This column mid last year had written the Trilogy of Twins. It had started as a travelogue to Oshogbo in celebration of the wedding of the twins I delivered 27 years ago to the multiplicity of twin deliveries on coming back to the ultimate delivery of the Siamese or rather conjoined twins now named James and John.

For the records, I was not invited to perform the caesarian section because the Medical Director of the hospital, Dr. Nnamdi Okanu, knew that the twins were joined at the abdomen. It was routine for an obstructed labour in multiple pregnancy. The diagnosis of a Siamese twin was made intra-operatively and whatever maneouver we used to deliver them was instinctive and not a learned technique. For a recap, we had to deliver the second twin before bringing out the first twin whose head was already molded and engaged in the pelvic cavity.

On arrival of the twins, the feeling in the theatre was mixed: Excitement, despondency and ultimately depression. When the babies were fully resuscitated and dressed, the anxiety and worries over their future began. We tried to assure the parents that the management of this condition was beyond them and that by right they were government’s responsibility and property. They were skeptical and I could understand this, especially in this environment. At this point, we sent one of our correspondents to talk to the parents and take photographs for a human angle story in our health pullout pages. Yours truly thought of getting the wife of Lagos State Governor involved. Options were coming so fast and at a point a commissioner of health from the home state of the parents from the South East was sent on a fact finding mission in anticipation for assistance.

In the interim the twins were referred to a teaching hospital in Lagos. In the euphoria of the moment, the Chief Medical Director of the hospital called a press conference that soon the hospital would be separating her first Siamese twins. The expectation was high and I was excited that after all these years of economic haemorrhage from medical tourism, providence had made it possible for us to have a good story to tell. The hospital had commenced preliminary investigations. In cases like this, emphasis usually is in using imaging technique to determine which internal organs the twins share. The most relevant in this occasion were CT scan and CT Angiography. This became necessary when it was discovered that the twins had a FUSED LIVER.

Additional findings was that the PORTAL VEIN, which is the vessel that conveys digested products from the intestine to the liver for processing and the HEPATIC VEIN, which drains the liver and empties into the large veins that convey blood to the right side of the heart, were FUSED. The arterial supply was from both twins. Technically speaking, it meant that an Endocardiovascular surgeon would have to be involved in the separation procedure. As results of the various investigation rolled in, the twins were given one month appointment while the hospital mobilised and tried to put the team together.

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In practice generally, such procedures may need international collaboration and acquisition of new of new equipment. It is usually an opportunity to acquire relevant experience and skill. After this, the facility can transform into a referral centre in our country for similar cases. But this was not to be. One clay-footed doctor in the hospital called the father of the twins aside and told him that they had never done a case like this before in the facility. In his candid opinion, he should seek for help elsewhere! In the mind of the man they were going to use his twins, as Guinea pigs and he would have none of that.  In fact, added to this was even a more profitable angle to the narrative. They were to raise funds from churches, NGOs and proceed abroad for the procedure.

They went back to the hospital where the twins were delivered for the medical director to assist them in getting the best offer abroad. In Europe and America, where the surgery could be done, were too expensive and they had to settle for an Indian hospital that gave them a bill of N8million. I was pleasantly surprised when I saw them in my parish, SS Michael, Raphael and Gabriel Catholic Church, Satellite Town Lagos one Sunday during mass appealing for financial assistance. I wouldn’t know whether they went to other churches. But the response from the church was overwhelming after the parish priest, Rev. Fr. Vincent Ezezue, appealed to the parishioners.  By the time they left to India almost double the amount had been raised by the church.

On December 10, 2017 I had a phone call from an ecstatic and jubilant member of my parish that the twins have been successfully separated in India. The parishioners were jubilant and the atmosphere was that of celebration. Some of the parishioners wanted to give more for the upkeep of the twins. They interpreted the whole phenomenon as a kind of double blessing. Some of us who started the story took it with mixed feelings. To us that was an opportunity of “can do spirit” that we have lost.  At this point, I’d like to say thumbs down for my colleague, who chickened out, and betrayed us. The hospital was still mobilising and there was nothing out of place in inviting surgeons from abroad down here to benefit from their experience.

A day after the phone call, I was in an event with the predecessor of the Chief Medical Director of the teaching hospital in Lagos Television at Ikeja. He had been invited as a guest speaker and I was lucky to be on the high table as the chairman. In the course of our discussion I had to intimate him that the twins had been separated in India. As a very amiable professor, he just shook his head and smiled. But I still asked him to help pass on the message.

A fortnight ago I was at the hospital, where the conjoined twins were delivered, yet for another Caesarian Section; and on the wall of the consulting room the Catholic Church calendar for the year 2018 was hosted. On the first page of the months of January and February were the pictures JAMES and JOHN UGWOKE, before and after their separation. Finally, kudos to Dr. Nnamdi Okanu, First Covenant Medical Centre, Satellite Town and Rev Fr Vincent Ezezue, the parish Priest of SS Michael Raphael and Gabriel, the Archangels who made it happen.