She had been right to feel suspicious of this joy that filled her heart for the past two months. Two full months of bright moons and clear skies. She remembers how she woke up one day and broke the news to Nana, and then almost immediately regretted why she did. Somehow, a part of her knew that this beaming joy was ephemeral. 

“Let’s wait to tell people, Nana. The universe likes to make jokes.”

“Look how far we’ve come. Surely God would not bring you this far to rob you of this moment!”

She remembers this conversation very vividly. She wants to burst into laughter. Laughter because the joke came even sooner than she had anticipated. Something about this memory amplifies the joke, but she can’t tell what it is. Suddenly, the huge burst of joke coalesces into a lump that squeezes her chest and knots her throat like she has just choked on a piece of yam and can’t find a glass of water to unclog it. She holds back the tears.

That’s the thing about her. She has always managed to hold the tears back and keep the grin on her face with little effort. Maybe it’s true that the names we’re given cast a spell around our entire being and always strike back to remind us of their meanings. Kulazikulabe is definitely a name that only curses a child. Why would you command your own offspring to grow up and face the hardships through a name? No! This is gibberish thinking – she shakes her head. If the names indeed left a trail, why are both her names failing to keep their end of the bargain?

This is how she knows the story. Nana only had one child, and that’s her. But there came thirteen pregnancies before her that ended up in the ground. Nana had almost left her husband because she couldn’t take the daily insults of her sisters-in-law anymore. But Nana’s mother and father could not bear to be the laughing stalk of the village.

“I already have your sisters pushing out men’s children in my house without getting married. Bazaalidde ku lujja. I can’t have you come back. Stay and cook for your husband. We now rear goats in what used to be your bedroom,” is all her father had said. 

Her mother had looked at her with the painful, pitiful look of a mother, and the following morning before the sun could open its eyes, she’d woken her up for a journey to Nalongo Muzaalisa.

Nana had refused to indulge in anything that’d have even the slightest semblance of witchcraft. Anything heathen.

“You can go back home if that’s how you want your mother to die – of misery from looking at her daughter producing children for the grave! Is that it? Do you not see?”

Her mother’s words had sounded almost more painful than the pregnancies she had lost.

“Nze siri mulogo. Nze ngaba nzaalo. Mwesibye ku by’abazungu nemusuulirira eddagala lyaffe nga mutuyita abalogo! I’m not a witch. I only give children to those who need them. You’ve taken up the ways of the white man and abandoned our medicines while calling us witches…”

Nana’s mother had looked at her again to reassure her that Nalongo was right. Nana tells her it wasn’t that complicated: she only had to strip naked and sit on a banana leaf outside Nalongo’s hut. Then she was bathed in a mixture of herbs while incantations to ward off evil spirits and the spirit of barrenness ensued. Secondly, she only had to take home a few herbs with which to make tea. A few months later, Nana had conceived.

Nana had told her not to tell anyone about how she went to Nalongo Muzaalisa, but that it was all God’s grace that she had bore a child.

“Besides, if God had not wanted, I’d not have had you!”

And that’s how she got her surname: Kisakye – God’s Grace. She also named her Joy because on the early morning of her birth, the midwife in attendance had recited the lines: weeping may endure for a night, but joy comes in the morning. The midwife had written the name Kisakye Joy on the card and on the baby name tag immediately. 

The lump in her throat has now sublimated a little, and she turns to face the rest of the ward that had ceased to exist for a while.

The walls look beautiful. They’ve recently been repainted. Bright, jolly cartoons looking upon the children from the wall. Constant beeping and alarms from monitors that she soon ceases to hear. But some things haven’t changed: there’s an insulting stench coming from the toilet in the middle of the corridor; a nurse somewhere is screaming at a mother to pour water on the fire with which she wants attention; elsewhere, a father is pleading with a medical student about the price of the X-ray that he can’t afford as if the medical student can do anything about it. To the patients’ attendants, everyone is a musawo. That’s the problem with that Luganda word. It fails to distinguish doctors, nurses, midwives, dentists and lab staff or medical students apart. 

She notices someone. She’s sure she knows the person. It’s Amanda! Definitely Amanda Nabirye. Amanda’s mother too turns her head and beams with joy after noticing her. 

“Musawoooo,” she almost screams. She still calls her Musawo. Kisakye wants to tell her that dream is now dead. It’s a deluded fantasy. But she simply smiles back and walks over to sit by Amanda’s side. 

“How beautiful you look these days, my musawo ! Your skin glistens like that of a lizard that’s just been dipped in milk!” she reaches out to poke her index finger at Kisakye’s nose. 

“There’s something about your nose, Musawo! It’s one of those noses that come with pregnancy! And I’m never wrong about these things.”

Kisakye wonders how older women come up with such ingenious summises! But she chooses not to focus on the subject. Amanda’s state overwhelms her and she tries hard not to cry. 

