and kids are ok now also.  All government employees except the military are on strike so schools and hospitals etc are closed except non-government ones. The strike is because the government has not paid them and says there is not enough money. Don't know how long that will last. Could get interesting.  

They say the rains were late coming so the rice crop is spotty. Some fields look ok and some not. 

They say the problems with the "prefet" are being resolved. He has irritated enough people including his superiors so maybe they will get rid of him or transfer him somewhere else. 

Please note that my email has changed to: drbland42@gmail.com  
Thanks for your prayers
Rollin and Dolores Bland
Hôpital Adventiste de Bere
52 Boîte Postale
Kelo, Chad, Africa

The life of a foreign missionary is often glorified in various stories and problems are not mentioned. Yes there are rewards sometimes but sometimes one does not see results that are good. Sometimes it just seems like "work". We see lots of interesting pathology in the medical work but after 100's of hernias and hydroceles, etc it becomes a blur. A "missionary" in a foreign country has to be adaptable, flexible, patient, and know why you are there. 

One has to deal with thieves that were people you had trusted. It seems that some think that foreigners are made out of money. Loans often become gifts because they usually are not repaid. Some steal from school accounts as parents pay for their kids school. Some try to take bribes from patients at the hospital. Often in the government hospitals patients have to pay extra to the nurses and lab people to get the care that is already paid for and we try to prevent that here. Since we computerized the med ordering here we think it has decreased some of the bribery and stealing. It seems crazy that they can sue you for lots of money after they were fired for stealing lots of money or not doing their work. 

One has to make do with equipment that does not operate properly. Many of the surgical instruments don't clamp or hold as they should. Many drapes have holes that we try to match with other drapes with holes in different places. The good drapes tend to develope legs. The autoclave sometimes will burn the cloth wrappings. The electric autoclave takes so much power to use so is not hooked up yet. One has to be inventive at times to get things done with equipment that was supposed to be for something else. We do have an operating room light now whereas initially we had to use a head light which gets very hot and uncomfortable. There is no public power so one has to hope that the generator keeps working but sometimes it does not. If no electricity then no water as the water pump is electric. It is difficult to get parts for generators and other things. Sometimes people send stuff that didn't work properly for them so "donate it to Jesus". "Junk for Jesus" which unfortunately costs good money to get shipped here. Our gloves often have seen too much heat or something on the way to Chad and tear easily or stick together or were defective manufacturing. Almost everything comes from China or France. 

Communication is a problem although now we do have some semblance of phone and internet service part of the time, but very slow. Some places in the cities have good phone and internet but not good here in the rural area. Not able to get on most web sites and not able todownload pictures unless they have been downsized a lot. Not being able to communicate with the many different languages here is a problem but I have not even learned well the official language French either, so I am handicapped.

Then there are the various diseases that you don't have to think about back home. Of course malaria is the big one in the tropics and can be fatal if not taken care of properly. Typhoid is common but there is vaccine for it but it is not 100% effective. Most of the locals have not had the vaccine. There are many different parasites and bacteria that can give diarrhea or many other problems. One has to take these awful tasting meds every so often for the various problems. HIV is very common so if one gets a needle stick may need to take the HIV meds for awhile which make you feel bad. 

Transportation can be a problem as there are almost no roads that have ever ever been graded here in Chad and central Africa. There are just ox cart trails and if there is much traffic the water holes in the trails get pretty deep especially in rainy season. Often in rainy season one cannot go on the "roads". The "moto" (motorcycle) is probably the most dependable to in some places other than ox cart especially in rainy season. Large trucks can go only in dry season. 

Getting meds is a problem much of the time. In Chad the government mandates that all meds come through the central government pharmacy which often does not have sufficient in stock and lots of meds not available at all. We are not permitted to import our own. Also the government mandates that all medicines that are past date or even short dated be thrown away which is crazy. Even though lots of studies including the US military show that most medicines are good for years past their dates. Lots of perfectly good meds have been dumped but they come around inspecting to see if you have any expired meds. There are very few blood pressure or diabetes meds even available. I've even heard that in some other countries perfectly good donated food was dumped because it "might be contaminated with GMO food" instead of giving it to people to keep them from starving to death. Ignorance kills so many people. 

