Against all odds, , the conjoined twins who underwent extensive surgery to be separated, came back home to Egypt this year For Ibrahim, the two Egyptian boys who were born conjoined at the top of their heads, it was an especially rewarding year. For the past four years the twins have been in and out of hospitals, their future uncertain. But after undergoing extensive surgery -- which many doubted would be successful -- this year, they finally came home, Dena Rashed reports Born in Qena, a small town in the heart of Upper Egypt, on 2 June 2001, 's extremely rare condition came as something of a surprise to their parents. With an occurrence of only one in 2.5 million, the twin's case is considered by doctors to be one of the rarest in the world. Mother Sabah and father Ibrahim realised that their sons had to undergo a complicated and risky surgical procedure that would separate them. Both Egyptian and American doctors claimed that the likelihood that the children would survive the operation was slim -- between zero and three per cent. It was an Egyptian doctor, Nasser Abdel-'Aal, head of the neo-natal unit at Abul-Reish paediatric hospital, who gave the family the support and hope they needed. Having himself suffered the tragic loss of his only son, Abdel-'Aal gave the twins his undivided attention. Judging from similar cases, he knew that it was highly probable the twins would die after 24 hours. Abdel- 'Aal's first challenge was to provide a safe and suitable environment for the children; soon afterwards, he contacted institutes and doctors abroad in an attempt to find them the most suitable and advanced medical centre. Having consulted the mufti at Al-Azhar about the legality -- from a religious point of view -- of the operation, the Egyptian team was reassured by a fatwa (ruling) which indicated that since it was not a medical "experiment", and was not designed to save only one of the twins' lives at the expense of the other, doctors should do whatever possible to save the children, even if there were only a slim chance of success. In 2002, the family was invited to stay in Dallas, Texas in the United States; their two nurses and three doctors -- who had been caring for them in Cairo -- accompanied them. After a year of planning, on 12 October 2003, doctors at the Children's Medical Center in Dallas carried out the operation, which took a gruelling 34 hours. Over 50 medical personnel, including several neurosurgeons and plastic surgeons, took part. So far, the operation and treatment has cost approximately $2.5 million, donated by Arab and American charity organisations and individuals. The boys, who have been progressing remarkably, still wear helmets to protect their heads. They have also spent hours in rehabilitation therapy and undergone reconstructive surgery on their skulls. Their lives transformed, the children are finally able to develop, learn and play. Ahmed is the quieter of the two, Mohamed the more active. During their three-year stay in Dallas, many became aware of the twins' touching story, and eagerly awaited the outcome of their separation. When they finally made it back to Cairo a few months ago, crowds of people were waiting to greet them at the airport. Meanwhile, over the past year, another successful separation was conducted by an Egyptian team of doctors headed by Mohamed Lotfy, the head of the brain surgery department at Cairo's Qasr Al-Aini hospital. The astonishing success of this operation, in which baby Manar was separated from her seriously deformed twin sister, was the first of its kind in the world. In the same hospital in Abul-Reish where Ahmed and Mohamed spent the first critical months of their lives, two other twins, Ibrahim and Mohamed, who are joined at the waist and share three legs, wait to see if they will be able to live and experience the world as separate individuals. Their challenging condition is believed to be the 22nd most complicated case in the world. While many other cases have had desperately tragic endings, the heart-warming story of Ahmed and Mohamed suggests that the risk is certainly one worth taking.