“The swellings have come back, munnange. The cancer has come back for my Amanda.”

“But…” Kisakye stops, realising the questioning would only make it harder.

She recalls what Amanda looked like when she first saw her, in this very ward, her belly curving out in front of her, glistening, veins making tortuous lines on it, and a huge mass disfiguring her left jaw. 

She had been a third year medical student at the time, rotating in the Paediatric wards. She recalls how the Professor had mocked her in front of the patients and her classmates. 

“What are your differential diagnoses, Joy? Or has the joy turned into frowning?”

“How do you tell there’s shifting dullness? Or should we percuss your head instead? Are you sure we won’t get the same result?”

Amanda had been diagnosed with Stage four Burkitt’s Lymphoma. Kisakye had watched the masses shrink and disappear within a few days of the treatments that had been started. But no! Amanda’s mother had not believed it was cancer. They had no one with cancer in their family. Such was the work of evil dealings, evil spirits looming the earth. A few days later – eight or ten – Amanda’s mother had disappeared from the ward. Runaway, the nurse had written on the pink file. Kisakye had heard that Amanda’s mother had sought a powerful witch in Busoga to cast away the evil spirits. She had no telephone at that time, so Kisakye never got to know what exactly happened. But that doesn’t matter now, she thinks. Amanda is lying in her bed, tubes coming out of her chest from both sides, tubes carrying oxygen to her nostrils from bubbling water in a tin pinned on the wall, and another tube pushed through her nose into her stomach through which her mother has just flashed down half a cup of milk. 

“How are you, my Amanda?” She forces a smile. 

“I’m fine.”

Yes. She heard that right. Amanda responds with an I’m fine like all the children have been taught. Kisakye wonders whether all schools just decided there are no alternative responses to this greeting and so all children had to just give in the generic. A pointless thought, she shakes her head. 

The eyes go blank, staring at the ceiling. The chest isn’t moving anymore. Her nostrils stop flaring. Amanda’s mother screams: Musawoooo. Omwana wange tassa. My child is not breathing. 

The bed has been rolled out of the ward. Amanda is now completely covered with a white bed sheet, in a side room, waiting to be transported to the mortuary. Her mother has been carried out of the  ward by an elderly lady, whose daughter is seated on her bed, probably only able to tell what’s going on from what she has been hearing. It’s obvious to Kisakye that the girl is blind. She must be eight or nine. 

Kisakye has been seated on a chair at the nurses’ station, watching. She has been trying hard not to focus her mind on the few times she had almost died, but didn’t. It’s very difficult not to contemplate one’s own mortality when this is what you see everyday. When this is what you think about every day that you wake. No, it’s a pointless thought! The past two months have been beautiful. She doesn’t want to think about the first time she almost died. She instead walks over to the blind girl. 

“What’s your name?”

“Miracle”. Kisakye almost chokes, but restrains herself. 

“Are you the musawo?”

“Yes. No. Yesss.” She finally decides it’s a yes. 

“Where’s my mother? I want to go to the rooftop to feel the sun. Can you take me?”

The midmorning sun makes Kampala such a dazzling beauty. The view of how tiny Mulago Hill looks from the top is amazing. From within the wards, it’s an immense building of pain and crying and screaming. From up here, the building is only a tiny mound on a small hill that the rest of the world doesn’t seem to care about. She thinks it’s beautiful to look at her life this way, how her predicament doesn’t seem to matter, viewed in the lens of the rest of the world. The boda bodas down in the streets carry on with the chaotic speed, cars and taxis the same, Katanga slum sitting comfortably in the valley while Nakasero Hill and Makerere Hill overlook the valley with their beautiful trees swaying with life and grace. 

“Musawo, will I ever see again? I want to go back to school.” 

She kneels down before the girl, gives her a long embrace, and sobs quietly. She has at last failed to fight the tears. 

It had started as a simple fever that made her miss school that day. She had decided to take Panadol and rest. When Nana walked into the room, she told her she looked pale and worn-out. Wenna opeeluse! 

Nana had prepared a basin of herbs behind the house and bathed her like she had always done for her as a child. Somehow, the herbs had always tamed the fevers. But not this time. The following week, her joints had started to ache with such resolute excruciation; a hospital visit was necessary. Several blood tests, needles into her backbone and hip bone later, the doctor sat her down with her mother and told them—leukaemia. 

He had gone on with his talk, explaining how the treatments would take months. How the treatments would make her sicker. How she’d lose her hair… Something about remission and not cure. Something about bone marrow. transplants that at the moment were only possible in countries like India if you could afford them. 

Nana had refused to accept the diagnosis. 

“And neither will your grandmother, or your aunties. These diseases aren’t there in our family. And neither are they there in your father’s family.”

