October 1997

TRANSKEI HOSPITAL

Malwanda has just acquired a dozen mothers.

Nokwanda’s lifeline is a five- year- old bundle of mischief and eyelashes. He hovers close to his mother’s bed while he carefully explores his new home, the hospital. Within hours he discovers other members of his own tribe – children – and soon is engaged in robust play just outside the hospital door.

Nokwanda glows with pride as the other women admire her son.

“My heart is white,’€ she declares her joy.

Despite the exhaustion from the journey, Nokwanda’€™s spirit is held aloft by the renewed identity of being a mother, one that surpasses the identity shed earlier today, that of the terminally ill. She also quickly discards the aura of fairy godmother as she reasserts her authority with the child who appears to have been assessing her limits at the same time he assessed his new environment.

Life pours into the collapsing vessel. Nokwanda’€™s voice becomes stronger when she disciplines Malwanda – in exasperation a quick, light slap like lightning followed by thunderclouds from the child that pass as quickly as the slap.

Malwanda is both a patient and a cure. He has been given the routine tests a child receives when the mother contracts TB and appears to be healthy. Reluctantly he attends the hospital school for child patients while he waits for a relative to fetch him. The rest of the time Malwanda and the gang of unfortunate children – some are sick, others are just unlucky – plague the adults with boyish mischief. One child, abandoned at the hospital by his mother, has attached himself to Nokwanda who mothers the orphan, discipline and all. Malwanda’€™s mischief makes Nokwanda stronger. Sometimes Malwanda taunts Nokwanda by running from her, knowing she can’t catch him.

Nokwanda is able to walk around the hospital grounds and sits in the sunshine with the other TB patients. The women have become like a club, they share a blanket on the ground like a pile of playful puppies until, exhausted, they return to their beds. Now Nokwanda is one of the stronger ones who care for the weaker women on the ward, as others did for her in the beginning.

Sometimes the cough persists, like an endless argument with her body, she covers her face with a face cloth and becomes annoyed. That’s when Malwanda decides to throw a tantrum about some food he wants that belongs to someone else. The young mother waits him out in a silent stand-off. When the wails subside she offers him some chips from the stash she keeps in the bedside table. Within minutes the boy is distracted by child-play again.

Xolani visited Nokwanda at hospital recently. He didn’t stay long. He has not been tested for HIV. He did not ask to have Malwanda returned to him.

Nokwanda’€™s boundaries stretch and strengthen. Her stand is nonnegotiable, “Malwanda goes where I go.”

Nokwanda begins to make arrangements for Xolani’€™s mother to send Matthew, her other son, from Johannesburg as soon as school holidays begin in December. She contemplates where she should go with her children when she is released from hospital.

She decides to return to Xolani.

14 March

Transkei Hospital

The Isolation Ward. Nokwanda will most likely never leave this hospital again. The large trees and passing people seen through the ward windows might as well be a movie set to be watched but never felt.

There has been no contact from Xolani since Nokwanda left his home at the end of the holidays in January.   Right now it’€™s her mother she misses most. But Joyce has difficulty visiting because she cannot afford to leave her job and the pay that supports the other children at home, now including Malwanda.

Nokwanda’€™s roommate is Sindisa, who also dies from AIDS. The AIDS sufferers are ghosts in the corridors and rooms.

In contrast, the veteran band of children rampage through the halls in their child’€™s play, dodging the moving shadows, oblivious to sickness.

Now Nokwanda’s lifeline is the IV tube that carries the clear fluid into her arm. She tries to drink milk or juice but vomits it all back up. She coughs incessantly into her blanket. Her eyes are bright but her body has caved in as though the disease is consuming her from within. She drifts in and out of sleep.

The vomiting and diarrhoea began 10 days ago while Nokwanda was still at her mother’€™s home. Malwanda helped to care for her, bringing her juice mixed with water.

It was her sister’s husband who insisted they arrange transport to get her to hospital.        

“She is dying, you can’t leave her like that,” she repeats his words but makes no further comment about the reference to death.

Malwanda knew on an instinctive level what was happening. He cried when his mother became so sick, he cried when she left for hospital.

Nokwanda knows about but does not talk of her imminent death. It’€™s difficult for her to talk at all. She sinks into the bed, turning away from the window and the outside world and makes small murmurings, her legs twitch with light spasms, her body heaves with every breath.

16   March

Understaffed, undersupplied, the system’€™s forgotten stepchild, this hospital heaves with the swelling numbers of AIDS patients. Daytime is chaos. A television in the entrance to the ward blares. The nursing sisters outblast the television calling to each other in the corridors. Unaccustomed to the volume of hospice care that is now demanded of them, the sisters, trained to help patients live must adjust to helping them to die. Dr Sarah and the sisters struggle to create ways to accommodate this change.

So there are times when Nokwanda vomits alone. The pad under her bottom becomes soiled with urine and diarrhoea but assistance and fresh sheets are in short supply.

Dr Sarah has picked a few flowers from her garden to brighten Nokwanda’s room.   A friend has brought a bright pillowcase.  

Nobantu, a social worker, visits Nokwanda at Sarah’s request.   Soft-spoken, she gently strokes Nokwanda’s bony leg through the covers while they talk. Nokwanda bursts into furious tears, a sister has scolded her for taking the drip out of her arm herself. Nobantu’€™s stroking quiets Nokwanda and she steers the discussion to Malwanda’s future in a simple straightforward exchange that stops when Nokwanda begins to cough more, her breathing becomes laboured, she shivers. Making arrangements for her son’€™s welfare forces her to confront the reality of her situation. Exhausted, she sleeps.

To be continued