“We’ll need a neurosurgeon because we don’t know what nerves they share, we’ll need someone who deals in reproductive health because we don’t know which of these organs they share, we’ll need a plastic surgeon; we’ll need a highly specialised anaesthesiologist because we’re dealing with two patients who just happen to be conjoined and we may need many more.”
But as things stand, the fusion is not life threatening and so the doctors would prefer to wait for Favour and Blessing to, “flesh out,” a bit.
Besides, Lessan says, it’s time the doctors need.
“More than half the battle is planning. We’ll need to do extensive scans to know exactly what they share, down to blood vessels and nerves. To do otherwise would be like going in blind.”
Allowing the girls to grow stronger is also important because they’re likely to go through various stages of surgery.
“We’ll need to create a stomach opening through which they can pass faecal matter because when we separate their bottom, the area will have to be kept sterile. They’ll also have to grow enough skin to cover what will be an open wound once we separate them. So we’ll first have to go in and put in tissue expanders,” Lessan explains.
It’s a lot. But there is a lot more besides the medicine of it all.
“What happens if only one of the girls can get the anus? Who between them gets a permanent colostomy? What if they’re sharing a uterus? Who gets to have children and who doesn’t?” Lessan asks by way of explanation.
These are decisions that would fall to the girls’ mother, 26-year-old Caroline Mukiri, who stands passively by.
But perhaps all she had to say she said when she named her girls Blessing and Favour.
“I found out I was carrying twins when I was seven months heavy but I had no idea they were conjoined,” she says. But she stands by her girls.
And Kenyatta, Lessan says, will stand by the single mother.
“It’s not her fault her babies came out conjoined so we’re not going to have her worry about how many millions the surgery will cost,” he assures.
Besides, the twins’ case will provide an invaluable learning opportunity for the teaching hospital.
“Theirs is a case that will undoubtedly be published in a medical journal,” Lessian says.
In over a decade as a paediatric surgeon, he has only ever been involved in two cases. One of which was in South Africa. “But they were nothing like this; one was of parasitic twins and in South Africa, they were joined at the abdomen.”
It is life altering surgery for which the adults will have to make all the decisions as Favour alternately lets out a cry and sticks her thumb in her mouth and Blessing sleeps undisturbed.
And it’s a responsibility, Lessan says, they don’t take lightly.
“Once we separate them there’s no going back. Their mom can’t come back and say return my girls to me the way they were. The girls will have to live with the decisions we make for the rest of their lives.”
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