For a moment, Kisakye had considered how chaotic and hostile medical school had been, and how she had made it through half the time to graduation, and now she possibly couldn’t even live longer than the other half. She had asked the doctor if there were any long time survivors, and the doctor had said of course, but Kisakye had made up her mind that hope would kill her faster. 

Yes, she was angry. At the disease. At the universe. At herself. At her mother, too. Because all she thought about, even after all these years, was her being accepted into her husband’s family. At first, because she did not have a child. And now that she had given them a daughter, she was worried they’d still reject her because her disease is not ours! 

Kisakye remembers how they had first rejected her: that is not our child. She just drank the child, how can we even be sure. But then, during the subsequent visits to her Jjajja, she had undergone several inspections from the old woman who had now grown to accept her and lover her as her true grandchild. 

That nose was your late grandfather’s. The feet are purely mine, no doubt. And those eyes, oh beautiful eyes, it’s exactly how your father looked when he was your age. Wasika omusaayi gwonna! 

And more recently: that intellect is definitely inherited from our family. See how we’re soon going to have a doctor in our family. 

Maybe that’s why she had wanted to keep the news away from Nana. Because everything seemed conditional these days. The happiness. The love. The acceptance. It all came with caveats. And who knew how long it might last. 

A little over a year ago, the doctor had told her she had leukaemia. Then she underwent several months of intensive treatments that almost killed her and kept her in the hospital almost all the time. In the end, the doctor had told her she had attained remission. We just don’t know for how long. In no time, her hair had grown back, her breasts as supple as ever, and she felt beautiful again. The only thing that had remained constant throughout this period was Mukwaya, her boyfriend.He always visited. He brought flowers. He brought foods that she had eaten and thrown up because of the excessive nausea. He told her about how the professor of psychiatry had run mad and they laughed because they didn’t know what else to do. He sat through the long hours of chemotherapy administration with her. He pretended not to cry. Kisakye chased him away countless times and yet he kept coming back. 

And when she told him the news, he had cried. 

“I’m going to be a father. We’re going to have a child!”

He must have jinxed it. No, her mother must have jinxed it. Why was she already going to markets to buy baby clothes? Why was she opening her old suitcases with baby clothes and picking out which ones her child would wear? Kisakye was okay with the herbs – those she was willing to drink until the baby was term. But the hopeful look on Nana’s face. The theatrical joy that came out of Mukwaya’s voice when they talked on the phone. That was the most heartbreaking. It felt like she was trying to hold onto a hundred pieces of broken glass without bleeding. 

*

She suspected this last week. She has been doing monthly visits to the hospital since she attained remission, and the doctor would tell her to return after a month. But last week, she had a nosebleed while waiting for the doctor. The doctor had ordered a test and told her to come back to the hospital in a week with her mother. 

Nana came along, but she passed by the market to buy some mumbwa. Medicinal clay soil. 

The doctor has told her the cancer is back, and we don’t know if you can carry the pregnancy to term without treatment. The baby won’t survive the treatments, of course, if that’s your decision. Take some time to think about what you want, but don’t take too long. That was the hundredth piece of broken glass. She took a walk outside the clinic and into the children’s cancer ward. But what was there to think about? Did she have to? 

Yes, up here on the terrace, on the tiny hill of Mulago, her predicament ceases to be as immense. And, despite the ugliness of what’s inside her body and in the wards, Kampala and its hills still manage to hold onto their beauty. That alone should be satisfying, for now. 

“Musawo, how are you ? Are you crying?”

“No, dear. I’m fine”

She now lets go of the little girl, and hands her the handbag and phone. 

“Let me play a song for you as I go out to look for your mother. Hold here” 

Kisakye inspects the entirety of the rooftop, and the bustle of the city outside. No one’s watching, not even the girl. It’s peaceful here. She reaches the extreme end of the rooftop and holds onto the metallic bars. It’s a long way down, she thinks to herself. But perhaps not as long as another day of holding onto the broken pieces. She lets go. 

The sun is getting hotter. When the first song ends, the phone starts ringing. Nana is calling. But the girl just continues to mumble along to the lyrics of the song. The phone stops ringing. The music keeps playing. 

About the Author:

Dr. Alex Ssali is a Ugandan medical officer/doctor and writer who shares his inspirations and imaginations through poetry and short stories. Having run his WordPress blog for more than eight years by sharing mostly diaristic musings that found their way into other people’s social media spaces, he continues to be bolder and more unafraid to tell the stories that for many might forever stay silent in their bosoms. He is currently working in Kampala’s Mulago National Referral Hospital, with JCRC’s Paediatric Haematology and Oncology Unit taking care of children with cancer and blood disorders and hopes that one story told could be the reason one human holds onto their life, even for just another day. Twitter: @AlequSsali// WordPress: @alequssali // www.ssaliskitchen.wordpress.com // Instagram: @ssalialex59

*Featured image by Peter Cusack