When paediatricians first saw Joshua’s heart, they looked at each other and asked: “How is this boy still alive?”
The reply from paediatric cardiologist Dr Adele Greyling on the four-month-old baby’s remarkable survival was simple: “You will have to ask his mom.”
Through motherly instinct and an abundance of love – but mostly because she constantly held him to her own chest – Joshua’s foster mom, Elmarie van der Merwe, managed to keep alive the baby who was placed in her care when he was six days old.
This was even though he had only half a heart with many malformations.
Van der Merwe, 52 – who has now celebrated Joshua’s fifth birthday with him – recounted the astonishing love story this week at the start of Heart Awareness Month.
“I had just got divorced and I thought I had lost everything. Then Joshua was placed in my care,” she said.
Joshua had been removed from his mother by social workers due to drug abuse.
Van der Merwe is a registered safety mom and runs Forever Family Homes in Walmer.
“When I got Joshua I didn’t know anything about congenital heart disease,” she said, describing their journey through open heart surgeries and visits to the cathlab to fix his malformed heart.
“For the first four months of his life I couldn’t put him down. I learned to brush my teeth while holding him. I had to strap him to me to do anything,” she said.
Initially, while he was struggling health-wise, doctors and nurses assured Van der Merwe that Joshua was fine.
“I think that is the biggest problem with babies with congenital heart disease. They don’t show obvious signs of illness,” she said.
While braving the public health system and raising money for private doctors, Van der Merwe kept on looking for an answer.
Eventually she took him to paediatrician Dr Wayne Jones.
“He asked me: ‘Is he always this colour?’
“He looked a little blue but he had a respiratory infection so I thought that must be it,” Van der Merwe said.
It was on that day that Jones called Greyling in to consult.
Joshua’s body was getting so little oxygen that the equipment available at the doctor’s rooms couldn’t measure it. It was too low.
“I will never forget how Dr Greyling sent him home that day with me saying ‘just keep on doing what you are doing’,” Van der Merwe said.
A few weeks later – after doctors discovered how badly malformed Joshua’s heart was – they also discovered the answer to their question.
The infant was in Provincial Hospital’s intensive care unit following open heart surgery and was in very bad shape.
At the time, Van der Merwe posted on Facebook: “Love. Just Love. That is all I can do now.”
Despite hospital protocol, nurses pushed a chair into Joshua’s room and Van der Merwe picked him up and held him to her chest – just like she did in the first four months of his life.
“And then he got better. You could see it within a minute how he improved. The nurses were all astonished.
“And then his little hands that were always a little blue, just became pink,” Van der Merwe said.
The pair have been back to the hospital several times since then.
“I speak to him about death and about going to Jesus. He would tell me, ‘if Jesus comes to fetch me, he will bring you too’,” she said.
“It was always me and him against the world. When his condition was critical, I just thought: He is my own flesh. This child is so deep in my heart,” Van der Merwe said.
“He saved me from so much heartbreak.”
When Van der Merwe took Joshua for his check-up after the first surgery, Greyling saw him in the passageway.
“She laughed and said: ‘Look how fat he got’.
“Before he had his first heart surgery doctors warned me that he would likely have brain damage as he struggled to get oxygen for so long.
“He is five now and I had him with the occupational therapist the other day and there is no sign of damage.”
Greyling said Joshua had a very complex heart condition.
He had already had two surgeries and needed another one, she said.
Van der Merwe is now in the process of adopting Joshua.
“We don’t know how long it will last but he is doing well for now,” she said.
“Many people think that I have saved him, but he actually saved me too.”