Nursing is not what you would expect. They often or usually sleep on the job esp at nights. There is almost no communication between shifts. Hopefully, meds will be given the same day as ordered but often is not.  Knowledge is very basic or minimal. When a patient leaves the OR they are almost on their own but usually have relatives to help care for them. Basic math is lacking in many staff. 

But in spite of the problems it still is a great and challenging life and helps to develope your character . The Lord does truly take care of us through various problems. The Lord is good. 

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

July 17, 2016

It has been relatively quiet this past week. Although two of the volunteers were detained and had to pay 3000 cfa "fine" for riding as 2nd passenger on a moto. They had walked almost to the market then was offered a ride then was stopped at the market. Later Olen was talking to the commissair (head of he area police) and found out that the ones who collected the "fine" did not have authority to do so. The commissair was going to "talk to the prefet about it" Haven't heard any more. Incidentally the "prefet" is still around so the rumor that he was sacked was not true.

We had a man come in with a partial obstruction intestine with history of previous surgery elsewhere for a "cancer of the cecum". Not sure what surgery was done. Did not find any evidence of cancer anywhere even though he had been told it was in his liver and kidney also. But now he was obstructed at the cecum and had lots of adhesions. Probably was appendecitis and now was scarred down. We took out his cecum and terminal ilium short amount and reconnected his ilium to his ascending colon. He is doing well post operative. The other man with strangulated hernia and dead intestine that we had to remove is doing well. A man with a neck abcess that was actually improving just gave up and refused to eat and drink even with IV fluids and finally died. We had a thyroidectomy and some hernias and prostatectomies that are all doing ok. We had another 1.7 inches (about 42 mm) 2 days ago so over 3.3 inches this past week.

Dolores has an eye infection that has been painful but hopefully is improving. Addison and Juniper had some sort of eye irritation also.

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

July 25, 2016

Monday the 18th we had a strangulated inguinal hernia (did not require intestine resection) and also had strangulated internal hernia that had dead intestine that had to be removed. Also had a sigmoid colon volvulus (colon twists on itself and shuts itself off) All that was besides a scheduled hernia repair. This past week we also had a parotid mass that was mushy and very vascular and we did not get it all out as too involved with other structures and probably was a cancer. We had done her thyroidectomy previous that was possibly malignant and she had done well with that. In general the hospital has been slow except Pediatrics but even that is not as much as some previous years. We have a Pediatrician from Brazil that is taking care of Pediatrics for the next 2 months. We have a couple (Eddie and Carolina Perry) here this past week that want to start a clinic in the Congo. She is finishing a FP residence with some tropical medicine and he is doing ER work. They hope to go in the next year or so. 

Our computor system has quit working so have had to go back to the writing out things on paper. Olen has spent lots of time with it and texting Zachri Jensen in Washington to try to get it going again. The computer that was using for server does not seem to cooperate. I am computer challenged so am no help.

Our generators all seem to be in good working order now. Had problems with a frequency sensor that was not adjusted right also a fuel filter problem but all seems ok now.
Everything is pretty and green now. Dolores' eye infection is much improved. 

Putin recently signed into law that no Christian Bible studies were to be allowed even in homes. The window of opportunity for Russia is almost closed. The USA recently passed laws that will make it difficult for Christian schools and institutions to operate. Many of the Moslem countries have laws against Christianity and so difficult to tell the story of Jesus. We hear various ones talking about possible world financial collapse. The end surely must be near. What are you doing to let people know about the soon coming of Jesus? "Even so come Lord Jesus"

We will be gone on vacation annual leave the next 2 months leaving July 29.
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

July 10, 2016

Olen, Danae, Lyol, Zane, Addison, and Juniper all arrived back here Friday evening July 1. So glad to have them back. Addison and Juniper have had a fever. Not sure if malaria or just some virus. They are being treated and are doing ok. Our hospital census is up especially in Pediatrics which is usual for July. Lots of malaria and typhoid. We have a pediatrician from Brazil for 3 months so she is taking care of Peds. We also have a medical student from Loma Linda and an OBGYN from Texas (friend of Danae's) and a Family Medicine from California for a short term visit.

