Humanity among chaos

I've been here over one week now, and am starting to get used to things, but a lot of it is still a mystery to me.  I continue to be amazed and frustrated by the chaos and inefficiency of the hospital.  Rounding each morning is a trial of my patience.  We have to figure out whether each patient has been getting their medications for the last 24 hours, including a patient on anticoagulants for a stroke secondary to cerebral sinus thrombosis, a patient on antimalarials, and patients getting empiric TB treatment.  Patients on critical medications only sporadically receive their doses.  The pharmacist from our team has taken to getting the meds from the pharmacy herself and giving them to the patient to self-dose.  

At the end of rounds one day we had a lab slip for some blood-work.  I still haven't figured out who these pieces of paper go to - there's so much paper floating around the wards it's amazing that any labs get completed at all.  I asked one of the 6th year Kenyan med students (they have 6 years of med school instead of 4) what to do with the paper, and she shrugged and said she didn't know.  Someone who has been in the hospital for 3 years doesn't know what to do with the lab slip after the phlebotomist has come through for the morning.  It took asking 3 more people to figure it out.  Nurses don't know where sterile urine cups are.  No one can find the sanitizing gel we use before doing LPs.  No one seems to know how the hospital runs, even the people who help run it.

With this constant barrage of chaos, I have found it easy to get lost in feelings of frustration and inutility.  So I try to find the positive moments among the chaos.

We have one patient who is encephalopathic, likely due to TB meningitis or toxoplasmosis. We'll call her E. She now occasionally opens here eyes to her name, but still doesn't speak or move much and needs to be lifted into sitting position, supported, and spoon-fed.  Her mother is by her side every day, without fail.  She shares the bed with another woman who is being treated for bacterial meningitis.  Several days ago, E's mother sat her up and sat behind her to keep her upright, reaching over her shoulders to try to feed her.  The other patient in the bed got up, without being asked, and took the spoon and cup from E's mother and began feeding E.  I almost cried.  Time and again the patients here help each other, from feeding each other to telling a doctor how the patient has been doing to wiping sweat off their foreheads.  They are in horrible conditions getting poor medical care, and yet they never complain and are always willing to help each other.  They never forget their humanity.  What a beautiful thing to witness and to remember should I ever be in a situation half as dire as theirs.