Margot
Staunton RNZ Pacific senior journalist
Three
different countries asked for US$1 million upfront before
they would surgically separate rare conjoined twins born in
Fiji.
The 10-month-old girls – Di Cecea and Jesipeli
Kikau – were born prematurely in a set of triplets at the
Colonial War Memorial (CWM) Hospital in the capital,
Suva.
“The doctors said this is the first case of
conjoined twins in Fiji in 20 years,” their mother Akenata
Vulimaiigiladi said in a video shared by Fiji’s Health
Ministry.
“When they were born two months premature
the doctors said they might only survive for a few days. We
are grateful to the nurses, doctors and medical staff here
at the hospital for their service,” she said.
Help
sought
A team of paediatric doctors at CWM spent
eight months seeking help from multiple other countries,
including neighbours Australia and New Zealand.
“We
approached Mexico, the United Kingdom and the United States,
but they wanted US$1 million upfront to perform the
surgery,” one of the team in Suva who looked after the
twins, Dr Ilisapeci Tuibeqa, told RNZ Pacific.
She
said several countries they approached were only interested
in performing the surgery for research purposes.
“We
asked Australia if they would offer the family humanitarian
support, after (the Sydney Children’s Hospital) agreed to
operate on the conjoined twin boys from Papua New Guinea.
But we were told it was not possible.”
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“The initial
surgical team had asked New Zealand if it would consider
performing the surgery but doctors said that they were not
able to assist us with that,” Dr Tuibeqa said.
“I
think they made the decision knowing the complexity of the
surgery and the need for a multi-disciplinary team to do the
operation.”
Riyadh to the rescue
However, the
Saudi Arabian government offered to perform the surgery for
free on humanitarian grounds, while also paying for the
family’s airfares and accommodation.
The family flew
out of Nadi International Airport on Wednesday night bound
for Hong Kong, Doha, the capital of Qatar, then onto Riyadh,
the capital of Saudi Arabia.
Fiji’s government has
paid for a paediatric registrar to accompany the family on
the trip and liaise with doctors at the King Salman Hospital
in Riyadh, who are performing the surgery.
Dr Tuibeqa
said the hospital in Riyadh would review the case again
before fixing a date for the operation.
“We’ve shared
imaging and medical reports with them from when they twins
were about two or three months old,” she
explained.
The twins – fused below the sternum – spent
the first two months of their lives with their sister,
Hossana, at CWM Hospital’s neo-natal care
unit.
Humanitarian grounds
Dr Tuibeqa said she
was “exhausted” but “overjoyed” that the Saudi Arabian
government offered to perform the surgery on humanitarian
grounds.
The outlook for the twins was positive, given
they did not share vital organs, she said.
“They’re
joined below the sternum, so below the chest diaphragm,
they’re joined just below that down to the pelvis. They have
their own heart and they have their own lungs,” Dr Tuibeqa
said.
However, she said they do share some
organs.
“Between the two of them there’s only two
kidneys instead of four and there’s two ureters, they’re
sharing a bladder, some parts of the intestine, and a colon,
but they have their own stomach.”
Dr Tuibeqa said the
conjoined twins have had no major health problems so
far.
“They got admitted at one stage with
Hematochezia, so they had a bit of blood in the stool, then
we thought they had an anal fistula, they’re sharing one
anus as well and one set of female genitalia, but they’ve
got four legs ,” she said.
“They’ve been really well,
they’ve been growing. They’ve been admitted just once or
twice, we’ve been seeing them in clinic regularly. They seem
to be both equally well,”
Hopeful
Dr Tuibeqa
said the prognosis for the girls post-surgery is
good.
“Twins that have surgical separation below the
chest, the outcomes for them are almost always favourable.
People can survive on one kidney, you can reconstruct
genital parts, one intestine can be given to one and then
you can do a colostomy on the other one, so its favourable
in that sense.”
“Having said that, we’ve advised the
family that anything is possible, they may lose one and save
one, but we are all hoping that both of them will be
separated successfully,”
This is the second case of
conjoined twins in the Pacific region in the past year,
after brothers Sawong and Tom Kevin were born in a remote
village in Morobe Province in Papua New Guinea last
October.
The boys, fused at the lower abdomen,
underwent emergency separation surgery at Sydney Children’s
Hospital last December, however only Sawong
survived.
In June 2004, Fiji recorded its first live
birth of conjoined twins at Suva’s main hospital.
Twin
girls of Indian descent were born sharing a heart and liver
and were joined along the front of their
bodies.
Preparations had been underway to send them to
the Royal Melbourne Children’s Hospital for separation
surgery, however the girls died in Suva of a cardiac
complication.
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