Last time I mentioned the "prefet" was here with his military and guns snooping around the hospital looking for expired meds that he said we were killing people with. In fact there is no evidence that any expired med has killed anyone and previously we had gotten rid of expired meds but he also calls short dated meds the same way. But the next day he went on the local radio and then national radio in NDJ saying we were killing people by selling expired meds. For whatever reason he does not like "Adventist". Then the same week the regional Delegae (government doctor over this region) came with his entourage looking everywhere in the hospital even in some back dark corners and said he found some expired meds and "verified" what the "prefet" had said. The Delegaie's visit, including 2 hours of meeting after the exploration, lasted most of the day. The local MCD (government medical director for the area) accompanied both visits and only referred to me as "the old man" or "that old man". The Delegae never acknowledged that I was even present even though I accompanied them most of the time. They were very negative about Olen and Danae about them "not being cooperative" and telling the MCD when they were coming or going etc which actually was not true at all. They knew Olen and Danae were not here then so they came then. The Delegae kept saying that Olen and Danae or the administrator were not in charge of the hospital but the MCD is to be. Today I hear that the "prefet" was sacked and he is not in his house. I don't know if this is true or not.

Today we had a strangulated hernia with dead intestine (terminal ilium, cecum, and part of the ascending colon) that we had to take out and reconnect the intestines. The maternity has been fairly quiet since Danae returned. We had plenty before. We had 4 different patients with bladder stones this past week.

We have had no rain the past 2 weeks and some of the grass is starting to wither or turn brown. It is supposed to be heart of rainy season now to bring up the crops especially the rice. It could be bad if it does not start raining although it is nicer for the "roads". Tonight we got 1.6 inches (40 mm) of rain so better now.

Is it true that Donald Trump states he would make all who claim to be Muslim register in some sort of national data bank? Could it be extended to another minority group also? It sounds dangerous in America.

Jesus will soon come to take His people home. The signs are all around us. Pray that it will be very soon. Pray for our situation here 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
Blog www.weareamissionarybland.blogspot.com

June 20, 2016

It is pretty and green with grass greening and needing lawn mowed, and most people are out plowing and planting rice, millet, cotton, beans and peanuts etc. We had about 4 inches (about 254 mm) last week. The "roads" are with deep water holes and mud. So far most of the water holes are only 12 inches deep but that will increase with more rain. 

 
Some days we are busy and some not so busy with surgeries, consults, and maternity etc. We were having generator problems everyday for awhile but that seems to have straightened out somewhat now. There are quite a few on medicine service now. Friday eve I picked up Zach at Kelo after he had returned from NDJ on some hospital business. The drive to Kelo is about 1 1/2 hrs even though it is only 45 km (25 miles) The bus from NDJ was late so we got back from Kelo about 2200. Then at 0200 had to see an OB with previous c-section x2 and a small pelvis in active labor so did a c-section and got back to bed about 0500. Then got up at 0630 to go to branch SS at 0700 then to church at 1030. I slept some before and during potluck lunch and in the afternoon. I was feeling weak. In the evening we had a retained 2nd twin with arm presentation in a 18 yr old that delivered 1st twin at home. I finally managed to change it to a footling breech but she was having no contractions and the cervix had clamped down some. Finally delivered with lots of pulling but the retained head took a lot of time. Of course the baby was dead. Sunday morning at 0500 we went to Moundou as I had agreed to do some surgeries there (probably a mistake). I did 4 ortho cases that were very difficult. Fortunately Zach drove the vehicle for which I was very thankful as I was not feeling well and came back in the evening 3 hours each way. By then I was aching all over and had headache and no appetite. It seemed like malaria so began the Malarone and some ibuprofen and wet the bed with sweat. I feel a little better today. I rested this afternoon. No surgeries today or complicated maternity although an incarcerated hernia came but I was able to reduce it so it can be done later. 

 
Today we had the prefet (chief) come by the hospital with a bunch of military and the MCD etc. They went through the whole hospital I think then had an assembly to talk which was another 2 hours. He talked about how bad expired meds were and lack of compassion and not sure what all. Some say he is quite deranged. The MCD gave a power point on free meds and some history of such in Chad. As best as I could tell as I could not understand the prefet's speech very well. Previously they made us throw away a lot of perfectly good meds because they were short dated or past date. Olen has previously presented many studies including some by the US military that show most meds are good for many years beyond their expire date. A lot of this is gimmicks by the drug companies so they can sell more meds but unfortunately ignorance costs lots of money and lives. 

 
We are looking forward to the return of Olen, Danae, and the kids July 1. They have had a nice deserved vacation which one needs after working here awhile. 

 
We recently had an email from someone in Australia that reads our blog. We appreciate emails. It makes life a little easier. 

