JOHANNESBURG: Nelson Mandela remained in hospital for a fourth day Sunday after South African officials said the anti-apartheid hero was making steady progress following treatment for a recurrence of pneumonia.
The frail 94-year-old, one of the towering figures of modern history, was admitted late Wednesday for his third hospitalisation in four months.
Doctors drained a build-up of fluid, known as a pleural effusion or "water on the lungs", that had developed from the lung infection.
That procedure helped him "breathe without difficulty," President Jacob Zuma's office said in the last update issued on Saturday.
Zuma's spokesman Mac Maharaj said on Sunday: "I am still waiting to hear from the doctors, so my update of yesterday remains."
Asked if the doctors' silence should be cause for concern, Maharaj said that "if there was a turn, a significant turn, they would say something."
"I have said he is responding (to treatment), making steady progress," Maharaj said earlier.
It was unclear how long South Africa's first black president would remain hospitalised.
Mandela's recent health troubles saw an outpouring of prayers as Christians celebrated Easter Sunday, but have also seen South Africans come to terms with the mortality of the revered Nobel Peace Prize winner.
"Yes, we are concerned that he is ailing, and he is getting worse, naturally we should be concerned. I think this is the question in the back of many of our minds, when is the end? Is he going to die?" Father Sebastian Rossouw, an assistant parish priest at the Regina Mundi Catholic Church in Soweto township told worshippers.
"We should rather celebrate what he stood for, and what he continues to stand for, that he has been an icon of peace, an icon of service."
The Regina Mundi church was once a pivotal centre in the resistance against apartheid, offering shelter to activists.
The former president is idolised at home, where he is seen as the architect of South Africa's peaceful transition from white minority-ruled police state to hope-filled democracy.
Nearly 20 years after he came to power in 1994, Mandela remains a unifying symbol in a country still riven by racial tensions and deep inequality.
South Africa's renowned lawyer and Mandela's friend Gorge Bizos was confident Mandela would pull through the latest bout of illness.
"I know he has come out of quite serious illnesses before," Bizos told Eye Witness News.
It is the second time this month that Mandela has been admitted to hospital, after spending a night for check-ups on March 9.
That followed a nearly three-week hospital stay in December for another lung infection and gallstone surgery, his longest since he walked free from jail in 1990.
He was diagnosed with early-stage tuberculosis in 1988 during his 27-year jail term and has long had problems with his lungs. He has also had treatment for prostate cancer and has suffered stomach ailments.
Keertan Dheda, professor of respiratory medicine at the University of Cape Town, said a pleural effusion was the accumulation of water between the lining covering the lung and that of the chest wall.
Having the fluid tapped was normally a minor procedure, but other cases required the fluid to be chemically broken down if it had formed pockets. A minor operation would be carried out if infected.
But with age "the longer pneumonia takes to get better," and "a bit more complicated the older you get," he said.
French pulmonologist Jean-Christophe Renaud said Mandela had a good constitution and could recover well.
While Mandela's legacy continues to loom large, he has long since exited the political stage and for the country's youthful population he is a figure from another era who served as president for just one term.
He has not appeared in public since July 2010.
Labour unrest, high-profile crimes, grinding poverty and corruption scandals have effectively ended the honeymoon enjoyed after Mandela ushered in the "Rainbow Nation", but his decades-long struggle against apartheid still resonates.
Meantime at Tyrannus Church in Midvaal, south of Johannesburg, plans were already afoot to pray for Mandela even before he was taken ill.
"We pray that God will lift his hands and touch you and heal you, we still need you," said pastor Simon Mokoena.
In attendance at the service was Mandela's grand daughter Ndileka.
"I feel fortified and strong" that the prayer was planned before Mandela was hospitalised.
"Never in my wildest dreams did I think that by the time the prayer came he would be in a hospital bed," said Ndileka, according to the public broadcaster SABC.
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