Urgent Surgery Planned for Conjoined Twins from Papua New Guinea

Surgery to separate fragile conjoined twins, Tom and Sawong, from Papua New Guinea is set to take place imminently in Sydney. The twins were medivacced from Port Moresby last week after receiving medical advice that urgent intervention was necessary, as Tom’s condition has deteriorated significantly.

The situation reached a “critical point” following prolonged discussions regarding the twins’ medical care, including which hospital would perform the surgery and the funding arrangements. Specialists from the Sydney Children’s Hospital Network traveled to Port Moresby to facilitate the transfer of the twins, who are now under the care of a dedicated medical team in Sydney.

Critical Condition and Family Concerns

Jurgen Ruh, the family spokesperson, stated that while there is no confirmed date for the complex surgery, it is “imminent” due to Tom’s rapid decline in health. Ruh has requested privacy for the family, emphasizing the emotional toll this situation has taken. “Today is a mute day, please pray for Tom, Sawong, their mother Fetima, their father Kevin, and the amazing medical team in Sydney,” he said.

The twins were born on October 9, 2023, in a remote village in Morobe province. Since their birth, the family has faced a “rollercoaster” of emotions, accepting the grim reality that Tom, the weaker twin, may not survive. They have shed many tears during this challenging journey.

Medical Challenges and Funding Issues

Funding for the twins’ medical care became a pressing issue. Sydney Children’s Hospital mandated that financial arrangements be secured prior to the twins’ transfer. Ruh indicated that the financing involved a mix of sources, which took considerable time to organize. While it is understood that the parents sought assistance from the Papua New Guinea government, Ruh did not confirm this detail.

The twins are joined at the lower abdomen but have separate limbs and organs. They share a single liver, bladder, and parts of their gastrointestinal tract. Additionally, both boys have spina bifida, while Tom has a congenital heart defect, only one kidney, and malformed lungs. Dr. Kone Sobi, the medical director at Port Moresby General Hospital, expressed concerns about the twins’ prognosis. “The underlying issue is that both twins present with significant congenital anomalies, and the chances of survival are very slim,” he stated.

Initially, plans to transfer the twins to Sydney were abandoned when funding from a charity fell through. Subsequently, the hospital advised the parents to remain in PNG, warning that one or both boys could die without intervention.

In response to growing public pressure in both Papua New Guinea and Australia, a multi-disciplinary team from Sydney Children’s Hospital assessed the twins on November 21. At that time, the twins weighed just 2.9 kg combined, with Tom relying on Sawong for survival.

The Sydney team later confirmed in a letter to the PNG doctors that surgery was feasible. They noted that Sawong had a reasonable chance of survival, while Tom’s outlook was bleak. “The reason for the early separation is that Sawong is working hard to support Tom. This is why the team has recommended transfer as soon as possible with specialized transport,” the letter stated.

As preparations for surgery continue, a team of specialists, including liver surgeons, urologists, and cardiac anaesthetists, will be involved in the twins’ care. They will undergo multiple medical evaluations, including MRI and CT scans, to assess their anatomy and vascular supply. The dedicated efforts of the medical teams in both countries highlight the urgency of the situation and the hope for a successful intervention.