Conjoined Philippine Twins Set for Surgery
at Tzu Chi Medical Center
Hualien, Taiwan- Tzu Chi Medical Center
(Tzu Chi General Hospital) is scheduled to separate omphalopagus
conjoined twins, Lea and Rachel, on June 28. The twins were
discovered by Tzu Chi volunteers from the Philippines, who
then donated and raised money for the operation.
Lea,
Rachel, and mother. On the night of April 16, 2003, the twins
and their mother departed Manila for Taiwan. When they arrived
in Hualien at midnight on April 17, the mother remarked that
since she is from a poor family, she never thought she would
experience so much love and caring.
A difficult beginning
Lea and Rachel were born on July 1, 2002
in the mountains of the Kalinga (a province 16 hours away
from Manila by car) to aboriginal tenant farmers. Their parents
had a daily income of about 50 Peso (US$1) but after the twins
were born, the parents could no longer farm the land because
they needed to devote their time and energy to taking care
of the twins. As a result, they lived in extreme poverty and
had to ask for help from the government. The government in
turn provided some financial assistance for the twins to be
sent to Manila Children's Hospital.
A chance meeting with Tzu Chi
In January 2003, Tzu Chi International
Medical Association (TIMA) volunteer Wei-kao Lee saw the twins
while he was accompanying a hydrocephalus patient to Manila
Children's Hospital for diagnosis. At the time, the Children's
Hospital was already raising funds for the conjoined twins
to be surgically separated. However, it was going to take
a long time to raise the large sum of 1 million pesos (US$20,000)
required to pay for the surgery. As the success rate for such
operations decreases with the age of the patients, time was
of the essence. In order to perform the operation as soon
as possible, Wei-kao Lee consulted with the Children's Hospital
and they agreed to let TIMA help. This is a "relay race
of love" across national boundaries and Tzu Chi is grateful
to do its part.
The Tzu Chi Medical Center appointed the
Director of Pediatrics, Dr. Chi-po Hai, and the Director of
Image Diagnosis, Dr. Chao-chun Lee, to examine the twins and
estimate the survival rate after separation. Since the twins
are joined at the torso, the success rate is about 60-80%.
Once the doctors received parental consent, the Tzu Chi Medical
Center quickly formed a team for the task. The team includes
experts from General Surgery, Plastic Surgery, Cardiac Surgery,
Anesthetic Unit, Imaging Diagnosis, Special Care Unit, Support
and Caring Unit, Documentation and Administration. The team
also purchased several new pieces of medical equipment to
prepare for this operation.
On the night of April 16, 2003, the twins and their mother
departed Manila for Taiwan. When they arrived in Hualien at
midnight on April 17, the mother remarked that since she was
from a poor family, she never thought she would experience
so much love and caring.
The challenge
Dr. Hai-chi Po, the coordinator of this
operation, explains that typically, conjoined twins have unequal
shares of their organs and Lea and Rachel are no exception.
The twins are joined at the liver, but the possession ratio
is different. The smaller baby, Rachel, has 60% of the liver
while Lea has only 40%. In addition, medical imaging shows
they share an estimated 240 square cm of skin.
Dr. Po further stressed that the operation would not be simple.
If the conjoined torso were simply cut into two, there would
not be enough skin and tissue to close the wounds. Therefore,
on May 20 the hospital performed a preparatory operation to
place a tissue expansion device into the connected area between
the twins. Then, saline solution was injected into the expansion
device daily in order to stretch and grow the skin and tissue
near the connected area. The extra skin and tissue would then
be used to close the wounds on each baby after the separation.
The doctors also need to be cautious about
loss of blood, blood vessel distribution and timing for sutures
in this difficult operation. After the preparatory operation,
the doctors assessed that the survival rate would be about
70%. In such operations, there is an 80% chance that only
one twin will survive. The chance of disability after an operation
for abdominal conjoined twins is low.
The Tzu Chi International Medical Association
The Tzu Chi missions of charity, medicine,
education and culture are carried out all over the world.
Tzu Chi has volunteers in 138 offices spread across 38 countries.
The Tzu Chi International Medical Association (TIMA) is comprised
of volunteer medical doctors and other healthcare professionals.
They regularly hold free medical clinics all over the world.
Currently, TIMA operates in 19 countries. In the Philippines,
TIMA has already treated over 200,000 patients, including
pulling 20,000 teeth and performing thousands of cataract
operations since its inception in 1995.
