Urgent Airlift for Conjoined Twins from PNG to Australia

A rare case of conjoined twins, Tom and Sawong, is undergoing an urgent airlift from Papua New Guinea (PNG) to Australia due to a critical health situation. The twins, who are joined at the lower abdomen and share vital organs, require immediate surgical intervention that cannot be performed in their home country. The situation reached a pivotal moment when specialists from the Sydney Children’s Hospitals Network arrived in Port Moresby to facilitate their transfer.

Born two months ago in a remote area of PNG, the twins were initially brought to Port Moresby for treatment. Tom, the smaller twin, is facing significant health challenges, including a congenital heart defect and a solitary kidney. Recently, his condition has worsened, leading doctors to expedite their transfer to Sydney for complex surgery.

Critical Condition and Urgent Transfer

Dr. Polapoi Chalau, the chief executive of Paradise Private Hospital, noted that Tom is showing signs of low albumin, a protein essential for maintaining fluid balance in the body. “I think we’ve just about reached that critical level now – something needs to be done,” he stated.

In a letter to PNG doctors, the team from Sydney highlighted Tom’s multiple congenital anomalies, indicating that his long-term survival is uncertain. In contrast, Sawong is reported to have a better chance of survival post-surgery. The letter explained, “The reason for the early separation is that Sawong is working hard to support Tom. This is also why the team has recommended transfer as soon as possible.”

Upon their arrival in Sydney, the twins will be subjected to a range of diagnostic procedures, including MRI and CT scans, to assess their anatomical and vascular conditions. A multidisciplinary team, including liver surgeons, urologists, and neonatologists, will be involved in their care and preparation for potential separation.

Background and Challenges

The decision to transfer the twins comes after weeks of intense discussions, during which Port Moresby General Hospital’s doctors initially recommended against sending them overseas. Chief executive Paki Molumi emphasized that the decision was made in consultation with Australian doctors, considering the low likelihood of both twins surviving the separation. “Taking all these factors into account, our team collectively agreed that it is in the best interest of the twins and their family to continue care here,” he remarked.

Following this, the parents moved the twins to Paradise Private Hospital, where they have been receiving care since mid-November. Recently, a team from Sydney assessed their condition and strongly recommended that they be transferred to a specialized facility as soon as possible.

Dr. Chalau expressed relief that the transfer is finally happening, stating, “They are a very special case, and with the limited resources that we have, that puts more pressure on us.” He acknowledged the complexities involved in negotiating care arrangements with the parents and various stakeholders, including foreign governments.

While arrangements were also considered for transferring the twins to a major hospital in Germany, the deteriorating health of Tom led to the decision to proceed with the closer option of Australia. “The decision to go to Australia is, number one, it’s closer to us,” Dr. Chalau explained.

As the twins prepare for their journey, the emotional toll on their parents is significant. Janet Sios, co-owner of Paradise Private Hospital, reflected on their hopes, saying, “The hope of the parents is that they must go down and get the best they can get. Hope is what they’re holding on to.”

Despite the uncertainty that lies ahead, both the medical team and the parents are focusing on the potential for a positive outcome. “Even if Tom doesn’t make it and Sawong makes it, Sawong might be a prime minister one day, he might be even a doctor one day,” Sios said, illustrating the optimism that persists amid the challenges.

Dr. Chalau added that while the transfer is a crucial first step, the journey does not end there. “Surgery is just part of it, but the long-term care and rehabilitation is another thing,” he cautioned. As the twins embark on this critical journey, their families and medical teams are hopeful for a successful outcome.