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

June 14, 2016

There are people searching for something better in life, people who want to learn more about Jesus and the Bible. "God Pods" are an easy way to give the Bible to people that you might not reach otherwise, and a high percentage of people here in Chad are illiterate. However, they can listen to these devices that have recorded much of the Bible, and have their friends and neighbors listen as well. With heavy usage these God Pods last about a year. Some have solar panels on them so they can recharge the batteries. People have come to know Jesus through these $30 devices. Maybe it’s a project that you can donate to. These God Pods can go where you cannot go. They can be recorded in whatever language.

It is very difficult to get Christian literature into this country, with lots of hassles and expense to get it across the border from Cameroon. Everything imported has to come through the country of Cameroon. If we had our own printing press here in Chad it would be much less expensive, and literature could be more available. Jonathan Dietrick here has been working on this project and researching options and cost. Initially maybe a small digital printer (about $3000) could be used until a larger one was needed or replace it. Unfortunately most of them say they should not be used in heat over 90F, so a room would require A/C which would require a generator to run it and the press. There is no reliable public power in the country although some public power is in N’Djamena (NDJ) and Moundou but not reliable. Probably need about $10000 for that.

A window of opportunity is open now for a Christian 1000-watt FM radio station in NDJ. The paper permission work is promised without cost now and the equipment for it has been promised from a donor. That power would reach about 100 km (about 60 miles) radius which could cover NDJ and some of the surrounds. We need a suitable piece of property maybe on the south edge of NDJ. Don't know cost of that yet. Maybe a suitable 1 or 2 hectares in edge of NDJ that could have the printing operation, the radio station, and maybe the mission headquarters together to create more efficiency. Of course need money for the buildings also. The radio station would need A/C also. The main thing that is needed is a person with communication and radio skills to operate the station until maybe a Chadian could be trained to do it. (Maybe a year or so.) The person needs to know French.

Maybe The Lord will impress some of you who read this to help Contact us for further details.

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

June 6, 2016

It was beginning to get a little dry since the last rain one week ago but today we got 0.9 inches very rapidly with strong wind. Everyone is busy working ground and planting. It has really greened up in fact some lawn is needing to be mowed. "Roads" are full of huge water holes now. Mango season is about past. 

 
The hospital has been slow EXCEPT for maternity. I have done c-sections for shoulder presentation (today), ecclampsia, previous c-section for various reasons and prolapsed cord all within past two weeks. Have done a few vacuum extractions in fact one each night past 3 nights. Also have had an ectopic pregnancy, tuboovarian abcess, also hysterectomy for 2.5 kg fibroid uterus. Surgery otherwise has been slow. 

 
Our phone and internet has been totally nonfunctioning part of the time ie. 3 days after the last rain storm but only a several hours today. It is never very good.

I had the talk for church this past Sabbath on "Two Lost Boys" also the story is known as "The Prodigal Son" Those that knew the languages better than me said my translator was not very accurate and sort of had his own version part of the time. 

 
Dolores is on "vacation" now!!! Anyway she misses the kids a lot. They will be back July 1. She is trying to do some sewing and some house cleaning and reading. We are healthy presently although I had vomiting and diarrhea 2 weeks ago and some diarrhea today but seem ok now. 

 
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

May 26, 2016

Rainy season has really begun as it rained 0.8 inches (20 mm) last night and 0.7 inches (17 mm) the evening before. Everyone is happy for the rain and will be busy planting their crops. I saw a few planting a few days ago hoping for the rain. Actually it is beginning to green up a little in the yard already from the previous tiny showers. It was down to 77 F (about 24 C) last night which almost felt cold. 

 
Danae, Olen and family left here early am of 22 May for NDJ so they can get visas renewed and attend an AHI (Adventist Health International) board meeting then leaving NDJ early this am on Air Moroc for France and their Mediterranean cruise, then on home to USA on their annual leave. They are to return here July1. Addison has been very ill with severe diarrhea even some bloody stools but she is better now. 

 
Dolores has a "cold" now probably from Danae and kids before they left. I had severe diarrhea and vomiting one night and day but am ok now. The previous vertigo problem has cleared. Have been busy in the hospital this week with about 50+ inpatient to round on and 3 surgeries each day and consults to do. It should get less busy now that we have had some good rain. 

