At the start of June 2021, my spouse and his colleague left their office heading to hospital. Both presented with discomfort in the body and a splitting headache that, over a few days, had remained non-responsive to meds, increased fluid intake, and rest. They went to different hospitals. My spouse was sent home with instructions to rest up. The doctor, surmising his symptoms were from fatigue as initial blood tests didn’t show signs of an infection, dismissed his requests for a COVID test. Two days later we learnt his workmate had tested positive for COVID-19. The immediate screening of my household revealed my spouse was COVID-19 positive too. We sighed in relief as the rest of us weren’t. Within days more from their office were found to be positive and some acknowledged having had a range of symptoms from days prior. For a few, family members were positive too. However tracking patient zero in the office ─no one ever wants to be it─ proved difficult as all believed their life patterns adhered to the SOPs. I got started on the COVID treatment of antibiotics, vitamin C, and zinc was advised, as advised, in light of my prolonged exposure. Within the week I had what felt like a really bad case of sinusitis. Convinced this was triggered by having to wear a mask for extended hours and with symptoms differing from those my spouse had had, I dismissed the idea of it being COVID. But a few days after the onset of symptoms I was in bed all day and a follow-up test showed I was COVID positive.
As I lay in recovery, I struggled with a mental fog, lethargy, and a crushing loneliness. The latter compounded by the physical separation. My anxieties ─exacerbated by a year’s worth of COVID stories; how others had fared, the myriad of complications reported, and the run-away death tolls─ were nonstop. I fretted over what qualified as a high temperature and if this was the same for those whose baseline temperature was on the lower end of normal. My skin was consistently warmer to the touch though my body temperature never hit 37°C ─so much for all those temperature guns wielded at the entrances to public spaces. I worried about COVID positive people who, presenting with “normal range” temperatures, were freely going about in public spaces. I worried too of the possibility of a rapid deterioration in my condition more so if this occurred in the middle of the night. How I’d call for help and what the likelihood was of a simultaneous deterioration in condition for my spouse and me. Who would come to my help? Did I have to wait till I was breathless? Was my definition of “breathlessness” the same as the doctor’s? Was this the beginning of hypochondria?
Should the discomfort I felt on my side be of concern or was it just bloating? I definitely didn’t want to be the idiot raising the alarm when it was the latter what if I was ignoring signs of the beginnings of COVID-19 complications. What made one susceptible to developing complications? Could I avoid getting any? I’d read the cases of COVID patients who had died after developing clots and a friend ─sick for the same length of time─ said he’d developed lung adhesions. For weeks nothing could break past the fear I’d develop either. I was afraid too, should I live, I would never return to normal. I fail to describe how washed out I felt even after I was past being actively sick. What was the threshold for wellness I wondered? I’ve known the human body to have a knack for endurance. My thoughts turned to what I should include in my will as I struggled with the futility this brought on.
While I waited on my recovery, two grand-aunts, sisters, died of COVID-19 within days of each other. They’d met at a much-anticipated family event. For days the extended family worried for the many others that were sick. Soon a childhood acquaintance ─exposed at her workplace─ was admitted to the ICU where she died a few days later. The month prior, we stood listening to her speak animatedly ─a rare occasion— as we condoled with her on the passing of her father. A man we held in great respect. Now her family buried her too. Later I hear of the death of a friend’s husband. I hope I heard wrong even as I reach out to her. “He died,” she confirms when we finally connect. The unimaginable unfolding: a premature end to happiness I recall witnessing when last I met with them and their young kids. When I think I can’t take it anymore news of the passing of a young relative arrives. Thought to have recovered from the virus he was discharged from hospital weeks prior only to be rushed to ICU and dead within hours. The medical report showing he had lost 60% of his lung function. Adhesions. A week later his father is buried too. Ka mahano, Ngakitalo nyo, never felt so hollow. And the phone is a shoddy replacement for the simple act of sitting with the bereaved, attending to their physical and emotional needs as we say our goodbyes.
With the almost daily accounts of who was positive, in ICU, fundraising to clear astronomical hospital bills, or had died, I had to resist the compulsion to hurl my phone across the room or power it down indefinitely ─if only to slow this new decimation of families. As the days went by I found myself increasingly mute devoid of any desire to participate in life beyond my isolation room. Shutting everything, everyone out. I was worn out with praying for miracles. Several times I was surprised by the breath caught in my chest.
