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How a Hungarian medical team separated a pair of conjoined twins in Dhakka, Bangladesh

0BSZ 9563

Will they survive? This was the question that had been constantly on my mind for the past couple of months, and now, as I am standing here in the largest, best-equipped operating theatre of Bangladesh, with the conjoined skulls of the twins in front of me, I can see the convolutions of their brains and the fact that they are alive. Their existence baffled me ever since I met them, but seeing them in the flesh still boggles the mind every time. I wish for them to have a long and happy life. Science and statistics say that the odds for that are less than 50%. They have been under anaesthesia for more than 24 hours, and the work the doctors are performing on them surpasses all records.

We have learned a lot of things about the twins ever since their separation. A little less-known fact is that they have spent nearly seven months in Hungary, if not in secret, but certainly under media silence. The kids conjoined at their heads were brought to Hungary in early January 2019 by the Action for Defenceless People Foundation. The last phase of the series of surgeries, the final surgical separation itself was preceded by 18 months of rigorous preparation. The doctors were secretive, nothing was allowed to jeopardize the safety of the twins. A 35-strong Hungarian medical mission was getting ready to complete the 18-month procedure during the 24-hour surgery to be performed in a far-away and unfamiliar operating theatre. These doctors and select medical professionals could not have anything on their minds other than the great task at hand; the separation of craniopagus conjoined twins is amongst the most difficult medical procedures in the world.

The first half of the mission - eleven people, counting the kids and their parents - arrived at Dhaka a week before we did. Just like them, we also had to change flights in Dubai. As we were in line for boarding our plane to Dhaka, we realized that the thus-far glamorous airport had somehow changed around us, making it apparent that Dhaka is a different sort of destination, our fellow passengers mostly seem to be commuters. As I was waiting in line at one of the checkpoints, somebody tried to hand me a package, asking me to take it through. It was just a plastic bag, but that is a bit too risky for an international airport. That shattered my remaining semblance of a sense of security, though I was already well aware that Bangladesh is not exactly a popular tourist destination. From the moment we left our plane, we were escorted everywhere by a troupe of armed bodyguards.

"Rabeya regained consciousness after five days, and since then, she had been playing and talking, and she was already released from the ICU - On day 33 after the final separative surgery, Rukaya suffered a severe brain haemorrhage caused by coagulatory problems prompted by the return of previously successfully treated infective complications. As a result, the condition of the child that was on the verge of regaining consciousness had significantly deteriorated at the beginning of September. Dr Csókay and dr Pataki returned to Bangladesh in September and have performed a five-hour surgery involving cranial and soft tissue reconstruction on both separated children. By the end of the month, Rukaya's condition improved continuously, she is now capable of moving her limbs and opening her eyes, and we are hopeful that she will get to leave the ICU shortly. As of yet, no responsible statement can be made about the anticipated extent of her recovery," the project's chief coordinator Dr Gergely Pataki told Index.

Update: As of 24 October 2019, Rukaya was also released from the ICU.

Operation Freedom is a joint Hungarian-Bangladeshi Project for separation of craniopagus twins (conjoined twins fused at the head) Rabeya and Rukaya. The Hungarian medical team of the Action for Defenceless People Foundation (Cselekvés a Kiszolgáltatottakért Alapítvány) performed the third phase of Operation Freedom, the final, 33-hour separative surgery. I was present in the surgical theatre as a volunteer for the foundation.

The following list can only be republished by citing the source: Action for Defenceless People Foundation „Cselekvés a Kiszolgáltatottakért Alapítvány – cselekves.org”.

  • Team Leader In charge of leading the neurosurgical team and the final separative surgery: Dr András Csókay PhD, neurosurgeon.
  • Chief Coordinator of Operation Freedom and the team of plastic surgeons: Dr Gergely Pataki surgeon, plastic surgeon.
  • The leader of the anesthesiological and intensive therapy team: Dr Marcell Csapody.
  • Members of the neurosurgical team: Dr Attila Fekete, Dr Péter Vancsó, Dr Csaba Kunos, Dr Artúr Kalatovics, Dr Máté Jancsó, Dr Bence Lajtos, Dr András Petrovics, Dr András Ungor.
  • Members of the anesthesiological and intensive therapy team: Dr Erzsébet Ezer, Dr Katalin Szenohradszki.
  • Members of the surgical team, assistance: Marianna Ilcsik, Enikő Czirják, Zsuzsanna Karsza-Kiri, Ibolya Mogyorósi, Margit Csenteri, Imre Szabó, József Pejkó, Balázs Muhari-Papp, Bernadett Csókay, Veronika Vancsura.
  • Pediatric psychologist: Zsuzsanna Császár
  • Head of Communications: Alexandra Valéria Sándor

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