Umhlaba Uyahlaba

Umhlaba Uyahlaba is a Swazi saying meaning literally “The earth is hard,” or “Life is hard.”

I was there when Sibusiso, a patient at Hope House, died this morning. I don’t know what shocked me more, his death, or others’ reactions, or my own.

I wasn’t even supposed to be there. Normally I go on Mondays, but because there was something I needed to do at FBS that Monday, I called and told Sister Elsa (the Catholic nun that coordinates Hope House) that I would be coming on Tuesday instead. Something makes me think that I was meant to be a witness to what happened.

Sibusiso lived in House G, with Bheki, the Zimbabwean volunteer nurse. Bheki came to Swaziland from his home country looking for a job. He came looking at Hope House, and there were no jobs, but now he volunteers to take care of patients who don’t have any family to stay with them. So at least he has a place to live. Anna, a staff nurse at Hope House, and I had been out in the garden planting the seeds from a pumpkin they had eaten yesterday. “Just scatter them anywhere,” she said, laughing at the protests of the garden boy tending his neat rows of maize, pumpkin and squash. On our way back from the garden, we stopped at House G to say hello. Bheki had just finished cooking emabele (sorghum porridge) and was trying to feed it to Sibusiso. Sibusiso ate a few spoonfuls, but then shook his head when Bheki tried to continue. Sibusiso looked sideways at me and gestured, making sounds that I knew were words inside his head, but they weren’t coming out right because he never completely closed his mouth when talking, so it just sounded like “Uhh…uhh…” Finally Bheki decoded the message and laughed. “He says he wants you to push him.” I looked at the frail old man leaning forward in the big leather armchair he was sitting in and smiled. “I’m not that strong,” I told him. Bheki went over and got the wheelchair and helped Sibusiso into it. Sibusiso looked like he didn’t know what to do with his feet, so I bent over and flipped the footrests down and lifted his big, yet surprisingly light feet to rest on them. While he was eating, I had noticed how skinny his arms were – I could see the exact outline of the bone in his forearm. His clothes hung on him like sacks on a stick. Later, I found out he only weighed 45 kg (99 lbs) – and he would be tall, I think, if I could have seen him standing upright.

Bheki wheeled him over to his bed, where Sibusiso collapsed, moaning and coughing. The cough sounded awful, like his lungs were full of junk just sitting in there. Anna was crushing some pills for him to mix with water so he could drink them. But when they tried to pour the liquid down, it just spilled right out of his mouth onto his pants. He groaned and lay back on the bed. Anna and Bheki looked at each other and decided they should take him to the Nazarene Hospital. They got busy making phone calls to a taxi driver and writing the referral letter to the hospital and collecting all his medication to bring in to show the doctor – and it was quite a lot, since he was taking the cocktail of ARVs (anti retrovirals) as well as the TB drugs.

The taxi driver arrived and sat at the kitchen table with me, as we watched Bheki try to change Sibusiso’s pants from where he had spilled on them earlier. But Sibusiso was being most uncooperative and finally the dirty pants remained on. Bheki lifted Sibusiso into the wheelchair and went to discuss something with the driver. As I watched, Sibusiso pitched forward from the wheelchair and threw himself back onto the bed. Bheki laughed at him, “He’s very clever, this one, he doesn’t want to go.” And I could understand why. Last time they were at this hospital, Bheki told me that they had waited for 12 hours, from noon until midnight.

But it was obvious Sibusiso had to go – when he was sat back upright, a line of drool escaped his lips and dribbled down onto his pants again. He seemed to have given up his feeble protests, and was quickly placed back into the wheelchair. I followed them out to the taxi, carrying the referral letter that had been forgotten on the table. Bheki parked the chair by the taxi’s open back door and went to get the drugs and other things and put them on the front seat. I stood there blinking in the bright sunshine, trying to figure out how we were going to lift him into the back seat.

Then Anna said quietly, “This one doesn’t need to go to the hospital anymore.” I was puzzled by her words, and as I stood behind Sibusiso’s chair, I noticed the strange angle of his head – it was tilted all the way back. Bheki came around and quickly wheeled the chair back up the walkway into the house, kicking off his sandals urgently when they got tangled in the wheels. I seemed to be rooted to the spot on the porch where I was standing. I watched them through the open window as they laid Sibusiso back on his bed. I didn’t quite understand what was happening, although in a way I think part of me knew the minute Anna had spoken. The rest of me caught up very quickly when the taxi driver, who was standing beside me, clarified matters: “This man has just passed away,” he said matter-of-factly.

I stood there numbly watching Anna and Bheki through the window as they moved in a flurry of activity that involved sheets and a pillow. The driver and I just stood in silence, watching. Then Bheki and Anna came out and started talking about whether or not the driver should get paid, and if so, how much. Bheki thought E20 (about $3) was enough. Anna looked at me and said, “Don’t you want to go for tea?” I turned my head with extreme effort and looked at her incredulously. I tried to think of how on earth I could respond to that question. After what seemed like a long time I said, “I’ve never seen anyone die before.” And I slid to the ground with my head on my knees and started to cry.

Once I started I couldn’t stop. I was vaguely aware of Anna leaving (to call the family, I found out later) and the two men concluded their haggling. “Ncesi,” (sorry) the driver told me, “Don’t cry.” And he handed me a tissue before he left. Bheki brought me a roll of toilet paper and said kindly, “Just cry. Just let it all out. I have to go, but I’ll be back soon.” I don’t know how long I stayed like that, but eventually I became aware of my surroundings again – the bright sunshine on the green grass, the birds chirping, the sound of wheelbarrows and workmen whistling. I felt like my world had just stopped, and I couldn’t understand how everything and everyone else was just continuing on with their business on a sunny Tuesday morning.

