The greatest gift: Twins reunited after months-long fight for survival

Being together over the festive season had special significance for the Ndlovu family after one of their identical twin babies returned home, thriving after spending months fighting for his life in a paediatric intensive care unit in another province. “Our twin boys, Kwandokuhle and Kwenzokuhle, were born in April 2025 and at the end of May, when they were just over a month old, both of them developed a flu-like illness. We rushed them to the hospital, and Kwenzo was placed in isolation while we awaited their blood test results,” Andile Ndlovu, from Howick in KwaZulu-Natal, recalls.

Both twins tested positive for respiratory syncytial virus (RSV), and doctors discovered a hole in Kwando’s heart that further complicated his situation. While Kwenzo remained in the local hospital, his twin, Kwandokuhle’s condition was deteriorating, and doctors discussed the need to transfer him for specialised care at Netcare Waterfall City Hospital in Gauteng. “We were so worried about him, and the doctors explained that his life was in danger, but there was an option to take him to Johannesburg for specialised treatment called extracorporeal membrane oxygenation (ECMO), but that this also came with risks that we had to be aware of,” Mr Ndlovu recalls.

Netcare, together with specially trained advanced life support paramedics and cardiothoracic surgeon, Dr Sharmel Bhika, operates an ECMO retrieval service specifically for children like Kwando, who are too critically ill to be transferred by conventional ambulance services, enabling their transport to centres where they can be continuously supported and receive escalated care for the best chance of eventual recovery. At the referring hospital, Kwandokuhle required maximum mechanical ventilatory support and yet he was not reaching adequate oxygenation. “High pressure positive-pressure ventilation, lung overdistension and high inspired oxygen concentrations can all lead to secondary lung injury, which increases the risk for multiorgan injury and dysfunction,” Dr Bhika says.

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ECMO is a form of life support in which specialised equipment artificially performs the functions of the heart and lungs, giving them a chance to heal. “It was a clear indication in Kwandokuhle’s case as his rapid deterioration and increased demand on mechanical ventilatory support were possibly causing more harm to his body, and secondly, ECMO would be required for the safe long-distance transfer of our tiny patient,” she says. ECMO is only considered in life-threatening circumstances for young children, and paediatric ECMO transfer is a highly specialised and complex service involving extensive teamwork and months of training and preparation.

“It is not viable for every child in respiratory distress, and even for clinically-appropriate patients who receive this advanced heart and lung support as a last resort, the odds against survival remain significant. But for some, like baby Kwandokuhle, it offers a chance for recovery where there is otherwise very little hope,” Dr Bhika added.

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