“Sickle cell isn’t a death sentence. I can live a full and happy life. I deserve that. I know that now.”

There are several books on what sickle cell is, what a sickle cell crisis feels like, the quality of life of its patients and the different shades of sickle cell, but Busayo Matuluko’s ‘Til Death stands out.

‘Til Death is a young adult thriller set in Lagos, Nigeria, and explores the theme of marriage and family, as well as subtly yet pertinently, the stigma surrounding the chronic illness of sickle cell disease (SCD). ‘Til Death focuses on 24-year-old Derinsola, who is among the 4% of SCD patients who experience less than three vaso-occlusive crises per year. This reality informed Derin’s decision to hide her sickle cell diagnosis from almost everyone, including Lara, who is technically her sister. The need to conceal her truth highlights the fear of judgment and differential treatment associated with the illness, “I have been conditioned to not talk about it all my life because it never affected me, and then when it did, life felt like before and after.”

Despite the bias against love in Lagos, Derin had found sweet, soft love in Lagos to a Yoruba man. Except love won’t save her life from her mother-in-law, who thinks it is a crime for her son to marry a sickle cell patient and would go to any extent to stop it. Since Derin’s engagement to Kayode, she started receiving threatening notes to call off the wedding and acts of sabotage, including a ripped wedding dress and potentially poisoned wedding cupcakes, all indicating a deliberate attempt to disrupt the wedding. The protagonist, Lara, draws on her ambition to be a detective and assumes an investigative role to discover the enemy. Busayo employs suspense and plot twists to keep the reader desperate to know what happens next.

Busayo’s ‘Til Death explores love and romance through the lens of a sickle cell patient. It embodies the core theme of commitment despite past relationships, interfering family members, and external threats. It reveals how a medical condition can affect one’s chances of finding love and having a happily ever after. The narrative also reveals the extent a Nigerian mother would go to prevent her son from marrying a “sickler.” Kayode’s mother had broken up Kayode’s relationship with Seni simply because she was carrying a sickle cell trait (AS). With Derin, she doesn’t mind if it costs her life or her son’s happiness, she just doesn’t want either the trait or the disease in her family.

There are many more Kayode’s mothers in Nigeria who think sickle cell is a death sentence. With about 50 million people carrying the sickle cell trait and 150,000 newborns affected yearly, Nigeria is the sickle cell capital of the world, as it accounts for 33% of the global burden of sickle cell disease (SCD). Despite this, the stigma and ignorance surrounding the disease are as high. Advocacies usually focus on how sickle cell diseases can be prevented in terms of genetic compatibility and how sickle cell crises can be managed. But beyond the crisis, a lot of Nigerians still live in the dark about what sickle cell truly is and how the lives of the patients are affected. And it is this rarely talked about side that Busayo’s ‘Til Death explores.

Uncle Tayo’s efforts to organise a blood drive are rooted in the need to “debunk stigma and help those who need it the most,” indicating the prevalent negative associations with sickle cell. Uncle Tayo’s support of hiding Derin’s illness is rooted in the fear of his daughter being treated differently and viewed as fragile. As he told Lara, “If you knew about her sickle cell, you would’ve treated her differently, whether you think so or not.” The pastor’s sermon at the blood drive, which links infidelity to the birth of a child with sickle cell, further illustrates how the condition is often entangled with negative moral judgments.

Busayo also explores the complex web of family relationships within a Nigerian context. The uncle who lacks financial literacy and squanders money, the wives of brother-siblings whose relationship is a light switch, the child who is studying what his father chose for him, the child who refuses to have her career chosen for her, the bride with the multiple mothers, and the mother-in-law who has reservations about the bride all create a realistic Nigerian environment. The narrative also incorporates elements of Nigerian life, such as the obsession with punctuality for flights.

Busayo also uses ‘Til Death to address the social scene of wealthy Nigerians and the influence of gossip and social media on relationships. The platform, Naija Gossip Lounge, plays a significant role in the narrative as it reveals the damage which social media, anonymous online harassment and cyberbullying do to one’s reputation and mental health. On the flip side, it also admits the importance of social media in advocacy, as Derin later decided to confront the stigma. She decides to use her platform to “educate people, destigmatise the disease, and show that you can have a happy life even with sickle cell.”

Busayo’s mystery is well-layered and normal-paced. The language is sharp and witty with a spice of humour, and there is an infusion of Yoruba language, which adds authenticity to the narrative. Busayo’s sharp writing, authentic characters and personal connection to sickle cell disease all make ‘Til Death a worthy read.