By the time Bheki came back, I had calmed down enough to talk. We sat in a pavilion as he kept repeating over and over, “I’m sorry you had to see that, I’m sorry you had to see that.” Finally I said, “Don’t be sorry. It’s not your fault. I know it just happens, but it was my first time to see it so close, right there.” I stared out at the mountains and felt the wind drying the tears on my face. “Doesn’t it bother you?” I asked. “It does,” he said. “But you can’t think too much about it. It’s the kind of thing you can never get used to.” I asked if he knew it was going to happen. “No,” he said, “he actually seemed to be improving.” I was struck by the arbitrary nature of life and death. As I talked to Anna later, she said that Sibusiso was a fighter, and she always thought that he would be one of the ones to make it. But his CD4 count was extremely low, and he had just started taking ARVs a couple weeks ago. “Sometimes the body is so depressed that it doesn’t even know which sickness it has. Then, when you start taking the ARVs, it recognizes that it has TB and needs to fight it, and that’s what ends up killing you,” she said.

I sat out on the pavilion for a long time after Bheki left, watching the workmen move back and forth, and gazing at the green peaks above and beyond them. Finally, I went into the bathroom to wash my face. When I cam out, I found someone standing outside the office, and my response to his greeting struck me in a new way. “Ngiyaphila,” I said. I am living.

I felt very tired for the rest of the day. The sisters came in late, and apparently got the report that I was traumatized, because they kept wanting to know if I was OK. I felt very much like a child overreacting to something which adults have learned to take in stride. I felt like I was being unreasonable, judging by the way everyone else carried on without a glitch. Is it not reasonable to mourn the passing of a fellow human being? Isn’t it unreasonable that this is enough a part of daily life that people have learned to handle it so calmly?

Death is a part of life. I knew that with my head before that day- leaves die and grow back. Animals die, like the chickens we sometimes kill for supper or the three little puppies born at our homestead who didn’t make it. People die, and are mourned with night vigils and chanting Zulu songs and early morning burials. I knew all of this. I experienced it. But now I’ve seen just how easily you can pass from one to the other. There’s nothing momentous about it. The barrier, the one we think separates life and death so distinctly, that makes them such opposites, must not be as rigid as we think it is. One minute, Sibusiso is a stubborn old man demanding to be pushed around his room, and the next, there is a small lifeless sheet-covered form curled on the bed, and Sibusiso has moved on, to a place that the rest of us can’t know about right now.

That night, I ate emasi (sour milk) and porridge for supper with my family. After prayer, my sister was talking about all the accidents she had seen on the road. “Three of them, bad ones,” she said, making one of those “life is difficult” noises with her tongue. When I told her that one of the patients at Hope House had died that day, she said, “Oh, well it’s good he died before he got in the taxi.” I stared at her uncomprehendingly. She explained, “It costs a lot of money if you die in a car because then you have to pay to get the whole car cleaned.” While I digested this, my sisters resumed chatting about the surprising lack of kombis because of all the police checkpoints.

I don’t know why Sibusiso died. I don’t understand death, but you don’t have to understand something to realize that it’s a part of life. The sun rises every morning, whether or not you understand the way the earth orbits the sun and makes a complete rotation every 24 hours or so. The rain will fall (or not fall), whether or not you’ve learned about the water cycle and how climate change is affecting weather patterns. The maize plants grow tall from a tiny seed, whether or not you know about germination and photosynthesis and chlorophyll. And people die, but the rest of us go on living, for now.

And we don’t understand why it happens. And it doesn’t make sense. And we want to know why. Why did this have to happen? And we agonize and mourn and feel confused and lost and hopeless.

At least I do. But this is not the end of my questioning. There’s more: Why do my Swazi friends not react as I do to death? What has happened to them inside, that they are able to talk about the price of a taxi or feel hungry for tea the minute after someone has passed away? Why is death so much a part of their daily lives that they can just absorb it and move on? Or maybe they don’t absorb it, maybe it’s just pushed away into a corner. Like Bheki kept repeating to me over and over, “Don’t think about it too much.” Even then, in the midst of my grief, something in me rebelled against this. Even though it hurts, even though I don’t understand it, even though maybe I don’t want to think about it, I have to. To ignore it is to die a little inside. If you don’t process through the experiences and the feelings, that death still lingers with you, and the deaths will just keep building up, and you’ll carry that with you. And it will weigh you down, try as you might not to think about it.

Thankfully, I don’t know this from experience. I just feel that this is what must happen to you eventually. The gash in my heart from Sibusiso’s death has slowly started to scab over, in the week and a half that has passed. The lacerations from hearing about deaths and attending funerals of HBC patients keep my heart sore and tender. I can never forget about death here, where the death notices are there every day in the paper, right before the classifieds, and my coworkers scan them, hoping not to see someone they know. Every night at home after prayer, my family listens to the death notices on the radio. Yes, death is very much a part of life here. Swazis don’t pretend that it doesn’t exist, like many North Americans do. They can’t. With the highest HIV prevalence in the world, poverty, drought, hunger, malnutrition and poor health care, denying death is impossible. However, I don’t know how many people actually realize the extent to which death affects their daily lives. Or maybe they realize it full well, and that is why they refuse to think about it too much, because it’s the only way to go on living.