Emergency Surgery Saves One Twin as Another Dies in Australia

A critical surgical procedure to separate conjoined twins from Papua New Guinea resulted in a tragic outcome when one twin, Tom, died shortly after the operation. The surgery took place at Sydney Children’s Hospital on November 21, 2023, after emergency intervention was deemed necessary due to Tom’s rapid deterioration.

The twins, Tom and Sawong, were conjoined at the lower abdomen and were medivacced from Port Moresby to Sydney following urgent medical advice. The separation surgery lasted approximately twelve hours, with a multidisciplinary medical team working tirelessly to separate the infants and reconstruct Sawong’s anatomy. Tragically, Tom died within minutes of being separated from his brother.

The decision to operate came after weeks of uncertainty regarding the twins’ medical viability and the logistics of funding for the surgery. A family spokesperson, Jurgen Ruh, revealed that at one point, the hospital requested $AU2 million to perform the operation, but funding guarantees could not be secured in time.

Sawong is currently in an induced coma in the intensive care unit, where he is expected to remain for several weeks. This is to minimize movement and pain as he begins his recovery. Following the surgery, he was reported to be in critical but stable condition.

The twins were born on October 9, 2023, in a remote village in Morobe Province. Their parents, Fetima and Kevin, faced a harrowing journey filled with emotional turmoil since their birth. They had anticipated losing Tom, who was the weaker of the two, but expressed bittersweet relief that Sawong survived the surgery.

Ruh described the moment after the operation when a nurse handed the surviving twin to his parents. “One body with two souls went into the operating theatre, then we had two bodies and two souls. Sadly we lost Tom but are happy to report that we still have two souls.”

Despite the successful separation, the path to surgery was fraught with challenges. Initially, doctors at Port Moresby General Hospital explored transferring the twins to Sydney, but funding issues caused delays. Dr. Kone Sobi, the medical director at the Port Moresby hospital, explained that multiple factors influenced the decision to operate in Australia instead. He noted the twins presented with significant congenital anomalies, making their prognosis uncertain.

The boys were eventually moved to Paradise Private Hospital in Port Moresby to minimize the risk of cross-infection. Public pressure mounted in both Papua New Guinea and Australia, prompting a multi-disciplinary team from Sydney to assess the twins on November 21. At that time, their combined weight was just 2.9 kg, with Tom relying on Sawong for survival.

In correspondence with PNG doctors, the Sydney medical team determined that while Sawong had a reasonable chance of survival, Tom’s prospects were grim. They recommended immediate transfer to a specialized facility, emphasizing the need for advanced care.

The complex surgery involved a range of specialists, including liver surgeons, urologists, and neonatologists. While the procedure itself was a success, the loss of Tom has left the family grappling with profound sorrow.

Ruh criticized the systemic delays and lack of support from the PNG health system, indicating that more timely intervention could have improved the twins’ chances. “It should never have taken eight weeks to get the twins separated; it should have happened in eight days, but no referral pathway exists,” he stated.

The family’s emotional journey reflects a struggle not only with the medical challenges but also with navigating the healthcare system in Papua New Guinea. As Sawong begins his recovery, the family is left to mourn the loss of Tom while hoping for a brighter future for the surviving twin.