Conjoined twins readmitted to hospital after protest

Twins re-admitted after angry relatives protest against the babies being discharged due to a lack of beds.

KARACHI: Twenty-five day old conjoined twins were re-admitted to the National Institute of Child Health (NICH) after angry relatives protested outside the Karachi Press Club against the babies being discharged from the hospital due to a lack of beds.

The protest ended when Sindh health secretary Hashim Raza got to the press club and ordered that the twins be readmitted to the hospital immediately. The secretary believed, however, that the protest was not necessary. He said the premature babies, born at eight months, had been kept in the hospital for as long as was needed at that time. They were discharged with instructions for routine weekly checkups.

In a government hospital, where there is already a dearth of beds at all times, doctors have to be objective in deciding which patients need the facility more, added Raza. What the babies need is to be breastfed, which they can get if they're in a hospital bed or their own home, he said.

The twins, now weighing around three kilogrammes, were born to Karima Bibi, nearly a month ago. When they were born they weighed just 2.5 kg.

While one of them is a boy, the gender of the other is unclear because of the conjoined pelvis, said Haider Bux, grandfather of the babies. Karima, a mother of five now, is living in Lassi Goth with her family. They moved from Thatta when the floods hit their home. The mother said she now wishes to make a life in the city.

Bux alleged that despite NICH being a government hospital, his family has spent about Rs20,000 so far on the medical care of both the mother and babies at Abbasi Shaheed and NIC hospitals.

He said that the family is going through tough times as it is displaced. "We barely have enough to get our daily meals," he said, adding that they could not afford the twins' medical expenses anymore.  He expressed concern that the babies are almost impossible to care for till they could be separated.

NICH Assistant Professor Dr Saleem Nasir, who is handling the case, said that the babies had been treated for neonatal problems. "They had no immediate need for medical care and hence were sent home with their parents' consent," he said.

He said that in cases of conjoined babies, the time to operate on them varies, depending upon what organs are shared. In this particular case, he said, they are not entirely sure about what organs are joined but it is clear they have a single urethra and anal opening.

He said that while the twins have been admitted again, their condition is not critical and hence they can take some time to operate on the babies. According to him, they need to make sure the babies are healthy enough for the operation.

He also said that both the babies had a very good chance of surviving the operation. Dr Nasir said cases of conjoined babies are very rare, almost one in 100,000.

Published in The Express Tribune, October 3^rd, 2010.