By Bronwynne Jooste
It's almost an understatement to describe the birth of Nhlahla Ncise, who turns five this week, as a miracle.
The lively little girl, who was formed in her mother Cwayita's liver, turns five on Tuesday.
In 2003, she was born healthy after a lengthy and complicated operation. At the time doctors said she was only one of a handful of babies in the world to survive this type of medical complication.
Ahead of her big day, Nhlahla was playing with her four siblings in a park near her mother's little home in Samora Machel, Philippi, just like any other four-year-old.
Cwayita Ncise said she suspected something was amiss when she had not yet started showing six months into her pregnancy.
The Hanover Clinic noticed her blood pressure was high and referred her to Somerset Hospital. Staff were shocked to discover that Ncise's womb was empty.
She was sent to Groote Schuur hospital immediately, where doctors saw the baby was in her liver.
Normally, the egg is fertilised in the fallopian tube and then moves down into the uterus. In some cases, the fertilised egg travels the wrong way, falls out of the fallopian tube, and disappears.
The egg can then attach itself to a part of the body and start growing in an extra-uterine (out of the uterus) pregnancy. Usually it grows for a couple of weeks and then dies.
However, Ncise's case is so rare that, at the time, only 14 cases were recorded globally.
A specialist team started preparing for the operation to remove Nhlahla. Because the liver is rich in blood vessels and bleeds easily, it is a dangerous organ to operate on.
"I was so scared when I found out my baby was in my liver. My first thought was that she would not be normal," Ncise said.
Doctors found a "window" where the amniotic sac connected with the outside of the liver, and entered through there to deliver the little girl, who weighed in at 2.8kg.
Ncise said she had believed she would not be able to fall pregnant again, or would have to endure the same complication, but she gave birth to a healthy set of twin boys just more than a year later, Hlelo and Hlumelo. And the latest addition to the brood is one-month-old boy Bukho.
Ncise said she had mentioned Nhlahla's dramatic tale to the child, but she was "too small" to grasp it yet.
Today, she enjoys the favourite things of all four-year-olds. Her favourite TV show is Takalani Sesame and her Barbie is her special toy. She's excelling at creche and can already read and write.
Ncise, a single mother, admits that raising her large family has not been easy. She is unemployed and lives in a tiny one-room corrugated iron structure. The only income she receives is monthly social grants.
Adversity aside, Ncise also has big goals for her children, including her miracle baby.
"I want her to finish school and not start having children too young. She must get a job and have a good life."