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Two-year-old sisters Safa and Marwa Ullah, from Charsadda in Pakistan, underwent three major operations to separate their heads at Great Ormond Street hospital (GOSH). Less than half of those survive more than a day after birth.The thought of losing one of them was unfathomable.The two years between their birth and their separation were spent getting British visas, organizing travel and gathering funding for the series of surgeries that would allow them to live fully independent lives.At the hospital in Peshawar, Pakistan, she was given a photograph to prepare her for the discovery to come: The girls were conjoined at the skull. The girls, whose father died of a heart attack while their mother was pregnant with them, were discharged from GOSH on 1 July and moved to a London address with their mother, their grandfather Mohammad Sadat and an uncle, Mohammad Idrees. In 2019 Safa and Marwa Ullah were separated at Great Ormond Street Hospital in London, England.

We got funding for the operation and the girls, Safa and Marwa Ullah… Conjoined twins occur in only one in 2.5 million cases, and only 5 percent are joined at their skull, according to the hospital.

But the team relied on more than 1.3 million pounds (more than $1.6 million) invested in the past six years into Great Ormond Street’s craniofacial surgery program and research.Great Ormond Street Hospital has a specialist operating theater for surgery on conjoined twins, and the series of operations on Safa and Marwa Ullah were supported by a team of scientists and designers.Safa and Marwa Ullah’s condition was extremely rare. Safa and Marwa will be their third set of craniopagus twins, more than any other centre. But this had an impact on Safa, who had a stroke less than 12 hours later due to the loss of the vein.The first operation took place in October 2018, when the girls were 19 months old. Finally, the surgeons worked on stretching the skin and building separate skulls with the girls’ own bones.That was in the winter of 2017. A potential solution appeared three months later, when the family was introduced to Noor ul Owase Jeelani, a neurosurgeon at Great Ormond Street Hospital in London, where teams of specialists have successfully treated two similar cases since 2006.The team used a virtual-reality replica of the girls’ skulls to understand the relationships between the girls’ brains and blood vessels and come up with the best strategy to separate them. It has been a long and complex journey for them … Their faith and determination have been so important in getting them through the challenges they have faced. The twins, born January 2017 were joined at the top of the head with separate brains and a cylindrical shared skull with the twins each facing in opposite directions to one another. A pair of twins from Chārsadda, Pakistan had been born fused at the head, which is an incredibly rare condition.

They are God-given.”It all began in January 2017, when Safa and Marwa were born via c-section and quickly whisked away from Bibi. Conjoined twins occur in only one in 2.5 million cases, and only 5 percent are joined at their skull, according to the hospital. The second operation separated their blood vessels.Bibi said she had no negative feelings about her daughters’ condition.“It was a very emotional moment,” craniofacial surgeon Professor David Dunaway told the BBC.

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