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Minister questions plans to separate conjoined twins Mon, Apr 20, 2009 The Straits Times by Judith Tan THREE of the four twins joined at the head who were separated in operations here are dead, and the fourth is not in good shape. Given this track record and the similarly dismal results overseas, Health Minister Khaw Boon Wan yesterday suggested that doctors reconsider plans to separate yet another pair of such conjoined twins. Indian twins Vani and Veena, five, will go under the knife at East Shore Hospital in August if the medical team involved decides to proceed with the operation. -------------------------------------------------------------------------------- Three cases involving Singapore doctors Ganga and Jamuna Shrestha, Nepal The 11-month-old Siamese twins underwent a marathon 97-hour operation at the Singapore General Hospital in April 2001. Ganga, the weaker of the twins, died on July 29 last year from a severe chest infection. Ladan and Laleh Bijani, Iran More than 50 hours into the historic surgery at Raffles Hospital to separate them in July 2003, the sisters died from excessive blood loss - 90 minutes apart. Vani and Veena, India Neurosurgeon Keith Goh, who led the teams in the previous two operations to separate craniopagus conjoined twins here, has been asked to undertake the operation of separating the five-year-olds from Hyderabad.

Aug 7, 2008 Nepal doc to S'pore: Finish what you started Twins' doctor says Jamuna should have cranioplasty performed here By Salma Khalik, Health Correspondent A TOP Nepalese neurosurgeon has accused Singapore doctors of failing to provide after-care treatment for former conjoined twins Ganga and Jamuna Shrestha. Dr Basant Pant, who heads the neurosurgery departments in two private Kathmandu hospitals, told The Straits Times in an interview in the Nepalese capital on Sunday: 'Have the twins been given the best care? The answer is 'no'.' The girls had not received the physiotherapy and occupational therapy they needed, he said. Also, he charged, Singapore doctors had broken their promise to bring the girls back to Singapore for cranioplasty, an operation to repair their skulls. 'This was absolutely promised by Singapore, but it has never taken place.' In reference to Ganga's death from pneumonia last week, he said that, 'at the very least', Singapore owed her surviving twin that cranioplasty. Reacting to his comments, Singapore General Hospital (SGH), whose doctors performed the 2001 surgery to separate the twins, said the Singapore and Nepalese medical teams had agreed that if the girls needed follow-up treatment that could be given safely in Nepal, it should be done there. 'SGH would supplement the local team if required,' its spokesman said. SGH said its doctors and rehabilitation therapists had drawn up with Dr Pant the twins' treatment and rehabilitation plans to be carried out in Nepal, and had tracked their progress in the initial years. 'Unfortunately, the family did not comply with the care plan and therapy,' the spokesman said. But the twins' family said things are not that simple. Jamuna's physiotherapy sessions at one of Nepal's public hospitals were stopped - despite the nominal fee charged - as the family could not afford the 200 rupee (S$4.40) taxi fare. It would have taken a chunk of the 8,000 rupees her mother Sandhya Shrestha earns as a teacher. Taking the crowded public bus is not an option because Jamuna cannot walk and has to be carried. She needs the cranioplasty for a chance at leading an independent life. The 2001 operation had left her and her sister with part of their brains unprotected by their skulls. The hole on Jamuna's head leaves her brain exposed to external pressure, which has affected her blood circulation and health. Since 2001, the family has returned here once - in 2005 - to East Shore Hospital, where Dr Keith Goh, a member of the 2001 team, now practises. That year, Jamuna was treated for her weak leg and Ganga had fluid drained from her head. Referring to Jamuna's possible return here soon, SGH said: 'Should the family decide to seek treatment for Jamuna at SGH subsequently, we will work in consultation with the Nepalese medical team on the appropriate treatment.' Madam Sandhya, still reeling from the loss of Ganga, wants Jamuna's operation done here. It is what she feels will give the girl the best chance. SGH is the custodian of the $58,000 that is left of the $660,000 raised in 2001 for the twins' medical expenses. It will release funds only for 'appropriate' treatment for Jamuna. It reimbursed Bir Hospital in Kathmandu in May 2004 for Ganga's scans, and East Shore Hospital in 2005. Dr Pant, who does about 400 operations on brains and spines each year, said cranioplasty can be done in Nepal, but that Singapore should finish what it started. Noting that the people here gave so generously in 2001 because they felt for the family and wanted to do the best by them, he said: 'This has not been done. Singapore started the show, so it should finish it.' [email protected]