Ọmọ London: The Sickler I

September is Sickle Cell Awareness Month (in USA at least, in Britain the month is actually July); so essentially you should be seeing more stuff to do with sickle cell on the news and whatnot, hence the ‘awareness’.

According to the NHS’ website, sickle cell disease is the name for a group of inherited health conditions that affect the red blood cells. The most serious type is called sickle cell anaemia. If you read on, the page will inform you in as not so many words, that black people are primarily affected by it. Essentially, sufferers of the disease have red blood cells that are curved, almost like a sickle (hence the name) due to an anomaly in haemoglobin (the oxygen-carrying protein of the red blood cell). A healthy red blood cell is supposed to be round, or at least, cellular (you catch my drift?). As a result, people with SCD are prone to episodes of poor health (which have been termed ‘crises’), have an increased vulnerability to infections, and tend to need blood transfusions due to the anaemia that comes with having SCD. There are more but I won’t go into them for fear of not doing them enough justice, as I do not have SCD and I do not want to say the wrong thing.

“That’s Jide” said Kunle to me as he gave me a nudge.

“From the Big House”? I ask. I look at the boy, walking beside Tayo. Jide is holding a chain and at the end of the chain is an intimidating German Shepherd.

“Yes” confirms Kunle.

I nod silently and look on as they walk past our house towards the market. A few people also look on; it isn’t every day you get to see Jide from the Big House. We see everyone that lives in the Big House regularly except Jide. Jide is only seen now and then. Only when he’s strong enough.

“What’s wrong with him”? I ask. My eyes are still fixed on him; Jide is probably a year or two younger than me and looks normal, so why doesn’t he play football with the rest of us?

“He’s a sickler” Kunle replies.

“What’s a sickler”?

“Someone that has sickle cell”

“Sickle cell”?

“You don’t know what it is”? Kunle turns to look at me, surprised that he knows something I don’t. I had garnered quite the reputation as being a smart kid. It was because I enjoyed reading, but many attributed it to me being from London.

“No” I shrug as if to show I didn’t care, but I did. I hated not knowing things, I like to know everything, even the small things that seem irrelevant.

Kunle then proceeds to tell me about how people are born with differing haemoglobin types, and how everyone is either AA, AS, or SS. Kunle tells me that AA people are healthier and can have children with anyone regardless of if that person is AS or SS as the children they would have will be either AA or AS. AS people can have children with AS but they have a higher risk of giving birth to a child with SS, even though they would also have children that are AS or AA. SS people are the sicklers, and they should ideally only have children with AA people, and never with SS, as “Sickler times sickler, equals to sickler squared”

It was a lot for me to take in at once, as I didn’t know such types existed in blood, I had only known about the ABO system at that point. Years later, my own research made me realise Kunle’s explanation was several marks off the target. While what he explained to me was rudimentary sickle cell anaemia, he didn’t know there was more to SCD than SCA. Being AA, AS and SS also is are not the only way to determine if one has sickle cell or not. Some people are born with haemoglobin C, D, E, O and Lepore, and each type has their corresponding sickle cell disease. There are other SCDs such as beta thalassaemia and delta beta thalassaemia. That being said, other SCDs only affect people from a specific ethnic group. You can read more about it on the NHS’ website, there’s a detailed PDF under ‘Carriers’ that can provide more depth.

I nodded and didn’t say anything. I didn’t know what to say.

“So are you AA, AS or SS” Kunle asks me.

I look at him, confused and bewildered. “How on earth would I know what I am when I just learnt about it now”? my voice cannot mask how stupid I think he is for asking me that.

Kunle was not to be stopped however “Ok, when last were you sick”? he asks me, ignoring my tone.

I give his question some thought and shrug. I rarely fall ill, even though mosquitoes feast on my foreign blood every single night, heralding their arrival at my ears before they dive in. “I don’t know” I say.

“Then you are an AA” Kunle declares with an air of authority. “AAs rarely fall ill”

The logic was way off, but it made sense to me. Years later, I asked my mum what my haemoglobin type was, and she told me AA. It just confirmed what I already knew; I rarely fell ill, and I had stumbled across my dad’s blood test results, his type is AS. I concluded that since he is AS and I rarely fell ill, it could only mean that my mum is an AA and I was also AA.

We were still sitting on the bench in my front yard when Jide and his brother returned. Tayo held the chain now and Jide had a black nylon bag in his clutches. As they passed my house, Jide looked over and when our eyes met, I smiled. He smiled back and waved. I waved back, and Tayo looked over and scowled at me. If the scowl was because I beat him on FIFA last week or because he didn’t want me to speak to his little brother, I didn’t know or care.

I knew one thing though; come what may, Jide was going to be my friend.

My uncle’s voice interrupted my thoughts; I hadn’t finished my packing and I was going back to school tomorrow.

I hurried back inside, bidding Kunle a hasty farewell.

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