Read time: 12 mins

The Failing Heart

by Gail Davey
26 April 2023

I’ll never forget that evening. I was sitting where the late sun falls on our threshing area, hulling broad beans.  We live at the top end of the village, and the sound of our neighbours’ oxen being released from the plough came drifting up to me, together with the chirps of serin settling down before dusk. It’s my favourite time—I love to watch the shadow of the escarpment lengthen, capturing the fields below us, terrace by terrace. A mist often collects in the bowl of the village; it is as though all we’ve done during the day is gathered there together, and then as the sun finally dips behind the escarpment, it is released up to the heavens.

That evening, I’d just called my little one over to watch a huge bright green beetle. It had landed on a rue shrub with such force that the whole stem bent double. We were both laughing at how it clung on even though its back was on the ground. Alem—she was only five—started stripping trefoils from the rue and crushing them between her fingers. Then I showed her the lemon mint, the sorrel and the verbena, so we were in a tizzy haze of sweet air when the headman’s nephew came running up the sheep track and jumped the low thorn fence surrounding our house.

‘Beza!’ he panted, ‘It’s about Mabrek—there’s been a call from Addis Ababa, from the house she’s staying in. You must go tomorrow; they’re expecting you.’

You can imagine how that left me. My heart rose up in my throat, beating so hard my silver cross bounded on my chest. The sharp scent of verbena brought me back to myself.

‘What’s happened?’ I croaked. Alem started crying, not knowing what was wrong but picking up the shards of distress flying all around.

‘I don’t know, but my uncle said to tell you there’s no bad news.’ He turned and ran back down the path, wrong-footing our nanny goat as he leaped the fence a second time. I could still conceive no good thing provoking a call of this urgency, but gathered myself, took Alem in one hand, the broad beans in another and went inside the house. I sent Alem to fetch her father from the neighbour’s plot, where he had spent the day making a new roof frame, and gathered a shawl and bread for the journey and a gift of honey. My husband Mistir arrived with Alem on his shoulders, sweat glistening at the base of his neck and anxiety stretched across his face. I told him all I knew; he listened, and we agreed he would stay at home with Alem while our son would walk with me to the road. It was late for buses, but we knew that if I reached Debre Birhan that night, I should arrive before noon the next day in Addis Ababa.

I found myself looking out of the bus as a half-moon etched the juniper forest with brittle light. Thoughts pressed from every side; memories rose up like boiling milk, but I told myself to think only of what lay ahead so as to give everything of worth to my eldest daughter, Mabrek.

Mabrek’s guardians were there at the bus station in Addis Ababa, scanning each bus that came from the north-west. I threw my arms around them, feeling Bizunesh’s thin shoulders through her clothes.

‘Don’t worry’, they both urged. ‘Mabrek is fine; we’ve had good news, and the doctor needs to speak to you.’ This could only mean one thing, and even through my travel-weariness, I felt hope prick its ears inside me.  The driver opened the door of Bizunesh’s car and helped me up onto a grey seat twice the size of the one I had just shared on the bus. We drove through those bewildering streets thick with hawkers, donkeys and scores of people walking here and there in every direction imaginable. Previously, I had been among those people, struggling to find the right way, trying to avoid tripping on the rough roadsides, but now I was borne past them like some feudal lady.

We arrived at the hospital gates close behind Bizunesh’s other car which had brought Mabrek direct from their house to spare her the wait at the bus station. I could see her head through the back window, hair in beautiful plaits like furrows on a field. I leapt out and ran to kiss her, running my hands over her tiny face and my eyes over the bright white dress and shoes she wore.  Suddenly I remembered my frayed bodice, the old, faded shawl I had wrapped round my head. But there was no time for embarrassment, and I hugged my little white bird to me, the sharp saps of grief and delight mixing inside me.

Our time with Dr Feleke was brief. He explained why I had been called: Mabrek had been offered surgery overseas, and before the process could go further, my permission was needed. He began to tell me that all might not go well—that of twenty girls like Mabrek, this number might not survive the journey, that number the operation—but I was barely listening. I knew my precious daughter must go, that this was the dream for which I had left her at her guardian Bizunesh’s house eight months earlier. He printed my name and her father’s name on a paper, and I signed hastily, eager to catch this opportunity before it was grasped by someone else. He then wrote papers for tests for Mabrek, listened to her heart and measured her weight. At thirteen years, she was only twenty-seven kilograms, certainly less than her ten-year-old brother, but this is what her condition had done, gnawing away at her from inside as a dog sucks the marrow from a bone.

