Zim in medical breakthrough: • Conjoined twins separated • Only Zim surgeons involved

Paidamoyo Chipunza and Susan Mabunze
ZIMBABWE has broken new ground in its medical history by successfully performing the first major operation on Siamese twins born in April, with a team of 50 having worked on the eight-hour delicate procedure at Harare Children’s Hospital.
Born on April 22 this year to a Murehwa couple, the twin boys christened Kupakwashe and Tapiwanashe, were joined from the lower chest to the upper abdomen and shared a liver.

The most delicate part of the operation was on the liver, which had to be cut into two to ensure that both boys were left with something, although a liver can grow back if a part of it is removed.

Speaking after visiting the boys who are recuperating in the Intensive Care Unit, Health and Child Care Deputy Minister Dr Paul Chimedza said the procedure was testimony to the quality of health professionals in the country.

He said the successful operation signified how quick the country’s public health system was recovering.

Zimbabwe health sector was affected by brain-drain and funding constraints over the past 14 years as the West’s illegal economic sanctions regime constrained Government’s capacity to fund the sector.

“This (the historic op) is something that the nation should sit and take note of, that our professionals can stand head-to-head with other professionals across the world and do exactly what they can do,” Dr Chimedza said.

“What we probably need to do is to give the professionals the environment to do their work, the tools of the trade, and to support them in whichever way we can.”

Dr Chimedza said Government would, with its little resources, continue to ensure that the environment was enabling for the professionals to effectively use their skills.

“We have Zimbabweans across the world who are doing big things in Canada, United States or Great Britain, but it is another thing when we do things here and especially at Harare Hospital,” he said. “It is commendable that we are doing things here.”

One of the paediatric surgeons who took part in the critical surgical separation, Dr Bothwell Mbuvayesango, attributed the success of the procedure to teamwork.

“We needed everybody for us to be able to separate the babies properly,” he said. “We also needed a lot of planning because it is not an everyday occurrence, there are very few incidents in the world where siamese twins are separated.

“This was an all inclusive Zimbabwean team of doctors. We did not get any help from any other doctors from outside the country and the success is because we managed to plan and work together.”

Dr Mbuvayesango said the twins were separated on Tuesday last week and their condition “is being monitored closely.”

“They are doing very well, they are feeding, they are breathing on their own, they are happy and they look strong,” he said. “We still have them in the hospital for a little while just waiting for their wounds to heal.”

Kupakwashe and Tapiwanashe, now weighing 4,4kgs and 3,4ks respectively, could be seen twirling their feet and fingers from their separate incubators, while their 25-year old mother sat with a watchful eye on them.

The twin’s father Mr Moses Chitigo, a fruit and vegetable vendor in Murehwa, said the success of the procedure was a relief to his family.

He said although his wife was going for antenatal care during pregnancy, no one had been open to them about the condition of the babies.

“The scan results read that there were separate heart beats, but there was no visible dividing membrane,” he said. “Although I was a bit suspicious about the part which talked of a “dividing membrane”, I did not discuss it with my wife because she is hypertensive and no one else really told us what it meant.”

Mr Chitigo who already has two other children with his wife aged four and two years, said he was then called on April 22 by his wife while on his way from Mbare Musika advising him to meet her at Harare Children’s Hospital.

“All she could say was that she had been referred to Harare Hospital because she had given birth to conjoined twins,” he said. “I was shocked. I was confused and I did not know what to do, but God gave me strength and I came to meet my wife. Together, we kept saying our prayers for the survival of our children and God has answered our prayers.”

Siamese twins result from either fission, in which the fertilised egg splits partially; or fusion, in which a fertilised egg completely separates but stem cells search for similar cells on the other embryo and fuse the twins.

So rare are conjoined twins that their occurrence is estimated to range from 1 in 50 000 births to 1 in 200 000 births in the world.

The overall survival rate for conjoined twins is approximately one in four.

They are known as “Siamese twins” after the famous pair of Chang and Eng Bunker from Siam, now Thailand.

The only known local operation on Siamese twins was a “very minor” one successfully done at the same hospital in the 80s.

Zimbabwe has had five documented cases of conjoined twins since independence and only one was referred outside the country, while in two instances the babies died before surgery.

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