 
We had been getting our visas renewed each year for a year at no cost but they have changed that now. They will only give visas for 3 months now no cost. If for one year you have to pay about $60 each to get it or you can present documents to show you are needed in Chad such as medical school diploma, medical license, and curriculum vita, etc. We have not done the one year since they changed the rules. Maybe they need more money and think there are too many coming that are not essential. 

 
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

May 10, 2016

We have had some more rain with 0.4 inches one time and 0.3 inches another time. It has soaked the ground down enough so they can begin working the ground for their crops. The humidity stays high most of the time now. Dolores has quit drying mangoes as humidity too high. 

I went with Olen and Danae yesterday to an Arab village way out in the bush about 30-45 minutes away. Actually the trail out there was smoother than the main road. They keep their village neat and clean and inside some of the mudwall houses with thatch roofs was very decorated and nice looking 4 poster beds. It reminded me somewhat of the gehrs of Mongolia. They are of course Moslem but very friendly and and enjoyed having me take photos of them and their houses etc. Olen took Ndilbe with us as he knows Arabic and they talked a lot about the Koran etc. If Christians spent as much time with their Bibles as they do the Koran and prayed as often to God as they do maybe the world would be a different place. But they don't know Jesus as their Saviour. Most of their prayers are ritualistic rather than talking to God as a friend but some Christians are that way also. 

We did a thyroidectomy last week on an Arab lady that was hyperthyroid and large thyroid. Her pulse was 170 but post op was 90. She did well talking and eating normally. Thyroidectomies always scare me even though all of them have done well. Yesterday we did a large left side neck mass that resembled a unilateral thyroid mass somewhat but as we dissected it out, it was a very hard almost like cartilage mass that was right on the carotid artery. It was about 10 cm diameter. Don't know what kind of mass it was. Fortunately it dissected out and off the carotid fairly readily. 

Our new maternity is finally open. The first baby was birthed there yesterday. We have more beds available now but the overall census is down now as rainy season is approaching and everyone that is able wants to get busy with farming. 

Dolores has been busy sewing new drapes for partitions or privacy for the maternity.
Olen, Danae, and kids will be on leave the last of May and will return here last of June. They are taking a week long cruise on the Mediterranean on the way. We are taking our leave Aug and Sept with Aug 1 to Sept 13 driving around Europe in a small rental RV and arrive OKC, USA evening of Sept 13 and leave Oct 4 to return to Chad. Perhaps we will return to the USA more or less permanently about May 2017 but don't know yet. 

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

April 26, 2016

My thoughts about rainy season arriving a bit early have diminished as it has not rained more and it is still hot although humidity has been up part of the time. 

Some have been concerned that they heard that I was ill and vomiting and could not do surgeries. I did have vomiting one day, secondary to severe labrynthine dysfunction which makes you feel as if the world won't stop spinning. It is improved some, but improves with rest. It is probably the variant called BPPV (benign paroxysmal positional vertigo). If I don't move my head much it is much better. Some positions are much worse than others. This condition sometimes can last a month or more but hopefully will clear soon as it is improved already. Don't have any meclizine (Antivert) for it but Benedryl seems to help a little. Basically we are all healthy. Danae has had to take up some of the slack in OR.

We had an unusual case yesterday with a 1 year boy presented with intestine contents coming from his umbilicus and very foul odor for the past week yet he was not vomiting and was eating some. We did a laparotoomy removing his umbilicus which was a strangulated hernia with a strangulated Meckel's diverticulum that had necrosed and sloughed through the skin. Inside his abdomen was clear. Another patient we did an AKA (above knee amputation) for a leg cancer of bone today. Sabbath was a long day in the OR with an OB case previous c-section and bleeding a lot. Lots of scarring and the bladder was in the abdominal wall almost to the umbilicus so the dead baby was delivered "through the bladder" which was later repaired. The uterus would not contract down and had much bleeding and partial rupture so a hysterectomy was done. She had an abruptio placenta so dead baby and lots of blood lost. 

