Sunday, April 9, 2017

A weekend in Bere
We thought we were going to have a slow Friday but then a girl came in "acute ill" with distended abdomen.   We operated and found that she had some kind of retro peritoneal cyst that obviously had been there a long time but needed drained.   It had the appearance of chyle fluid and had about 1500 ml of fluid and we put in a drain.  Then we had another little girl about 10 that had acute abdomen peritonitis with lots of purulence when we opened her but could find no source for it.   No perforation, no lier abces, no pelvic infection etc.  We washed out her abdomen and put in a drain and now 2 days later she is doing well.  What was it??  Then a "maternity case" term pregnancy placenta previa bleeding so a c-section.  
Friday evening about 2300 the lights all went out.   The generator had quit because someone did not keep diesel in the tank.  We got diesel in it then about 0030 lights out again.   The battery was dead and was not being charged.  Actually we jumped it to start it when the diesel was out.  Somehow when the guys were putting the generator back together they did something so that the alternator is not charging the battery and it has to have battery power to run.  Somehow they did that to both Perkins generators and one of them had not had a problem before they began doing their thing.  So after that I started the little Caterpillar generator and it runs fine.  
Then about 0100 or a little after when I had gotten back to bed Dolores said her heart was pounding and racing and irregular and "felt as if I am going to die" and did not want to go to sleep.  The next few hours checked her frequently heart beat etc and used defibrilator as an EKG (we don't have an EKG machine) and she had atrial fibrillation with rapid ventricular rate of 150+.   We don't have adenosine or deltiazem or propranolol so I gave her atenolol 50 mg pill (only thing we had) and her rate gradually slowed somewhat.   I would check her frequently to be sure she was still alive etc.  I had texted Olen who is in Hawaii and we agreed there was not much else we could do except to pray.   I was to go at 0600 to pick up some people for a baptism from Delbian a village 45 min away or more.  I normally go to a "bush church" at 0730.  I got Vadym (a doctor here from Ukraine) to go to those places so I could stay with Dolores.  She was feeling better by church time here so we went to church.   Then there was baptism at the river after church.  She rested in the afternoon.   Sometime in the evening her heart converted back to sinus rythm with rate 64.   What caused all this???   Maybe took an extra dose of thyroid accidentally or electrolytes off with the high heat or ??   She just had her heart checked out 2 years ago with imaging, stress test, etc, and all was good.   At that time she had costochondritis chest pain .  
After we got back from the baptism (18 were baptized) there was a strangulated hernia to do then there was a repeat c-section that was real mess with rupture uterus and bladder and various adhesions everywhere but baby is doing well then after that there was another repeat c-section with uterus beginning to rupture.   Mother and baby are doing well.   About 0300 the lights out again.  Someone had not refilled the diesel in the little Caterpillar generator.  I jumped the Perkins generator and started it (someone had filled the diesel in it)  then ran an extension cord from a transformer for 110v out to my chager and put it on the battery for the Perkins and has been running ok with that.   I have had to see every patient in the hospital each day also as Dr. Tirmo(the Chadian doctor who usually sees the med and ped patients) has been gone since Wed am to NDJ.   We have Vadym and two medical students here.   Vadym can do some surgery and had him do some hernias and hydroceles this past week.   His main interest is surgery.   He is to be in the Moundou center as soon as he feels more comfortable with surgery maybe another week.   Dolores is working on mangoes today.  
This evening a man was brought in with a large hippo bite in his proximal thigh.  One side just missed his scrotum and femoral artery although he had bled a lot and the other side took some muscle from his ilium area.  We closed the torn muscle and packed the wounds with antiseptic.  Hippos kill more people in Africa than lions do.  They can run fast even though they appear otherwise.   
We all seem to be healthy now so keep praying for us.  
Our emails are  and

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

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