Heat and mangoes

It is still hot here with highs about 110F and lows of 85F. We had a few sprinkles of rain so now we have increased humidity. Rainy season should be beginning within a onth in fact usually is starting to green up a little by June.

On our way home in June we will be going through Denmark, Sweden, Norway, and Iceland. It never gets very warm in Iceland so we will probably have to wear all our clothes to keep warm maybe in Norway also. we are planning a trip to Runde Island off Norway coast to see puffins and other birds. We are looking forward to seeing several scenic fjords etc. of Norway. 

 
The number patients in the hospital and surgery has really slowed down now. There are always some malaria patients. We had a little boy with pleural effusion and pericardial effusion which was drained. We plan to take out the chest tube today maybe. We also had a little one year boy with malaria and typhoid being treated for 3 days then had something protruding from his anus and he could not defecate and he was vomiting. He had an intussisseption protruding from his anus that we could not reduce. We took him to surgery and found an intussisseption within an intussisseption partly necrosed so had to resect his terminal ilium and ascending colon and reconnect his intestines. He had high fever pre and post op but I was somewhat optimistic that he might live but he died the next day. Malaria, typhoid, and all this surgery was just too much. We had another leg amputation this time for necrosed diabetic foot.

Dolores is tired of doing mangoes for drying and canning etc. Mangoes are still falling on our metal roof and make a terrific noise when they hit. Now she is making some fruit leathers with mango pulp that she lends up. We have more shade with our house by the mango trees but have to endure the mangoes hitting the roof in mango season.

Our internet is barely functional so hardly ever can get Facebook and things like that but can usually eventually get simple emails.

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
Blog www.weareamissionarybland.blogspot.com
Sent from my iPhone

April 15, 2015

It is tax time and in the stock market the bulls have been running for some time and the US dollar has been enjoying high value but we have bulls running here in Chad also. The dollar will get about 600 francs now instead of 500. But we have real bulls. We had two men that had their scrotum and penis almost pealed about 2 months ago one of which was from a bull goring. Now that same man is in with a goring in his chest with a fracture rib and a sucking chest wound which is now repaired and a chest tube in place. His previous injury has healed although quite a bit of scarring but I think his penis will still be functional. We have had gorings in the abdomen but more commonly in the extremities. The bulls and cows here have very large long horns and they are main beasts of burden pulling ox carts and pulling the plows for plowing the fields etc. They tell me that a good bull or cow is worth about US $700 maybe more so a team or yoke of oxen is valuable. 

We have had 3 more vesicovaginal fistula repairs. A large area skin graft of one week ago on a hip and thigh is looking good so far. Maybe I'm learning more about how to make them take. Also about a week ago we had a man with a necrosed sigmoid colon and about 3-4 meters (10-12 ft) of terminal ilium which we took out and reconnected him. Apparently a strangulated internal hernia. He is doing ok now but long term prognosis is not good with that much intestine absent. We have had two empyemas in kids reqiring chest tubes recently. We have a lady with very large central facial enduration so that can hardly see and nose and upper lip very large. It is not just edema as it is quite firm. Inside her mouth is normal. Is it yaws???? (yaws is a tropical disease same family organism as syphilis) We did an AKA amputation on a boy with a huge tumor probably malignant of his knee. His amputated leg weighed about half as much as the rest of him. It probably is not curative but hopefully help him for awhile.

Dolores is still doing mangoes, drying and freezing and cooking them etc. besides watching grandkids and writing emails to a few that write us consistently.

We are also planning our trip home leaving here June 3 and arriving in Copenhagen the same day. Perhaps spending a day or two there seeing castles in Denmark then a bus trip through Sweden to Oslo, Norway spending about a week in Norway then flying from Bergen, Norway to Rekavik, Iceland and a few days in Iceland then on home June 16. Then we have several appointments with doctors such as the oncologist and ophthomologist, dentist etc. Dolores is getting her cataracts done while we are home and of course getting checkup for her CLL.

Thank you to all who have sent money for our autoclave project.
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
Blog www.weareamissionarybland.blogspot.com

29 March 2015

I made a mistake or I was a fool on the previous blog about getting an autoclave for $2000 US. It was a very small 20L one which is not big enough for a hospital. There is a 70L for $10000 US which is automatic all electric 220v European. We are trying to negotiate for a lesser price but don't know how promising that will be. Everything is very expensive here in Chad. Motor oil 15-40 best grade is $24 per 5L.

