Mulago separates set of conjoined twins

Ms Hellen Kugonza and Mr Moses Talemwa, the parents, carry one of the twins after the surgery at Mulago hospital. The other is in bed on the right. PHOTO | STEPHEN WANDERA

What you need to know:

  • The hospital called for more funding from government in order to carry out more specialised surgeries.

A group of about 25 specialists at Mulago National Specialised Hospital have successfully separated another pair of conjoined twins.

The twins belonging to Mr Moses Talemwa,26, and Ms Hellen Kugonza,25, both peasant farmers in Bulinda Village in Hoima District, were on December 13, 2021 referred to Mulago hospital by Hoima Regional Referral Hospital.

A senior consultant paediatric surgeon, Dr John Sekabira, who led the team of specialists that performed the surgery, yesterday said the surgery was performed a week ago after the team carried out various investigations that indicated that they were co-joined at the chest, abdomen and also shared a liver.

“We received them from Hoima on December 13, 2021. They arrived here when they were two days old. After receiving them, we did a cross examination and found that they were joined in the chest and abdomen and were sharing vital organs like the liver. We worked hard and made sure that they were out of danger,” he  told journalists.

Before the surgery, the twins were put on a specialised diet to gain weight that would withstand the procedure.
“They were fed on special milk and by the time they were two months, their combined weight was 8kgs which was very commendable,” Dr Sekabira said.

The mother of the twins, Ms Hellen Kugonza, breast-feeds one of her babies as Dr John Sekabira, who led the team of specialists that performed the surgery, explains a point to journalists at Mulago National Referral Hospital in Kampala on February 28, 2022. PHOTO/STEPHEN WANDERA

The surgery took about five hours and they were then taken to the intensive care unit where they stayed for two days before being taken back to the ward.

Dr Sekabira said the babies have since stabilised and are feeding well.

He said cases of Siamese twins are becoming common in Uganda and he attributes this to increased awareness and better referral systems in the country.

For the past two years, Dr Sekabira said the hospital has successfully separated four sets of conjoined twins, with the most recent being those from Kole District.

“We are following up on them. They came back for a review and they have started walking,” Dr Sekabira said.
He said Siamese twins happen as a result of incomplete separation of identical twins at a time when the embryo is developing. 

Dr Sekabira advises pregnant women to attend antenatal care and also deliver from recognised hospitals, where complications can be detected early.

The deputy Executive Director of Mulago hospital, Dr Rosemary Byanyima, said the hospital is rising to the challenge of offering specialised surgeries and care.

“We have over time carried out separation of such twins. This kind of care has been possible because through the renovation, re-equipping and remodeling of the hospital sponsored by the government of Uganda, the theatre and intensive care are well equipped and even the wards have been remodelled to take care for such cases,” she said, adding: “We have trained people in different specialities, including paediatric surgeons, to handle such cases.”

Dr Byanyima, however, called for more financial support from government to enable specialised and timely services.

“We get drugs from the National Medical Stores but these are essential drugs. Now that we are doing specialised care, we make an annual plan and present it to government for funding and we are appealing for more funding so that we are able to do more of these specialised care...,” she said, adding: “What we allocated is never enough but we prioritise such complicated cases because we know they can’t get services anywhere and they can’t afford to be referred out of the country.” 

Dr Byanyima said working on one set of conjoined twins costs on average between $6,000 (about Shs21 million) and $10,000 (Shs35 million). For this set, the surgery was free.

“The time, equipment and drugs to take care of these patients are costly. Each pair of Siamese is unique. They are joined at different parts. It is not a one off. They even need a bit of follow up,” she said.
The parents of the twins commended the hospital for saving the lives of their babies.