Blog Sept 24, 2017

This earth is "waxing old like a garment".  Three major earthquakes in a month hit Mexico.  Another earthquake hits northern California.  Even tremblors in Oklahoma.  Cyclone batters Japan.  Hurricanes Harvey, Irma, Jose, and Maria devastate the Carribean islands, Puerto Rico, Texas, Florida, etc with severe winds and severe flooding.  There have been many deaths in all these disasters.   It is hard to imagine 175 mile per hour (280 km/hr) wind and up to 40 inches (101 cm) rain from a single storm.   
Danae and Olen and kids are all back here now.  Danae is trying to spend as much time as possible preparing for her Ob-Gyn boards that she is to take in Jan.  Olen spent some extra time with his dad after his mom's funeral.  Olen and kids had to take a motorcycle then canoe over part of the "road" to get here.  They are doing some home school for Lyol and Zane.  We are basically isolated here with no "roads" out.   The water is still rising.   But the rainy season should be decreasing soon and then it will turn dry.  The water table is at the top of the ground meaning that the water is at the top of the wells.   We took a ride a little way in a Land Cruiser with Jonathan Dietrick today until the water was hip deep and there were a few km to go on to the main river stream so near the bridge is probably at least 2 or 3 meters (6-10 ft) deep.   Hopefully we won't need to go anywhere but that is probably the main reason the hospital is slow because the patients can not get here except by canoe or ox cart.   Motorcycles are ferried in canoes to where the water is more shallow.   They like lots of water for the rice crop but they say this too much and it is later this year.  Mud bricks don't do well either as the water is up around some houses.   I'm sure there are some people that die especially in some remote villages because they can not get out. 
We had a miracle.  A volunteer several months (last rainy season) had broken a piece on our only lawnmower then he had completely disassembled the motor and everything and left a pile of parts.  While I was home on annual leave I was able to order a gasket set so to make it possible to reassemble the motor but I did not realize that a piece was missing that holds the blade onto the shaft.   We found a piece among some other pieces of old lawn mowers that fit.  We put the motor back together and the piece that we found that holds the blade onto the shaft.   Eureka!!!   The lawnmower runs and cuts grass.  Apparrently the volunteer did not realize that the only thing wrong was the broken piece that holds the blade on.   I can get some exercise mowing grass now.   
Our Chadian medical student was here last month.   Hopefully he saw and learned a few things.   He scrubbed with me on a typhoid perforation that we repaired also a strangulated hernia that had to have some intestine resected.   Also some C-sections for various reasons.   He has now returned back to school.  We had a quite large tubal abcess that we opened today.   Danae and I have done some vesico-vaginal fistula repairs since she has gotten back.   
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 Health Care in USA

I see an article about a proposal by Bernie Sanders for universal single payer health care for the USA.  To me it makes much more sense than any of the other proposals that I have seen lately.   If enough people would write their congressmen and senators maybe something could be done.  It should not make any difference whether Democrat or Republican.  It should be for the good of the country.  Of course it would be opposed by the insurance and pharmaceutical industries which have lots of your money to fight it.   Why should we be at the bottom of the industrialized world in health care.   We spend two times as much money per person as any other country on health care but what are we getting for it.  We are almost a third world country in life expectancy with 40+ countries above us in life expectancy.  There were formerly only 17 above us.   We are the only industrialized country in the world that does not have universal health care.   Part of our problem is the terrible life style eating so much junk food and being too sedentary that so many Americans do.  The fast food industry and the pop industry probably kills more people than tobacco.   We also need tort reform similar to other countries as well.   We need limits or set amounts per case for what the lawyer gets like other countries.   The pharmaceutical companies are gouging the American people.   Most medicines can be obtained in other countries for a fraction of what it costs in the USA.  We have great doctors and  hospitals but our system is rated the bottom of the industrialized by the World Health Organization.   If one has a major illness, it can bankrupt you for the rest of your life under the present system.  One big problem presently is lack of access to health care by millions in America.   His proposal basically would extend Medicare like coverage for everyone as I understand the proposal.   Several congressional people are backing it and cosponsoring the proposal.   Maybe they are finally getting the message that we need a change in our system.   The government people especially our senators and congressmen need to be on the same  system as everyone else.   I would think that most primary care health providers would back this.  Again we need to do something about the situation.   Post on face book or othe social media and write your senators and congressmen and congresswomen.   Everyone can make this a better healthier country if we all work together.  
Rollin Bland M.D. voter in Oklahoma, USA

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

Blog 13 Sept 2017

We are still in the heart of rainy season with rain almost every day.   It has rained 8.4 inches (21.3 cm) in the past 2 weeks.   It is great for the rice crop but bad if you want to go anywhere.   Some of the ground nuts (peanuts) are being harvested also some millet.   The countryside is pretty and green just don't want to try to drive anywhere much.  
Hospital business is somewhat slow this time of year although the census has stayed up pretty well partly because it is difficult to get here and partly no money until harvest time.   The pregnant lady that had sigmoid colon and some small intestine removed because of a strangulated internal hernia has aborted as expected but is doing well and went home yesterday.   Danae and I have done some vesico-vaginal (bladder to vagina) fistula repairs that so far appear to be holding and are dry.   Sometimes they can break down even after a month but hope they do ok with no complications.   We had a mid shaft femur fracture a few days ago that her family refused treatment here but took her to the "traditional healer" (witch doctor) instead.  Not sure why she was brought in.   The "traditional healers" have a lot of power over the people.  Spiritism and animism are still very strong.  Even some "Christians" believe and practice some of the "traditional" methods to keep the evil spirits away. etc.  
Danae is trying to study for her OB-Gyn boards that she is to take in Jan. so I am doing rounds most of the time so she can have more time.   Dolores takes care of the kids although this week she is recovering from malaria and a "cold".
We visited a nomad Arab group with Sarah Sexton, a midwife from the USA, that was visiting here for 2 days on her way to Rwanda and the Congo.   She wants to be a missionary to the nomads Arab and Fulani who are mostly Moslem and live with them.   We had to take a canoe across the river to their encampment.   They were very friendly and some have been to our hospital although the head of the group was reciting his prayers  while we were there.   They insisted we drink some warm fresh milk from the cows .   The milk was very rich.  
Haven't gone to the "bush church"  past 2 weeks because of the high water in the "roads"  We hear that a group of 200 that want studies and want to become SDA christians.  Pray for everyone that they may learn about salvation through Jesus and His grace.   There is a Fulani pastor who became a Christian, the first of his family or tribe.   It is very difficult for him as there is a death threat over him because of that.  His wife was taken away by his father-in-law and a son was also killed in front of him.  It is difficult for a Moslem to become a Christian.  He wants and needs more training but needs financial support.   He has a nice Nigerian wife now and now a new set of twins.  He wants to return to his own people and try to teach them about the love of God even though it may be dangerous to do so.   Pray for him
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