Dolores has been freezing and drying and canning mangoes besides taking care of the grandkids.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com

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

April 15, 2016

We have had several amputations lately. One was a diabetic dead foot so a BKA. Yes there is some diabetes here also. Another was a necrotic hand with severe infection so an amputation midforearm. Another was a dead arm with just bones sticking out and all covered or "dressed" with cow manure. It was amputated mid humerus. We had two strangulated inguinal hernias yesterday. We recently had a 35 day old baby brought in very distended and "had not had a bowel movement yet "but had "passed a little bit of gas." It was amazing that he was still alive. So I thought there must be a little bit of passage somewhere. With a finger or blunt instrument could not find any but saw a small possible passage. I used a urethra guide wire (that was given to me by a urologist in OKC) and was able to pass it easily through an apparrently very stenotic rectum congenital about an inch (2 cm) above the anus. I passed dilators over the guide wire and finally was able to dilate it more with cervical dilators. Immediately he began passing a large amount of stool which he continued to do much of the night. We also have a baby with meningocele that otherwise seems normal. Also an infant with a large mass or lump on her occiput which I aspirated some cerebral spinal fluid from. Maybe we will try to remove and close it. We also have a young man with minimal evidence of trauma to head that is now paralyzed on left side. We did anothyer small intestine resection and reanastomosis for a large obstructing cancer of the intestine today although had large mesenteric nodes. Recently we did an antrectomy (lower part of the stomach) and gastrojejunostomy (hook small intestine to stomach) for an obstructing tumor of her lower stomach. Probably not curative although no nodes or liver nodules. We recently had an Arab lady that we took out a large cancer in her pelvis but could not get it all but in the process her ureter was cut and had to be repaired so we kept her in the hospital a few weeks. She and the family were so very nice. She would always smile when we made rounds even though it was very evident that the cancer was coming back with a vengence. She finally went home and today the husband called Danae saying she had died. The husband had helped Danae with the camel also. Sometimes we are the ones that are helped in some situations.

Maybe rainy season has arrived. It has rained a few times but only about 0.2 inches at most each time but the humidity is staying up much of the time over 50% so the 90F at night feels hotter as you sweat more but don't cool much.

Dolores is still working with lots of mangoes when she is not watching grandkids.

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

April 3, 2016

They say there is a "strike" among the health care workers in this country now because some doctor was fired because of something he did but I don't know the alledged offense. Anyway now we have had a lot of maternity cases the past few days. One was a lady that came with a prolapsed cord for several miles from another facility but the baby was still alive. It was also a hand presentation that maybe prevented the cord from having the circulation stopped. We have had some stillbirths and a ruptured uterus. We had an above knee amputation for a dead foot and leg but had to pack the stump open because of a huge abcess around the femur which will need some time to get rid of the infection before it is closed. Yesterday we had another strangulated hernia but surgery was soon enough so no intestine had to be removed. 

 
The shower that we had only cooled us for a short time and now it is back to 100F to 110F (39C to 43C) in the house in the day time. It cools down to 85-90F by early morning . Of course April is usually the hottest month here. 

 
It is mango season now and mangoes are falling on the ground which means there are more flies now. Dolores is cutting some up to dry now that the humidity is less than 10%. The humidity in NDJ is 2% today. 

Everyone has recovered from their malaria now. Danae had it last week but is back to work now. 

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

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

Miracles still happen. The lady that I mentioned last time that we took the tumor from her wrist and forearm including radial artery, radius nerve, and flexor tendons and had question of her hand even surviving surgery is now doing well. Amazingly she not only has a surviving hand but has function and feeling and can flex and extend all her fingers. Dr. Greg Shank and I did the surgery together and we both thought she actually needed an amputation mid forearm and even asked permission to do so but was refused by her brother (husband was not here). The little girl that we took out a large sequestrum of her tibia is almost healed already. The lady that we did a 3rd ray amputation of her hand healed well; and now a man with a 5th ray amputation of his hand is doing well. Both were for necrotic (dead) fingers. We had another intussisseption a few days ago of descending colon and sigmoid colon down into the rectal colon and could palpate it through the anus. We resected part of the sigmoid colon and split the rectal colon longitudinally to be able to reduce the mass that had pulled the colon down then we repaired and reanastamosed the colon. She is doing well so far.

We are unable to get Facebook most of the time because of the bad internet. Facebook was banned from Chad for awhile because the "president's" boy and some other boys raped a pretty Arab girl and posted a video of it on Facebook. Cannot get Skype. 

I, with prayer, finally diagnosed the problem with my Toyota 4-runner. It would start and run sometimes and other times it would not so was afraid to go anywhere with it. It turned out to be a loose wire to the fuel pump. The loose connection was on top of the fuel tank which is under the back seat. The fuel gauge still does not work but if we keep track of the miles driven that is not too much of a problem. 

