Blog Nov 3, 2017

We have had a run on intestinal surgery the past 2 weeks.   We have had 2 strangulated internal hernias with dead intestine that had to be resected.  One had dead sigmoid and  dead terminal 1 meter of ilium (small intestine)   Also 2 strangulated femoral hernias with dead intestine and a strangulated inguinal hernia with dead intestine.   Also a strangulated umbilical hernia but the intestine was still ok.   With dead intestine there is often infected wounds.   Also had a typhoid perforation of intestine.    We also had a new born with no rectum so had to put in an ostomy in the abdominal wall with a loop of intestine.   Yesterday we had a perforated gastric ulcer and a appendectomy and 2 c-sections and an ectopic pregnancy with lots of blood lost and a vacuum extraction of a baby.   We also have about 60 inpatients to try to see besides the consults etc.  Olen and Danae left 2 days ago for the airport for Danae returning to USA  for her oral Ob-Gyn boards and preparing for them.  She is return here mid Jan.   Olen is returning tonight (thur) with the new doctor from Argentina.  
I hear that back home they don't treat strept throat now but here you better.   We see rheumatic fever and kidney problems as sequelae to strept infections also severe cutaneaus infections.   Although we do not have proof culture evidence of which infection it is.  I just saw my third case of "NOMA" which is a necrosing full thickness infection of part of the face.   I'm not sure if it is "flesh eating" strept or what but it is bad.  One of them got over it and the defect has mostly filled in.   Another one just left so don't know what happened to it.  One was to return in Jan for a recontruction team that was going to come but now we hear that they are not coming.   
The "harmattan" dust was come in so everything is very dusty.  Visibility is down to less than a mile and everything gets covered with dust quickly.     Harmattan usually does not come until Dec or Jan.   Harmattan is the dust that blows in from the north in the Sahara.    Probably no more rain until next May.  There was lots of rain with flooding then it shut off like a faucet with nothing more since then.  I think the rice and ground nut harvest is fairly good this year and hopefully the cotton will be good .   They are harvesting rice now all by hand.   Lots of work.    Grass etc is starting to turn brown.  
Pray for the Lord's work here. 
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