• The separation of Limpopo’s conjoined twins marked the first time such a complex surgery was performed at a rural hospital in South Africa, earning national praise, including from President Cyril Ramaphosa.
• On Friday, one of the twins succumbed to complications from post-operative infections, despite the medical team’s relentless efforts to save him.
• The surviving twin is showing signs of recovery.

President Cyril Ramaphosa hailed them as “miracle workers”.

But on Friday, the team of doctors who separated Limpopo’s conjoined twins on 29 January during complex surgery at Mankweng Hospital were mourning the loss of one of the babies.

Health Minister Aaron Motsoaledi, who visited the hospital on Friday, confirmed that one of the babies, a boy, had died from an infection, although he had been surprisingly the stronger of the two at birth.

“I am going to see the mother before I leave here. We want to limit traffic to her to avoid any further infections to the remaining baby.”

He added that the surviving twin had been taken off a ventilator and was breastfeeding.

“He weighs 3.9kg, which means he is growing very well. The doctors did their best, but ultimately, the outcome of life rests with the Creator. Medical staff can only do so much,” Motsoaledi said.

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On Friday morning, Limpopo Premier Phophi Ramathuba announced that one of the boys had died from complications linked to infections.

She received a call in the early hours of Friday morning informing her that one of the twins had gone into multiple organ failure.

“We do have sad news. One of our twins, unfortunately, experienced multiple organ failure. The team tried everything in their level best, but our baby succumbed and has passed on,” the premier said.

Speaking at Mankweng Hospital, Ramathuba said the death was a devastating blow.

“It is supposed to be Good Friday, but it is not a good one for us. It is indeed a painful and sad one,” she added.

The death comes just weeks after the province celebrated what was described as a medical milestone – an eight-hour operation led by Professor Nyaweleni Tshifularo to separate the boys.

This marked the first time such a complex procedure had been performed at a rural hospital in South Africa.

At the time, President Ramaphosa phoned into a media briefing to commend the team.

He said:

Tshifularo, addressing the media alongside Ramathuba on Friday, said the surgical phase had been executed successfully, but the danger had always lain in the post-operative period.

“We prepared very well. We operated on them; we separated very well. It is within that stage that we had problems,” he said.

He added that complications had emerged around day five after the operation, when both babies developed infections.

“It was so bad that we felt maybe something is not right inside. We need to go back to theatre. We checked, and we were happy that the babies were fine. We came back and continued fighting the infection,” Tshifularo said.

According to Tshifularo, the medical team managed to stabilise one of the twins, but the other one had not responded to treatment.

“We won with one, but with the other one, we didn’t win. We fought for the baby, but one could not win,” he said.

Ramathuba said the twin who died had shown signs of recovery after undergoing further procedures, raising hopes that the worst had passed.

“At some stage we thought we were out of danger. But in the past two days, the condition changed, and last night it deteriorated.”

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She added that infections remained a leading cause of death among neonates, particularly in the critical weeks following major surgery.

“Even for adults, post-operative infections can lead to complications, organ failure and death,” Ramathuba said.

She said a post-mortem to determine the precise cause of death had not been ruled out.

“We must check what could have happened, whether anything went wrong on our side. We do not want to speculate.”

Despite the loss, both Ramathuba and Tshifularo defended the surgical intervention and insisted the separation itself had been successful.

Ramathuba added:

Tshifularo added that the team had followed every protocol in preparing for the operation, including seven multidisciplinary planning sessions and simulation exercises.

“If another opportunity happens like this, we will carry on. We did everything right,” he said.

Ramathuba said the surviving twin remained under close medical supervision and was showing signs of recovery.

“Twin B has been extubated, is breathing on his own and is stable,” she added.

She appealed to the public to respect the family’s privacy and offer support.

“This is not the time for insensitive comments. It is a time to pray for the family and allow them space to mourn,” she said.

Meanwhile, Motsoaledi said Tshifularo was “devastated” at the loss of the baby.

“There was no way he couldn’t be devastated after working so hard to be so successful. The premier has informed me that he (Tshifularo) is not in a good space,” he said.