Danae's camel is quite obstinate at times. She is not trained yet. They tied a bag unto her back and the camel went crazy bucking and trying to get the thing off. She tries to kick sometimes. 

We had our first rain 2 nights ago. It was perhaps 1/4 inch (about 6 mm) It was still 85-90F during and after the shower. 

We are all healthy presently. 

Today March 25 is Dolores' birthday. Thanks for all the birthday wishes. We are unable to log into facebook presently. We are still young maybe younger than some that don't have as many years as we have. The Lord has been good to us. 

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

March 17, 2016

It is still warm with 100-105 (40 C) in the house in daytime and down to 90 F by morning.  One turns over in bed to change sides that are wet with perspiration.  One wakes up to drink water instead of going to the bathroom.  Fortunately, for me it is about 10 cooler in the OR than outside.  Our A/C is not real good but it helps in the OR.  The humidity is about 7-10% most of the time although it got up to 40% a few days ago.


We had 2 senior med students (deferred mission appointees), from Loma Linda University the past month.  One was Steve Tharp (father was director of Hope TV Channel) and the other was James Fernando (wife is a physician assistant).  One plans to be a mission surgeon and the other a family practide.  We had Dr. Greg Shank here the past 2 weeks.  He is a surgeon from Reedsport, Ore, USA and did lots of surgeries here so I had some time to do other things such as helping David Hendricks with electric and plumbing on the new buildings.  Several years ago Greg spent 5 years in Koza, Cameroon.  (Can not go there now because of Boko Haram)    His wife is a Family Practice doctor.  He came with a man that was to do the "annual" check up on the mission plane.


We heard that a big tumor (16 kg) in S America made national or international news but I suspect there are others especially in Africa that never get reported that are that large or larger.  We had one here a few months ago that was 17 kg but it was not reported to any "news agency."  Very frequently we have one that is 6-10 kg.  We had another sequestrum this time in a little girl in her distal tibia.  She came in walking!  The dead bone fragment was removed and she should do well.  We have had 2 different kids with bladder stones in the past 2 days.  We had a lady with a tumor of her wrist (tumor removed 3 yrs ago) that now returned larger than before.  She did not want amputation of her hand and forearm but probably eventually will need to have that anyway as all her flexor tendons, radius nerve, radial artery went through the tumor that we excised.  Not sure if the hand will survive the surgery.  Don't know what kind of it was but it had a lot of black pigment in it and was somewhat cystic.  Last week we had a forearm amputation for dead hand with maggots in it.  We have a lady with large breasts with necrotic distal part of each breast that needs bilat mastectomy.


The "election campaign" is supposed to kick off this Sunday the 20th.  There could be some demonstrations with a large field of candidates but don't expect any of them to gain much foothold against the present "president" who has help "office" for many years.  Many of the locals call him a dictator.  However the economy is very bad now with low oil prices and many government employees not getting paid on time.  There is "no money" to fix any roads (there are very few roads in the country to fix anyway).  There are still lots of military check points around the country allegedly to prevent Bolo Haram from gaining access.


We are healthy presently.  Dolores is busy working mangoes besides looking after grandkids.


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  

March 7, 2016

It is warming up in the northern hemisphere but it is also warming here also with lows in the 80's and highs 100-105 (about 40C). It is quite dusty most of the time. 

Zane and Juniper have been ill with malaria but are recovering. Almost all the new volunteers have had a bout of it also. Otherwise we are all well presently.

We have had 5 vesico-vaginal fistula repairs during the past 6 weeks. We also had a large brachial cleft cyst in a small child that we successfully removed. We have had 2 perforated gastric ulcers and a perforated typhoid small intestine recently. Also had an intussisseption of right colon into transverse colon, also did a right hemicolectomy as it could not be reduced. We also had an ovarian cancer that we resected,at least debulking that also involved the ureter that we had to stent and repair. Had a 20-year-old with a large sequestrum of his tibia (part of the bone died and sloughed after a fracture). His foot and ankle looked as if it might die but after we removed the sequestrum and began packs and antibiotics it is much improved and now does not appear that he will need amputation after all. 

