The sound of screams rose from the Bhobhoyi home of Mary Smith as her son hacked his two-year-old niece and three-year-old nephew to death with a panga on Sunday morning.

And when Siphamandla Smith‚ 20‚ finished his flailing blows‚ he set upon his grandmother with the machete in the rural KwaZulu-Natal south coast area.

The 57-year-old grandmother is the sole survivor of the family massacre‚ after Smith was run down by a car as he fled the scene of the horrific crime just moments later.

She remains in a critical condition in a Port Shepstone Hospital‚ having sustained severe head injuries in the attack.

Several of her fingers were also amputated as she tried to defend herself and the children from her son.

Police spokesman Lieutenant-Colonel Thulani Zwane said that Siphamandla Smith was mentally disturbed and had “gone on the rampage” shortly after 7am at his family homestead.

“He hacked his sister’s two-year-old daughter‚ Siyamthanda Precious Smith‚ and his brother’s three-year old son‚ Thobane Khwane to death‚” he said.

“It is alleged that the suspect then ran off to the N2 where he flung himself into a passing motor vehicle and was fatally injured. The Port Shepstone SAPS has registered two counts of murder‚ one of attempted murder and an inquest for investigation‚” he said.