We had another ectopic pregnancy today and yesterday (Sat nightd) we had a c-section hysterectomy for SEVERE bleeding from abruptio placenta and dead baby. We had to give her 7 units of blood and today her HGB is 6.4 and she looks pretty good now. Our anesthetist Mason left this morning on their annual leave but he helped us last night about midnight but he can sleep on the bus or plane.
Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Thanks to all of you

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

27 March 2015

We got our first rain since early October. It was almost enough to settle the dust a little but made it more like a sauna with high humidity but today the humidity is back down below 20%. The low this morning was 89 F. One wakes up in the night because he is dry and need a drink of water rather than needing to go to the bathroom. 

 
Dolores has been slicing and drying them lots of mangoes besides watching the grandkids. She had a birthday Wed the 25th. We had cake and watermelon. Danae made the chocolate cake. Dolores got a lot of "happy birthdays" via Facebook etc. There are not many tomatoes now as it is just too hot. Our papayas are about all gone now also. The mangoes are later this year and are just now coming on good.

A cluster of baby mangoes in mid-February.

Hospital is staying fairly busy esp with maternity and surgery.  Peds and Med is actually down somewhat now.  Had a boy yesterday with a large bladder stone and then a boy that had a bladder stone before and had a surgery in NDJ that left him with a suprapubic fistula and a penis that was almost completely closed. We were able to redo his penis and dissect out his fistula and close his bladder. Also had a BKA leg amputation for a large cancer of her ankle. This week we also had a vessicovaginal fistula repair that was easier than most of them in that it had more tissue to work with. Danae and I do all the vaginal fistulas together. Did a gastrojejunostomy on a lady with stomach outlet obstruction with nonresectable cancer of her antrum of stomach that was also in her periaortic nodes etc but maybe help her for a while. Also did a mastectomy for cancer of breast except this was primarily just a debulking not curative. We have presently 4 in hospital patients that are post op vessicovaginal fistula repairs, two of which we reimplanted the ureters and stented them. So far they all seem to be holding and dry. 

We had a bus accident a few days ago. One person was brought in with minor injuries, one had fracture femur and forearm but stable otherwise and one had a fracture femur, fracture humerus, fx ribs and head injury with blood from ear and divergent eyes. They were brought in by the MCD but both were taken out by the local "traditional healers" witch doctors which seem to have a lot of power and influence. I'm sure the one with head injury would be dying soon.

Our autoclave has been not functioning very well. Sometimes it burns holes in the wrapping and towels and other cloth things. A new one is located in NDJ for about $2000 US. I have sent the money to get it hoping that some donations will cover. Of course we need other things also so money will be well used. Also helping malnourished kids. Any donations can be tax deductible if sent to the Jay Seventh Day Adventist Church, Attn: Gail Hill, 13717 East 390 Road, Jay, Oklahoma 74346 marked "Bere Hospital Project".

We are thinking of going through Denmark, Sweden, Norway, and Iceland on the way home in June. One of our SM's here has a grandmother in Norway who has offered to help make various reservations for us once we figure out a schedule. The airfare is only about $300 more per ticket but of course there will be hotel, bus and train fares but we thought this was as good a time as any for us to do it and will be home by June 15 so Dolores can get her cataract surgery done. Plan to be at the General Conference in San Antonio the first weekend of July also part of the Oklahoma campmeeting in July then of course our 50th celebration July 26 in Jay. Plan to be back in Chad the first part of August. Hope to see some of you along the way.

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

March 13, 2015

It seems as if everything keeps going about the same except the usual problems. It is still dry season and quite warm now. Today the dust which infiltrates everything has increased again but that shields out some of the sun so maybe will be a little cooler. Visibility is less than 1 km (about 1/2 mile). The dust makes the voice more raspy especially if you are trying to sing. 

We are just now receiving Christmas cards and letters which we always enjoy. We especially enjoy all your emails and just knowing that you know and care about us out here. Linda, Gail, and Tina we hope you can email us as we don't have your email addresses. 

It has been challenging putting in a computer system. It has taken a lot of time to teach employees how to use it. It is used primarily for prescribing medicines, hopefully to prevent some of the theft problems. Patients are to pay for their meds as they get them, also pay for surgeries (maybe $100) before surgeries are done at least the elective ones. The software was created and donated by Dr. Dirk Wonderlich from Germany. Olen and others have spent quite a bit of time getting it initiated. We have a SM from Walla Walla University that has helped a lot. 

We had one day that we had 3 mastectomies besides some usual hernias etc. We did another mastectomy today. One lumpectomy was fibrocystic disease but others appeared to be cancers. We also had a little boy that was full of some sort of retroperitoneal cancer. Also had an AKA leg amputation for an infection that had necrosed his foot and leg yesterday. Last week we did a thyroid mass which about 10 cm diameter. Also we had a hematocolpos with imperforate hymen (Her menses could not get out because the vagina was obstructed) We are doing surgeries side by side in one small OR so that we don't have to work quite so late at night and yet get most of the waiting list done. Have not seen increase in infections with that arrangement.

