A Look Back at the Day These Siamese Sisters That Were Joined at the Skull Were Successfully Separated

This beautiful story made headlines in July 2019: after a 55-hour surgical procedure, Safa and Marwa, 2-year-old Craniopagus twins, were separated. Let's take a look back at this medical feat.

In January 2017, Safa and Marwa were born in northern Pakistan. They are Siamese twins, as are 1 in 100,000 births in the world. Their mother, who lost her husband two months before the birth, was all the more surprised because according to the Gulf News, she didn't even know she was pregnant with two babies.

Even more unusual: the babies were Craniopagus twins, which means they were born attached at the skull, a condition that affects only two to six percent of Siamese twins. The chances of survival are very low since according to statistics, 40% are stillborn, 33% die shortly after birth due to organ failure and/or abnormalities, and 25% survive, even having the option to be separated surgically depending on how the heads are attached. Safa and Marwa were among this 25%.

A 4-step procedure, over 4 months

After consulting several specialists in Pakistan, the two sisters were finally referred to the Great Ormond Street Hospital in London in the fall of 2018, where neurosurgeon Noor ul Owase Jeelani and plastic surgeon David Dunaway had twice worked on similar cases. In a press release, the hospital explained that they had 'set about a four-month four-stage separation process involving multiple specialities across the hospital — from craniofacial, neurology and psychology experts, to nurses, radiologists and physiotherapists.'

In total, a hundred professionals were involved in the fate of the Craniopagus twins. In order to prepare for the multiple operations, the team used virtual reality to create a 3D replica of the two skulls.

'I thought, "Safa is dead'"

The first operation was to separate the brains from the arteries, and the second, a month later, to separate the veins. But a complication arose after this surgery, and Professor Jeelani feared the worst as one of the sisters suffered a heart attack twelve hours later. 'I thought, "Safa is dead",' he told the BBC. Luckily, the girl recovered, and the third operation could take place in January 2019.

Doctors inserted tissue to stretch the skin to cover each sister's skull during the final separation, which took place in February last year. This final operation, which was paid for by a Pakistani businessman, also allowed the reconstruction of the top of their skulls using bone fragments from each of the two sisters.

This successful operation then aroused an understandable wave of emotion from their mother, Zainab Bibi :

'With God's grace I am able to hold one for an hour and then the other one'

The mother and young widow of 34 years did not forget to thank the London Great Ormond Street Hospital and the whole medical team who had managed to successfully complete this unprecedented challenge.

After several months of convalescence and physiotherapy, Safa and Marwa were finally able to leave the hospital a few weeks later and return to their native Pakistan.

Why aren't we taking mental health days even when we know we need them? Why aren't we taking mental health days even when we know we need them?