Doctors at Melbourne’s Royal Children’s hospital are preparing to operate to separate 14-month-old conjoined twins who arrived in Australia from Bhutan on Tuesday.

Nima and Dawa Pelden are joined at the stomach and have grown up facing each other. They are unable to sit down, though they can stand if they both agree to stand at the same time.

So far doctors have only been provided with basic scans which indicate the twins could share a liver and possibly a bowel, but that their hearts and lungs appear to be separate.

Rachel Cary

14-month-old conjoined twins Nima and Dawa have just touched down in Melbourne to undergo life changing surgery at the Royal Children’s Hospital @tennewsmelb

October 2, 2018

They and their mother, 38-year-old Bhumchu Zangmo, were scheduled to meet with specialists at the hospital on Tuesday afternoon to be assessed for the life-changing surgery.

“We need to very quickly gather a lot more information,” Dr Joe Crameri, head of paediatric surgery at the Royal Children’s hospital, told reporters on Tuesday. “Once we have that information we will be able to formulate a more correct plan for how we can separate these twins but at the moment we remain confident that we should be able to achieve that in a single operation and we should be able to achieve a good outcome for both twins.”

The surgery itself will involve two teams, one for each twin, with an array of additional specialists to help with their care and recovery.

“We know the key areas we are going to have to focus on are going to be the bowel and the liver, they seem to be the major areas,” he said.

Crameri said that as the twins got older their situation would become more difficult to navigate.

“Their life is getting very complicated now that they are old enough to mobilise when essentially they are facing one another and that makes it very difficult for the twins,” he said.

The Melbourne Royal Children’s hospital surgical team who will be involved in the conjoined twin’s operation.

The Melbourne Royal Children’s hospital surgical team who will be involved in the conjoined twin’s operation. Photograph: Royal Children’S Hospital Melbourne/PR IMAGE

The surgery and flights to Australia have been funded by the Children First Foundation, an Australian-based charity that focuses on ensuring children from developing countries have access to specialist surgeries and medical care.

The charity previously partnered with the hospital to fund the surgery that separated Bangladeshi conjoined twins Trishna and Krishna in 2009. The orphaned twins were joined at the head and shared blood vessels and brain tissue. They live in Melbourne with their adopted family.

The landlocked Himalayan kingdom of Bhutan is financially poor and has rejected gross domestic product (GDP) as a measure of progress in favour of a gross national happiness index.

The cost of both the surgery and medical care is $300,000, which the charity is hoping to raise through donations.

Chief executive Elizabeth Lodge said the hospital was providing the care at a humanitarian rate and she hoped the Australian community would be equally generous.

She said the twins had recently dropped a lot of weight and their mother was keen to see them separated.

“Mum said the girls are getting a little bit frustrated with each other, as you would at 14 months, and like any siblings they’re getting cranky, so mum is really looking forward to the operation happening sooner rather than later,” she told reporters.


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