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