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