* * *

I found myself thinking back to what I had been told about the condition. It is hard to believe the extreme effects that such a tiny particle can have. They told me Mabrek’s body had reacted against small splinters shed by a living speck, itself smaller than any visible seed or grain. At the time it seemed just like any other birrd or chill in a seven-year-old; she was a little feverish, complained of sore throat and went off her food for a few days. We steeped garlic in milk for her, and soon enough she felt better. It was only some months later that she seemed to struggle walking up through the village from school or stooping to harvest tef. Our attention and energies were then diverted by the arrival of little Alem, and Mabrek proved the most loving older sister. However, at Mabrek’s ninth birthday, we noticed how her new dress hung off her, how she stayed sitting rather than dancing eskista to the radio. She let me look at her closely that night, and I saw how her ribs had been pushed outwards by the struggling animal that was her heart.

Three days later, on the seventh of the month, I went to our priest, Father Henok. I elected to go on this day, Selassie, as it is the name day of our church. Abba Henok had been at prayer since before dawn, and at the third hour had just left the church to bless the mendicants at the gate. I brought him a package of food, described the changes we had noticed in Mabrek, and asked him for guidance. He appeared familiar with the course of events I described and commiserated with the heavy burden God had laid on us. He assured me Mabrek was in God’s hands and gave me holy water with which to anoint her but also counselled me to seek advice at the clinic in Hamus Gebaya.

The nurse in the clinic stunned me by saying there was nothing to be done and that Mabrek’s heart would fail before the age of marriage. He added that physical exertion was best avoided and implied that the lengthy walk to school should be curtailed, since the long-term fruits of education were unlikely to be garnered in Mabrek’s case. I am still not sure what made me angrier, this fool’s fatalism or his impudence in suggesting we take Mabrek away from the very sphere in which she still thrived and could forget her increasing debility. Whatever; I strode out, determined to seek some better advice for my precious girl.

I did not have to wait long; the midwife saw me leave the nurse’s room, my face tight to avoid spilling tears. She had looked closely at Mabrek while we were waiting and now beckoned me into her room. It was not much of a room. There was a couch, a single chair and a small desk with a plastic hearing trumpet on it. A poster on the wall showed a smiling, well-dressed family, mother, father, boy and girl, under the caption ‘Confidence—power in your hands’. Little in the midwife’s demeanour or surroundings suggested either confidence or power, but I sensed a simple, lazy goodness as she chucked Mabrek under the chin and lifted her onto the couch.

‘My cousin’s child became like this’, she stated flatly. ‘There is nothing for the condition here, but in Addis Ababa there is a clinic. Go to Tikur Anbessa hospital and ask for Dr Feleke.’

This was all she could tell me, but I stepped out of the clinic as though nothing lay between Mabrek and full health. We stopped to take cinnamon-spiced tea as a small act of celebration before catching the bus home, and thoughts of hope buoyed me as I gathered Mabrek’s tiredness to myself and leant with her in my arms against the window, watching fork-tailed kites swirling as the sky faded and finally bloomed black.

Of course, the process was not simple, and I look back now to the many hurdles set in our way with amazement that we surmounted them. There were long days in the hospital, waiting in line for registration cards, consultations, tests and medicines. There were indifferent people, weary people, discourteous people and bored people. There were children much sicker than Mabrek and families who had travelled twice or three times the distance we had. But there was also the marvellous moment when we saw the inner workings of Mabrek’s heart, writhing and rollicking in a grey mist on the screen. After this, we spoke with Dr Feleke. We were taken to his room where he indicated we should sit while he studied the sheaf of reports on Mabrek. He looked up, and I knew that he had made the same cautious statement to many families before us.

‘There is hope for Mabrek, but it lies outside our country. She needs an operation on her heart which cannot be done here. She will be put on our list for overseas treatment, but I must warn you that very few on this list are called. You,’ he removed his spectacles so as to look more directly at me; ‘you must make every effort to find a sponsor and come to another arrangement.’

So there it was, almost as bleak as the clinic nurse’s prediction. Part of me became discouraged as was only reasonable; part of me wished to rise to this new challenge. I had the presence of mind to offer thanks to Dr Feleke, wrapped Mabrek’s registration card securely in my shawl, and then led her out into the throng of the outpatient waiting area. It was more than usually crowded, yet people were mostly standing still, and all were facing in one direction. I turned and realized that the television had been switched over to a live broadcast. Our athletes were running.