Stuck in my room I thought often of the time a bedroom in my childhood home functioned as a palliative care unit. I recalled the strong hospital smell it carried, the alarming medical apparatus, and how hard I worked to avoid going in to say my hellos as required daily. It was frightening to see loved ones laid out, far removed from the life they used to exude. Scary too having to keep the strict instructions to avoid unsafe contact. I thought of the mental and emotional toll they must have faced trapped on their beds, unable to control the progression of the disease nor its devastation, dependent on others for their survival. Of how they felt shut off from the activity of the household, the sounds of which poured in through the walls, starved for loving arms. Hoping in futility. Once in a while, when I worked up the courage to raise my eyes to their faces, I’d catch glimpses of their old spark and the faintest smile. Sadly, less so as the illness progressed. One day the room was empty. What remained was the guilt of goodbyes unsaid. I’d assumed our tomorrows were guaranteed.
During that season it seemed death crawled into our lives and would never loosen its grip. As we went on with each day, we listened ─ compulsively ─ to the account of who had passed, read at the end of the news bulletin. Tense bodies relaxing only when this wasn’t followed by the frenzied alteration to the day’s plan, making way for urgent travel. Burials on repeat all around. On a bus as we travelled to one, I struggled to reconcile the jovial banter, among the adults beside me, with the somber occasion for which we were gathered. Did they not care we were off to bury my aunt ─a favorite aunt? But, as a family we’d already buried several and we knew more were to come. It was the 90’s.
Though not all deaths during this time were HIV/AIDS related, there’s no denying its exponential impact to our losses in the decade or so before antiretroviral therapies (ARTs) became more accessible. In that time, as Uganda, like the rest of the global south, was encouraged to focus on prevention measures our family was being decimated. Desperate for access to ARTs families tried to get ailing loved ones into clinical trials while others were rocked to learn partners ─men─ had hidden not just their positive statuses but also their access to the limited very expensive antiretroviral therapies ─ inequities in global access to ARTs playing out in families.
Despite soaring prevalence rates in the global south, the region’s limited access to ARTs during the decade was justified by the high cost of therapies ─concessions would have to be made for these countries to afford the therapies─ and the complexity of treatment. A failure to adhere to the latter risked the creation of new variants that would likely compromise progress being made in the global north. How many died prematurely as these concerns were weighed more pressing than their desperate needs? How many new ─preventable─ infections occurred? HIV/AIDS became the leading killer disease on the continent while ARTs were making it a manageable disease in wealthier nations. Then again the trouble with access to HIV/AIDS treatment wasn’t just about factors external to the continent. There were the Global fund scandals. How many had their treatment disrupted as those charged with oversight got more polished and eloquent in reprimanding those calling out the immorality of their behavior?
Three decades later Eastern and Southern Africa remain hardest hit. And time presents yet another moral query as global north partners hesitate to support the adoption of new therapies for HIV/AIDS, for the global south. New drugs have been proven to be more effective and reports now recommend starting ARTs at a higher CD4 count than previously set. But concern over the cost of making these adaptations threatens ─once again─ to outweigh the value of human life.
In tragic fate and with a case of bad timing, the continent finds herself seemingly dependent ─again─ on global north partners and new debt burdens in its fight against a new pandemic ─COVID-19. Preventive measures once again risking an upsurge in our losses. Meanwhile we watch reports of global north countries employing methods to effectively hoard COVID-19 vaccines. Maybe I’d hoard too if I thought the projected needs of the ones close to me far outweighed the current needs of the stranger so far removed. Elsewhere nations report less-than-desired numbers of vaccinated citizens; not from a lack of vaccines. Africa doesn’t have that luxury.
As I looked through family albums a few months ago it was uncanny to see our family’s happiness frozen in a time before the pandemic. As the number of how many were no longer with us struck I wondered again as to how my parents had continued to function during that season. Providing for a rapidly expanding family, nursing family members, caring for ailing parents ─more frail after the back-to-back losses, attending to one burial after another, and still keeping jobs. How did they stay sane? They were changed nonetheless. Helplessly watching a loved one deal with and pass away from a protracted illness is gut-wrenching. Having to do this for several more so. For a while care-free adult laughter seemed to fade. Grief does that. I still hear their laughter as my heart carries their love forward.
In the face of our losses, despite the disruption to our usual rituals for mourning, may we find healthy ways to grieve those we lost too soon.
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