She turned one year old this week. We had at last learnt which day her birthday was on. Liza had been found when the home she was born in was searched in a drug bust in Cape Town earlier this year. All the adults in the house were arrested. She, being ill, was brought to hospital. She was severely malnourished, showed signs of fetal alcohol syndrome, was riddled with TB and was HIV positive. Amazingly she has survived despite a number of severe hospital-acquired infections she developed owing to her extremely vulnerable health in those first few weeks. She went to a children’s home after many weeks in hospital. She could not go to her family who had neglected her abominably. The only positive contribution her mother seems to have given her is revealing Liza’s birth date to the police.

What a start to a life.

Liza – the biological by-product of drug-induced unprotected sex. We see many, many of those in Cape Town. Alcohol, heroin, tik (metamphetamine) are rife in Cape Town.

How many of her rights have been infringed since the alcohol first started passing down the umbilical artery into her developing organs?

How many of her mother’s rights were infringed when she herself was growing up?

Liza - the product of inter-generational human rights violations.

She was in hospital for her first birthday as her vulnerable gut could not resist another gastro-intestinal bug. But she smiles and plays; the anti-retroviral drugs, the food, and the love and expertise of her carers are doing wonders.

What does her future hold? We know what we have saved her from. What have we saved her for? How can we realise her rights and protect any children she may have (under more propitious circumstances, one hopes)?

The life Liza has lived may be extreme in its pathologies, but each of those pathologies makes up a significant strand in the fabric of child health in South Africa


Liza died in October. It is remarkable how her short life affected us in the hospital and at Nazareth House which became her home for the few weeks that she was able to stay out of hospital. She developed a bout of gastroenteritis that had her back in hospital. We were so encouraged by the fact that her HIV viral load dropped to undetectable. Surely, we felt, we can now see her through this setback. But the damage had been done. She could not come off oxygen because of what the twin HIV and TB infections had done to her lungs. Her intestines could not heal well and swelled up, being unable to cope with the most simple of feeds. She could not deal with the minor infections that came her way. Between these setbacks Liza smiled and started to use her hands. ‘She liked to use her fingers to play with my hair’, one of the nurses told me. Every nurse, every doctor, the occupational therapists and the volunteers spent time with her. Surely the positive neuro-endocrine effects of such attention and love could save her!  We really thought so. We arranged for her to have oxygen at Narareth House, but then it all went sour again. Nothing worked and one evening we made the decision that it was fruitless to try to cure this latest assault on her tiny frame. We concentrated on comfort and said our goodbyes to this ‘biological by-product’ of damaged lives. Liza was so much more than this – ask anyone who met her in the last few months, and any of the dozens of people who attended her funeral.

Someone suggested that we name a ward after Liza – to be a symbol of who we want to be: people who value child life, of whatever provenance and brevity.