Father of conjoined twins opts not to separate them

Ibrahima Ndiaye, 50, with his twins Marieme and Ndeye. The twins were scheduled to undergo a surgery to separate them in January, but their father could not make a choice on who should stay alive, as the two shared critical organs. [Courtesy]

It has been seven months since a father of Conjoined twins avoided a stark choice that would have ended the life of one of the babies.

Born in May 2016, sharing crucial organs, Mariame and Ndeye have now lived three years.

Their father Ibrahima Ndiaye says he now wants his twins to lead a normal life. They are set to start school in September.

“They are warriors, they are fighting. They are pushing their limits back. The only thing I can do is not to let them walk alone. Just be by their side, whatever the situation,” Ibrahima told BBC.  

The 50-year-old Senegalese was last January expected to make probably the hardest decision of his life; choose which one of his twins should die for the other to live.

He chose to let the twins live for as long as they could.

The heartbreaking decision captured by the BBC reported that Ibrahima’s twins, who are conjoined, were scheduled to undergo a surgery to separate them.

The doctors, however, warned that they could only save one of them. The other will have to die, but the choice on who dies should be the father’s.

In a documentary aired by BBC on August 5, the twins cannot be separated anymore.

“Both the girls’ hearts and circulations are completely entwined with each other, as well as Marieme being dependent on Ndeye and Ndeye being dependent on Marieme to be alive,” said Dr Gillian Body, from Noah’s Ark Children Hospital in Cardiff UK in the documentary.

Ibrahima took the twins from Senegal to the United Kingdom in a bid to save their lives at the Great Ormond Street Hospital.

The decision to fly to the UK was after fruitless efforts to find a solution in his home country.

The twins-Mariame and Ndeye-share crucial organs. While the two have separate brains, hearts and lungs, they share a liver, bladder, digestive system and three kidneys between them.

Each one of them has their own stomach, but they are still linked. They are also conjoined at the arms-left and right arms. They share the two legs.

BBC reported that Marieme’s heart was so weak that she might die-eventually. And if this happens while still conjoined, her twin sister will also pass.

The tough decision was: Should Ibrahima leave the girls to die together or let the surgeons go ahead with the surgery? “A surgery which will still have the same outcome as Marieme is not strong enough to persevere the scalpel,” the consultant doctor said. 

Ibrahima told the BBC the scan showed only one girl. And when his wife went into labour, three weeks early, there was nothing peculiar apart from her large bump.

Safe delivery

He was advised that she undergoes a caesarean section.

“The doctors removed the baby, and whisked it away, telling me all was fine,” he recalled.

The father of six leaned against the wall, sighed and whispered a thank you to God for the safe delivery.

But shortly after, he was called inside to meet Dr Lamine Cisse, a specialist in obstetrics and gynaecology, who had delivered two of his older children. There was a problem. It was written all over his face.

First, he was told that he had twins. But the scan only showed one girl, he wondered?

The first thought was that maybe his babies had been swapped; not a strange phenomenon in Senegal.

“So tell me… what is wrong with the twins,” he asked.

Ibrahima told the BBC that he “could not take it in”. He was angry at those who did the scan.

“I could not speak, tears were coming. I was kicking things and raging against God,” he said.

The twins were tiny, he said, just 3.8 kilograms.

“I could not understand how they were built. I was expecting four feet, instead there were two. They were both looking at me and I froze,” he said.

Even at birth, Marieme was already weak. She looked ill and was dehydrated. The girls were put on oxygen at a local children hospital.

To even more anguish, the children were left at the corridor of the facility-and they became the talk of the hospital that at one point he overheard a complete stranger saying she already had a photo of them.

Ibrahima said he asked to see the photo, grabbed the phone and went to confront the hospital management.

“I could not calm down. I broke the phone, something I should not have done, but I was furious,” he said.

What angered him more was that the hospital was not doing anything to contact experts for any possible solution. “They were just waiting for them to die,” he said.

That is when he took up the initiative.

Even when the girls were sent home three weeks after birth, Ibrahima said he had to lie to his friends that the twins were still at the hospital.

Once he resumed work, he would use every break to search for any facility that would be able to separate conjoined twins.

Ibrahima reached out to hospitals in Belgium, Germany, Zimbabwe, Norway and America before doing research and landing in the UK.

BBC reports that he placed a call to one of the consultants and after sending him the scans of the twins, he simply said “come”.

Ibrahima had, however, depleted all his savings and medical insurance from his previous job. He later got help from Senegalese First Lady Mariame Fay Sall.

At the hospital in the UK, they were received by Dr De Coppi, a paediatric consultant, and 3D scans and ultrasounds were done to see if the girls could possibly be separated.

Then in 2017, the news came in that Marieme’s heart was weak, and that it was growing weaker by the day.

Her heart, the consultant said, was too weak to attempt the surgery. If done, she was likely to die.

Then, in spring 2017, news came from the consultant.

“As soon as I knew the situation, I did not want to proceed. How could I choose this,” said Ibrahima.

Marieme was being kept alive by Ndeye, her twin sister, as she depended on her for oxygen and heart to pump blood.

This is now straining Ndeye, as her heart is now working for two.

Later in 2018, doctors told Ibrahima that if Marieme died suddenly, it would be too late to save Ndeye.

“For me, I need to know, in my heart, that I have done everything for them, provided them with safety and the best possible healthcare. When I look in the mirror, I need to be at peace,” he told the BBC.

He added: “Beyond this, I have no control. The future is uncertain but my girls battle every day for life and I feel very blessed.  I have found out through their lives what life is. My girls are warriors and the world needs to know this.”