A medical emergency, a cross-provincial transfer and months in a paediatric ICU stood between two twin brothers, until expert care and resilience brought them back together again.
KwaZulu-Natal, South Africa (28 January 2026) – Nothing prepares you for watching a tiny human fight for their life, especially when that fight means being separated from their twin and their parents for months on end. For the Ndlovu family, those months were filled with fear, long drives, hospital corridors and prayers, all leading to the moment they finally brought both their boys home, together.
Being together over the festive season carried extraordinary meaning for the Ndlovu family after one of their identical twin boys returned home, thriving after spending months fighting for his life in a paediatric intensive care unit in another province.
Born in April 2025, Kwandokuhle and Kwenzokuhle were just over a month old when everything changed.
“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,” recalls their father, Andile Ndlovu, from Howick in KwaZulu-Natal.
Both babies tested positive for respiratory syncytial virus (RSV), but further tests revealed that Kwandokuhle also had a hole in his heart, complicating an already serious situation. While Kwenzokuhle remained in the local hospital, his twin’s condition deteriorated rapidly, prompting doctors to raise the possibility of transferring him to Netcare Waterfall City Hospital in Gauteng for specialised care.
“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 says.
Netcare, together with specially trained advanced life support paramedics and cardiothoracic surgeon Dr Sharmel Bhika, operates an ECMO retrieval service designed for critically ill children who are too unstable to be transferred by conventional ambulance services. At the referring hospital, Kwandokuhle required maximum mechanical ventilatory support, yet his oxygen levels remained dangerously low.
“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 explains.
“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.”
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Paediatric ECMO is only considered in life-threatening circumstances and requires extensive preparation and teamwork.
“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 says.
According to Mande Toubkin, Netcare’s general manager of emergency, trauma, transplant and corporate social investment, “A long-distance ECMO retrieval for such a small patient requires meticulous planning and coordination from many specialised team members.”
For the Ndlovu family, watching the process unfold was heartbreaking.
“It was so painful for us to see about 20 medical professionals around our small baby. After a four-hour procedure to prepare Kwando for ECMO, we were glad to hear it went well and the next morning the doctors said they were confident he was ready for the journey on ECMO,” Mr Ndlovu recalls. Kwandokuhle was placed on veno-arterial ECMO to support both his heart and lungs as he travelled by ambulance to the Pietermaritzburg airport, then by medical evacuation flight to Lanseria, and finally by ambulance to Netcare Waterfall City Hospital.
One of the hardest moments came when the family had to let their baby travel without them.
“We saw Kwando being put on the plane, and it was so hard for us not to be able to go with him. Our other twin first had to be discharged in KZN, so we had to wait to pick him up and get Kwenzo settled in with his grandparents, before we could drive up to Gauteng early the next morning to be with Kwando,” says Mr Ndlovu.
When Kwandokuhle arrived at the paediatric intensive care unit, his condition was critical.
“A baby so young hasn’t had the chance to develop a strong immune system, so his body was fighting this ravaging lung infection on the one hand, while his little heart was also struggling due to the congenital defect. We were all extremely concerned for him, but we were determined to give him the best possible chance of survival,” says paediatric intensivist Dr Palesa Monyake.
Around the clock, ECMO-trained nurses and doctors cared for him while his parents travelled back and forth from KwaZulu-Natal whenever possible.
After weeks of uncertainty, Kwandokuhle began to show signs of improvement.
“Eventually, after a difficult road, the day finally came when Kwandokuhle recovered sufficiently for us to take him off ECMO, but his lungs were still under strain because of his heart defect. He faced a last major hurdle – the time had come for the surgery to repair his heart,” Dr Monyake explains.
“Kwando had so many ups and downs in the two and a half months that he was with us, and at times, we didn’t know if he was going to survive. For all our knowledge and experience, God shows us His will, and Kwandokuhle suddenly bounced back like a champion.”
The surgery to correct his congenital cardiac lesion, known as patent ductus arteriosus (PDA), proved to be another turning point.
“Without surgery, a PDA can cause a significant increase in blood flow to the baby’s lungs, raising pulmonary arterial blood pressures, which in Kwandokuhle’s case could result in difficulty weaning him off the ventilator and a more protracted ICU course,” Dr Bhika explains. “Fortunately, Kwandokuhle’s PDA ligation procedure was successful, and he returned to the PICU, where under the constant care of specially-trained PICU nurses and Dr Monyake, he was weaned off oxygen and began to gain weight healthily.”
When the Ndlovu family arrived to see Kwando the morning after his heart operation, they were overwhelmed by the change. Having spent half his young life separated from his twin brother and parents while on life support, Kwandokuhle was finally strong enough to return to KwaZulu-Natal, closer to home and family.
“We were very excited when it was time to bring him home. Kwandokuhle came back strong; he was even smiling, like a child should. Since the surgery, he has been doing very well, and he is playful, healthy and gaining weight,” Mr Ndlovu says.
Today, the twins are reunited, thriving and filling their home with laughter.
“We are so happy, it is the greatest gift to have our twins healthy at home and reunited. We celebrated our first Christmas together as a family at home. Kwando and Kwenzo play together so beautifully, and we are recording these memories for the twins when they grow up.”
After months of separation, machines and miles between them, two little boys are back where they belong, side by side, growing up together under the same roof.
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