Dr Greg Shank is here this week doing surgeries so I can help David Hendricks work on electric and plumbing so we can hopefully get into the new maternity by the end of this week. That will expand our bed capacity so we won't have to put so many on the veranda etc. I need some exercise as I don't get much just doing surgery so this helps that way also

My mom's sister died this week in Stillwater, Ok. She was 84 and the last of her siblings and will be awaiting the resurrection when Jesus comes to take his people home with Him. 

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

January 17, 2016

Business here at the hospital has been slower than normal for this time of year. Usually Jan is the busiest of the year with nearly 180 or 200 surgeries etc but it won't be that many this year. The crops were less as the rainy season was less and the oil prices are very low and lots of government workers are not getting paid because no money so the economy is not very good. We have been averaging about 2 prostatectomies per week and we have had several mastectomies and a few vaginal hysterectomies. We have also seen several unresectable cancers of various kinds. We have had several incomplete miscarriages that required curettages. The man that had been shot with a gun in his back was beginning to recover except still had paralysis in his leg; but then he got severe malaria and he died. 

 
We are looking forward to return of Olen, Danae, Lyol, Zane, Addison, and Juniper (which we have not seen yet except in pictures). They should be here in Bere Wed. Jan 20.
A volunteer, David Hendricks, has arrived to be here a few months helping to get some building projects done and usable. We are glad for that. 

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

January 15, 2016

The gun and knife club has arrived in Bere. Earlier this week we had a patient that had been stabbed in the abdomen. It had perforated his stomach and his liver. He is doing well. It seems that his cows had gotten into someone's rice so they decided to punish him. Now his relatives have taken revenge and bought a gun (which I thought was illegal here in Chad to own one) and shot the man in his back. The bullet glanced his vertebra and kidney and perforated intestines two times which we had to repair and then the bullet came out his front. We have had one or two emergency surgeries every day this week. We had a c-section in a multiparous lady with some sort of thick band in the uterus that would not let the baby come through and she had had no previous surgeries. 

It is at least 10 degrees warmer than it has been the past month. Now the lows are in the upper 60's instead of the 50's F and the highs are in the 90's F instead of the 80's. I think the harmattan dust has diminished somewhat and there is less north wind out of the desert. 

When we were in Denmark we were told that there were no guns allowed and that even most of the police did not carry a gun which we could see was fact. Denmark also has health care for everybody at no charge. Norway and Sweden have a very low co-pay. Of course they have higher taxes but when you compute all the extra costs in USA that are not covered with taxes or insurance it probably comes out about the same. In USA we have the greedy pharmaceutical companies and lawyers that drive up costs of everything so much. Here in Chad we have so much corruption but there seems to be some almost everywhere. 

We are well and in no danger that we know about any more than normal.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.

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

January 3, 2016

Another year has gone into history and one year closer to our Lord's return to take His children home. It seems that New Year's resolutions don't get done anyway so why even tell any. Hope everyone had a nice Christmas and New Years with lots to eat and lots of family time and maybe not too much football. 

I spent part of Christmas Day in the OR, operating on a lady with ruptured ectopic pregnancy that bled a lot into her abdomen and almost died but she has survived with the surgery and a few units of blood given. Today was in the OR with a perforated gastric ulcer with lots of gastric contents in the abdomen. Hopefully he will do well. We had 117 cases in the book for December so have been busy besides having to see the major portion of the inpatients. 

We have watched some Christmas movies and it is still "cold" here down in the 50's F each morning with lots of harmatten dust from the Sahara. Also there is lots of pollen in the air as the mangoes are really blooming now. It seems they are blooming more this year than last year. The beautiful red-orange flowers of the kapok tree are beginning to show. Some say that people are giving more attention to Christmas than they did formerly. There were even some Christmas carols (in English) on the local radio station. One of our neighbors (the hospital administrator) had his radio loud enough each morning and evening so we had the "benefit". On Christmas Day we had a late lunch or dinner and the same for New Year's. 

We got some ripe papayas from our trees by our house today. The kittens over at Danae's house are really cute but wild now. Dolores has been feeding them milk, peanut butter balls, and some fish. They are not weaned yet. Maybe Lyol and Zane can tame them when they get here in less than 3 weeks. There are 5 kittens and already 4 are spoken for that someone wants them. They say that the rats are worse this year than most years maybe because the crops are less. 

No more holidays for awhile so maybe we can all get to work. Ha!
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
Blog www.weareamissionarybland.blogspot.com