Three munchkins enjoying life

Dolores has not had any more chest pain problems since coming back from her check up in the USA. She is quite busy keeping up with the grandkids:  Lyol, Zane, and Addison.
We still plan to be back in the USA June and July perhaps going to at least part of the General Conference and the Oklahoma camp meeting.  Our 50th wedding anniversary celebration on July 26 in Jay, Oklahoma. We would like to see some of you there.

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

March 1, 2015

Dolores was having chest pain Jan 24 and 25, but no more until Jan 30 Friday morning when she awoke with it a sharp dull pain in the left chest so she even agreed that it needed checked out; and she is past 70. We flew in the mission plane Fri afternoon to NDjamena and got a flight on Air Morocco early Sat morning to New York and then US Airways to NW Arkansas where our daughter Danita works in the ER at Washington Regional Hospital arriving there by midnight Sat night and was admitted to the hospital early Sun morning. (Thanks to Olen for spending lots of time with a travel agent etc working out the details) She had the full workup with blood work, CT's, EKG's, nuclear med; cardiac stress test and found no evidence of ischemia and had an ejection fraction of 73 which is very good. She does have an elevated WBC with 80% lymphs so had a flow cytometry which was not fully diagnostic, then had a bone marrow but found nothing that requires any treatment so was given all clear to go back to Chad. Chronic lymphocytic leukemia sounds bad but usually requires no treatment for years, maybe decades. We had told the various doctors etc that we had a return ticket to Chad on Feb 18 so they did the work up as rapidly as they could. There was a lot of ice and snow but fortunately the hematologist did not close her office and we were able to get to her office on Feb 15 through the ice to get the reports that everything was ok. We have another appointment June 24 for a check up when we go home on our "annual leave". We don't know yet if this trip is "medical leave" or part of our "annual leave" as it seems there is not a clear policy on that for IDE's (interdivisional denominational employees). 

This trip certainly was not what we would call a vacation although we did tour Casablanca for a few hours during a layover on the way back to Chad. Air Morocco only flies 2 days per week to NDJ so we were fortunate but they don't seem to partner with anyone so we had to pay domestic baggage fees in the USA for our baggage especially on the way back. We barely made the connection in JFK as we had to claim our baggage then recheck it in each way. It involved getting our baggage and going to another terminal but an angel (an operations officer of Air Morocco) was also going to this other terminal and helped us to get to check in with only 3 min before closing the check in and we were the last onto the plane as they even helped us get through security to the head of the line. Otherwise we would have to layover either in New York or in Casablanca for 5 days for the next flight to NDJ.

We are safely back in Chad and back to work doing lots of surgeries etc. We had a lady that we took out a 17.4kg (38 lb) ovarian cyst last week. 

Boko Haram so far is quite a distance from us and has been repelled by the Chadian army thus far. Ebola seems to have quieted down. It is very dusty and warm here with high of 100F and low of 70F.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
We covet your prayers
Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique
Blog www.weareamissionarybland.blogspot.com

January 18, 2015

It is still "cold" with lows down to 50F but the dust is clearing so maybe it will begin to warm up a bit. The humidity is very low so things dry very rapidly. 

 
The busy season has finally struck for surgeries. We did 51 Monday through Friday which involves some long hours. Most of them are hernias and hydroceles but a few hysterectomies and appendix, etc. Had another with calculi in his bladder and penis. We had an intussisseption, a strangulated hernia, and a ruptured liver abcess today (we thought it was a bowel perforation at first but could find none anywhere). 

 
Danae and Olen have been busy trying to take care of some thief employees. It is amazing that the hospital has been able to stay solvent with so much that was being stolen. One main person was one that had helped catch the previous administrator with his large amount of stealing but now this one was doing just as much. I guess he let the devil get into him as he had said almost a year ago that someone had put a curse on him and he was afraid.  He was acting strange many months ago but thought it was anxiety which maybe it was in that he was afraid he would be caught then. The Lord has blessed this hospital in spite of all the problems. The stealing was from patients not from donations. When Jesus was here on earth he cleaned out the temple which had been made into a "den of thieves" but was to be a house of prayer. This is God's institution. Maybe we are not praying enough. Paul says to "pray without ceasing" which of course mneans to be in an attitude of prayer and talking to God all the time as our closest friend. "Resist the devil and he will flee from you". The devil has lots of power and control of many peoples lives. Many here wear some sort of amulets to keep the "evil spirits" away. Back home in the USA the devil just works in different ways but comes into most homes through the "one eyed monster" in the living room or he just keeps us so busy that we leave out God in our daily lives. 

 
Continue to pray for us and God's work. When are people going to be truly converted and be ready for Jesus soon return both here and back "home"?

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
Blog www.weareamissionarybland.blogspot.com