Conjoin Twins: The medical ‘Miracle’ at FMC Yola By Kazeem Akintunde & Muhammed Dodo

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The feat recorded at the Federal Medical Centre, Yola, recently, can best be regarded as a medical ‘miracle’.

In view of the fact that members of the Joint Health Workers Union (JOHESU), were on an ego-boosting strike, medical doctors, led by the medical director of the institution, Professor Auwal Muhammed Abubakar, embarked on a life-saving mission; a mission to separate a set of four months old female twins joined together in the stomach named Fatimah and Maryam.

The twins were delivered by caesarean section in Maiduguri, the Borno State capital on November 25, 2017 with a combined weight of 4.5 kilograms. The twins shared a single umbilical cord and were joined from the mid thorax to the mid abdomen. They were referred to the Federal Medical Centre (FMC), Yola, Adamawa State, on March 25, 2018, to be separated and have been on admission since then.

Fatimah and Maryam before the operation
Fatimah and Maryam before the operation

Preparations for the separation of the conjoined twins have been on since the arrival of the babies at the facility but the strike action by JOHESU became a spanner in the life and death situation of the twins.

But not to be daunted by the JOHESU strike, the medical team decided to separate the twins on Monday, May 14, 2018. Fatimah and Maryam, now having a combined weight of 11 kilograms, were moved to the theatre surrounded by more than 10 medical doctors. Other professionals deployed for the surgery included surgeons, anaesthetics, radiologists, laboratory scientists, preoperative nurses, cleaners, ICT and the media, some of whom shun the JOHESU strike to save lives.

After four hours of surgery, they were transferred to the intensive care unit of the health facility for post-operative management. In what looks like a miracle, Fatimah and Maryam were transferred to the ward on the second day after the surgery, after being certified fit following the resumption of normal feeding.

The leader of the operating team, Professor Auwal Muhammed Abubakar, who is also the Medical Director of the FMC, Yola, attributed the success of the operation to the spirit of team work and adequate planning. He told the media at the end of the operation that: “You are aware that the team is a combination of different professionals; surgeons, anaesthetics, radiologists, laboratory scientists, the people managing the theatre, the cleaners, the media, information and communication talking about your people, you know. We’ve had several meetings and drills. We made sure that the facilities to be used were set and the medical consumables necessary for the surgery were on ground. You see that everything worked according to plan. We successfully separated the conjoined twins,” Auwal said.

Even though the cost of surgery for the separation of the conjoined twins would run into millions of naira, when asked about who shouldered the financial responsibility for the surgery, Prof. Auwal said that the surgery was carried out free of charge as a Corporate Social Responsibility on the side of FMC Yola.

“The Federal Medical Centre, Yola, actually took the financial responsibility, considering the fact that the parents would not have been able to afford to foot the bills and the bills are also so much that we didn’t want to burden them.

“During investigations, the Federal Neuropsychiatric Hospital in Maiduguri did the CT scan free of charge. The Adamawa- German Medical Centre, Yola, also assisted. Another CT scan was also done free there. And everything for them has been free since they were transferred to this hospital”, Prof. Auwal said.

Prof. Auwal was asked how long the separated twins would stay in the health facility before they could be certified fit for discharge
“Well, this is difficult to say, you know. It all depends on the postoperative outcome. If they do very well, two weeks or less than two weeks will be enough for them to go home. We’re hoping that by two days’ time, they should be able to start oral feeding, this is going by the present assessment. Although, it is difficult to say for sure until the time comes. However, within two to three weeks, they should be able okay,” Prof. Auwal said.

He said that the cost of the surgery would come from the Hospital Paupers Fund, established by the hospital to raise money for the funding of indigent patients.

Another prominent member of the facility that took part in the separation of the twins was Prof. Fola Faponle, a Professor of Anaesthesia, who was the leader of the anaesthetic team.

She said that after putting the babies to sleep before the surgery commenced, the team had the responsibility of observing them and stabilising them after the operation, in the intensive care. She added that already, the babies were awake and stable.

Prof. Faponla confirmed that positive postoperative management was expected, in the sense that the surgery was successful and that there was no complication relating to their hearts. “We ensured that their drugs and everything necessary to ensure high level of care were readily available to take care of their needs; the blood was ready should in case they needed infusion, take care of their bowels and give them required anaesthesia and drugs”, she said.

Dr. Raji Bello, Consultant Anaesthesia, is the head of anaesthesia department with FMC Yola. Like Prof. Faponla said, he reiterated that everything went well preoperatively, ‘We didn’t also expect much challenges during the postoperative period. It was to be a routine exercise; the babies would be given intensive postoperative support that patients need when they are recovering. Other than that, we don’t anticipate much problem,” Dr. Raji said.

Muhammad Ramat, 30, and Kellu Adam, 27, are the parents of babies Fatimah and Maryam. Married in 2015, the conjoined twins are their first and only children. They were highly appreciative of the corporate social responsibility rendered to them by the management of FMC Yola.
“We had faith that the surgery to separate our conjoined babies would be a successful one, especially when we were counselled by Prof. Auwal Muhammad Abubakar and Dr. Wabada Samuel to be strong, hopeful and confident. The contributions of Professor Fola Faponle in strengthening our faith is also worthy of mention.

“It was not only the surgery that was done free of charge, everything was free; our feeding, accommodation, medicine and general post operative management were all free. We thank the management of FMC Yola for their professionalism and philanthropy.

“We are also soliciting on behalf of FMC Yola, for the government to provide the hospital with the needed hi-tech medical facilities like the MRI and the CT scan to be able to improve upon their efficiency and effectiveness. Individuals could also make generous contributions.

“We’re also soliciting for assistance from the government and individuals for the sake of our twin babies to have a meaningful future,” the parent said.

JOHESU strike notwithstanding, the happy parents of Fatimah and Maryam would have positive things to say about the health care system in the country for good.

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