As I watched, they moved to take the first three places, green tops and red shorts moving in synchrony, only the flicker of an eyelid to show they knew each other’s position. Cheers broke out from all round the waiting area and grew in volume as the three entered the final stage of the race. The second moved to the shoulder of the first, who strained but had to yield. People lifted children to their shoulders, and the whole area exploded with claps, whistles and roars of excitement as our athletes crossed the line: first, second, third. They embraced each other; one bent to kiss the track, and the camera moved in close. The winner looked up, her expression a luminous meld of delight and determination. A frizz of apprehension tickled the nape of my neck as I suddenly knew she was the one to whom we would entrust Mabrek.

It was four more days before the athletes returned to Ethiopia. I sent a message to Mistir telling him that we needed to stay in the capital in order to find Mabrek a sponsor and settled Mabrek with my cousin’s relatives in the Korean war veterans’ village. My task was to identify and meet the tiny athlete who would become my daughter’s only hope.

After two days of enquiry and much walking, I identified the house of Bizunesh Dagne, the athlete whom I had watched add the World crown to her previous victories. None of the athletes hid themselves away or took precautions to protect themselves from the public, but the house was on the furthest side of the city, and extensive road building meant that public transport was scarce. During my enquiries, I had heard that the athletes were to be welcomed back with a formal ceremony and tour of the city; thus I planned to wait a full day after Bizunesh’s return before approaching her.

When the day came, I woke early, kissed Mabrek and asked her to pray while I was away. She sensed I was taut as a loom but did not know in any detail the plan I had. She sat up, her arms painfully thin against the bulky blanket she had wrapped around her, and stretched out her hands to hold mine between them.

I knew that I was unlikely to be admitted to Bizunesh’s compound and so decided to wait for her at the gate and intercept her in the car. I had no very clear idea as to how I would win her attention or speak to her about Mabrek but trusted that at the vital time I would be given the right words.  I did not have to wait long: I heard the growl of the car bumping over the rough surface of the approach road; then the driver turned sharply into the narrow alley where I waited, sounding the horn twice. I could see Bizunesh bright in her national tracksuit in the front seat, and just as the gate was opened threw myself headlong in front of the car, blocking its entrance into the compound.

The next few minutes I find difficult to remember plainly. I felt myself struggling in a sea of emotions—terror and hope oscillated in me while exasperation, even anger, seethed around. One thing I believe I recollect accurately was the calm that radiated from Bizunesh, who quietened the resentment of her household and then listened seriously and thoughtfully to all I had to say. She brought me into the house, offered water and went away (as I later understood) to discuss my plea with her husband. When they returned to where I was sitting, the manner in which Bizunesh took my hand told me that they had decided in Mabrek’s favour. An enormous lightness welled up in me, almost obscuring what they had to say: that Mabrek would stay in their house while they made every attempt to find treatment overseas. Bizunesh hugged me and then started laughing as she realized that the dust I had lain in at the gateway had transferred itself down the length of her tracksuit.

* * *

At times these memories seem very distant; at others, they return clear in every detail. I sit as Alem hulls the beans and watch cloud banking up against the escarpment, just as it did the evening the headman came, lifting his legs stiffly over the thorn fence.

‘Beza, call Mistir’, was all he said, and a coldness entered me. The men talked together; the headman left, and Mistir sat by me.

‘Mabrek will not be returning home. She passed yesterday during the operation.’

He has never blamed me, never suggested my efforts for Mabrek were misguided, yet we can never talk about the additional loss we suffered being unable to bury her. There are those in the village that say we should not have let her travel, that Mabrek should have stayed here until her natural time came, so we at least would have been able to mourn her and bury her properly.

I find it hard to know if I did what was right. The part of me that seemed so immediately to know what was for the best has shrunk to bare existence. I pass through the days and the seasons willingly enough but dull to the extremes that previously moved me. I fulfil my duties in planting and harvesting, in threshing and grinding, but I hesitate to think outside this sphere, to remember the time when I struggled for more, when I reached out far and drew back my hand full of ash.

About the Author

Gail Davey

Gail Davey is a medical epidemiologist who spent ten rich years living and working in Ethiopia. She is now based in Brighton, UK, but continues to do research on neglected diseases in East Africa. Her short stories mainly centre on experience gained in Ethiopia.