Karachi, December 9, 2014: Two conjoined twins have been successfully separated after a surgery at the Aga Khan University Hospital, the first at the Hospital and the first in Karachi.
Their parents Ilyas, a policeman, and Uzma residents of Pano Akil, never thought they would see this day.
Conjoined twins are rare, estimated incidence is 1 in 250,000 of live births. More common in Southwest Asia, Africa and Brazil, conjoined twins are more likely to be girls than boys, with a small chance of survival. Saira* and Saima were joined from the lower breastbone to the upper abdomen, and shared a liver.
For the first two weeks of the girls’ lives, Ilyas went from doctor to doctor looking for help. He even travelled to Karachi, where doctors at a hospital told him that nothing could be done at the time and to return when the girls were older. Distressed but not defeated, Ilyas returned home with his daughters.
When the girls were around three and half months old, Ilyas and Uzma once again found themselves in Karachi where a doctor recommended that they go to the Aga Khan University Hospital.
“When we received the two girls, we were happy to see that at least one of them had been progressing at par with other children in the same age group,” says Dr Zafar Nazir, the paediatric surgeon who treated the twins.
The girls were admitted and a multidisciplinary team of paediatric surgeons, radiologists, cardiologists, anaesthesiologists, paediatric intensivists, nurses and operating room technicians was drawn together to discuss possible surgical scenarios and equipment – around 45 people in all. The planning phase of the surgery took about a month and a half in which the group broke up into smaller specialized teams, each with a particular role in the surgery. A day before the actual surgery, the teams did a full ‘dress rehearsal’ to check if all aspects of the procedure had been addressed.
On December 1, a 20-member surgical team headed by Dr Nazir, and ably assisted by Dr Arif Mateen Khan, Dr Saqib Qazi and Dr Ahmed Vaqas (paediatric surgery), Dr Fauzia Khan, Dr Faisal Shamim and Dr Hamid (paediatric anaesthesia) performed the seven-hour procedure; the others were on stand-by. Five days later, the girls were shifted to the special care unit of the paediatric ward.
Dr Nazir is optimistic about their future though one of the twins, with a congenital heart defect, a hole in the heart, will have to return for further surgery.
For Uzma and Ilyas there is a reason to hope once again that their daughters will grow up to live normal and happy lives. “We were told that this was not possible in Pakistan,” recollects Uzma, “but my husband and I clung to the hope that somehow, somewhere we would find a cure, and we did when we came to this hospital.”
The couple are also extremely thankful for the financial assistance provided by the Patient Welfare programme of the Hospital. “Now I have learned that AKUH is not only for the rich. Poor people like me can also afford the quality treatment provided here,” said the father.