Doctors weigh risks of surgically separating conjoined twins from Papua New Guinea

In a tumultuous medical journey that has recently grabbed headlines, the mother of conjoined twin boys born in Papua New Guinea hoped to send them to Australia for separation surgery, but those plans were halted. After the family considered sending the babies to Germany, a team of Australian specialists is now assessing the boys.

Key Takeaways:

• Tom and Sawrong are conjoined twins born in Papua New Guinea (PNG).

• They are currently in the NICU, and originally were going to be sent to Sydney, Australia, for separation surgery. When that plan fell through, their parents turned to Germany instead.

• Doctors believe the boys' chance of survival is slim, as one of the twins has a heart defect and needs surgery as soon as possible. However, after the family's story went viral, the twins were placed in intensive care unit and "a multidisciplinary team from Sydney Children's Hospital Network" now plans to assess the twins' condition.

The Details:

Born on October 9, conjoined twins Tom and Sawrong, who share vital organs as they are joined at the lower abdomen, experienced potentially fatal health complications. Currently, the twins are receiving treatment in a neonatal intensive care unit (NICU) in Port Moresby. They share a liver and parts of their digestive tract; one of the twins also has a congenital heart defect and only one kidney. They also have spina bifida.

Although the twins’ parents had initially planned to send them for surgery in Sydney, it was deemed too expensive, as doctors say the twins' prognosis for survival is not good.

PNG conjoined twins should not be separated due to risk of death, doctors say | ABC NEWS

“It would be at a cost that is far too high, so they said they are looking at other avenues," Fatima Tinga, the twins' mother, said.

As RNZ Pacific reported:

Doctors at the Port Moresby General Hospital initially explored the possibility transferring them to Australia for specialist care, but the hospital is now recommending against sending them overseas.

Medical director Dr Kone Sobi said multiple discussions led to this decision. "The underlying thing is that both twins present with significant congenital anomalies, and we feel that even with care and treatment in a highly specialised unit, the chances of survival are very, very slim," Sobi said. "In fact, the prognosis is extremely bad."

However, since the boys' story has garnered international attention, RNZ reports that "[a] multidisciplinary team from Sydney Children's Hospital Network arrived in the capital on Thursday to begin examining the twins":

The team is working with its local counterparts as well as the Australian High Commission in Port Moresby.

"Their priority is gathering information and meeting with the family," a spokesperson for the network said.

"However, the medical team's assessment does not guarantee a medical transfer (to SCH) will take place."

Zoom In:

Jurgen Ruh, a pilot and the chief executive of Mountain Area Medical Airlift foundation in Papua New Guinea, voiced the importance of urgent treatment for the twins and was attempting to get them transported to Germany:

“We need to move on because the more we wait, the higher the risk is of losing one of them. Once the hospital issues the paperwork that they'e accepting the patients, that'll be presented to the German embassy in Manila, who will then issue the visa. I can't really say how long it will take; we don't have much time as the smaller twin has a heart defect, and he needs neonatal open-heart surgery.”

However, key hurdles such as visas, referrals, and safe transport remained. But Ruh isn't giving up, continuing negotiations with a German hospital.

Now, Ruh believes the twins are in a better place after being moved to Paradise Private Hospital,:

"Where they were (in PMGH) there were premature babies, sick babies and a lot of (people) traffic in the busy neo-natal ward," Ruh said.

"Now they are in isolation, in a very sterile environment, receiving 24-hour-a-day care, so they are much safer," he said. He said there were eight nurses and a paediatrician taking care of the boys and the parents were allowed to sleep in the twins' room.

"In the last month the weaker twin (Tom) has miraculously improved, he started crying two weeks ago and his lungs appear to have improved," Ruh said.

The Bottom Line:

The twins’ story highlights the profound challenges medical facilities in many developing countries face in caring for critically ill newborns, particularly those with rare conditions, like these conjoined twins.

Should surgery be allowed for the twins, it could offer hope to many families facing similarly intimidating circumstances worldwide. Every life is worth fighting for.