On November 14, 2019, Prof. Emmanuel Ameh led a team of 78 medical personnel in an epic surgery to separate Siamese twins that lasted for 12 and a half hours at the National Hospital Abuja (NHA).
The conjoined set of twins were delivered in Federal Medical Center Lafia, Nasarawa State, with complicated body defects. They had one liver, a protruding tummy and a lower chest.
The success of the surgery has made viral news that Nigeria’s Minister of Health, Dr. Osagie Ehanire, issued a statement calling it a significant feat in Nigeria’s medical practice.
He said: “This is a demonstration of excellent team work, which also shows that with confidence in the health sector, we can do great things in Nigeria.
“One of the reasons why some Nigerians travel abroad for treatment is because they lack confidence in the health sector. They believe that we do not have specialists and the required medical equipment to handle sensitive cases, but this case has shown that we have the expertise. No foreign aid was involved in the surgery.
“The ability of these experts to work together means that we can stand up to many international hospitals, as far as advanced surgery is concerned. This is a complex one involving conjoined twins with one liver.”
The complexity of the operation needed more than expertise. Prof. Ameh explained what they did in order to deliver a successful surgery, which includes monitoring the twins for a 15 month period.
“We received the twins on August 14, 2018, and quickly constituted an interdisciplinary team, including pediatric surgeons, cardiac surgeons, plastic surgeons, nurses, imaging experts, dermatologists and other experts from various medical disciplines, as well as support staff.
“One of the major challenges was that the twins came with their intestines bulging out of the lower part of the tummy, which we quickly resolved.
“We also needed to determine if they could survive separately after separation. We found out that they had two separate hearts that were normal, but with a common cover. They also shared the lower half of the chest, and there was only one liver serving the two of them. Other organs were separate and normal,” he said.
Ameh further disclosed that the 15 month period of monitoring was to enable the twins to grow well enough to withstand the pain and pressure that would come from the complexity of the surgery.
“We celebrated their first birthday in the ward still conjoined. The surgery was performed on November 14 2019. By that time they were 15 months old. A total of 78 medical staff was involved in the 12 and a half hour surgery. We even planned to spend 48 hours if there was a need for it. After that, the twins spent a week at the Intensive Care Unit before they were taken to the ward,” he said.
This is not the first time a Nigerian hospital is recording success in Siamese twins separation, in June 11 2018, the University of Abuja Teaching Hospital (UABTH) announced that it successfully separated conjoined twins in an operation that gave hope to what’s to come. But the complexity of this one tested the expertise and the Nigerian medical institution’s capability to handle complicated cases.
The medical director of NHA, Dr. Jaf Momoh said the hospital saved the parents of the twins a fortune that they would have spent travelling abroad for the surgery. He said the cost of the medical operation overseas would have amounted to more than N20 million, but National Hospital took care of the bill.
“The cost of running a hospital is enormous. The average electricity bill of the National Hospital is about N19 million every month. That is why we collect money. We took it upon ourselves to mobilse resources and invest it on the twins.
“If the parents had the means, they would have gone abroad like some other Nigerians and spend at least an equivalent of N20 million in foreign currency. It is cheaper doing surgery here, Ameh said”
The call for Nigeria to stop medical tourism is as loud as the call for government to give due attention to the health sector. Ill-equipped medical facilities and depreciating medical workforce have been a major contributing factor in promoting the culture of medical tourism that Nigerians are famous for. Though President Buhari said the custom needs to stop, but he himself has been a regular visitor of foreign hospitals.
It is believed that Nigerian hospitals and medical staff welfare are being neglected because public office holders don’t patronize them, and that has resulted in mass exodus of medical personnel from Nigeria.
Yearly, about 2,000 medical doctors leave Nigeria for other countries in search of a better pay and system to work in. the rate is alarming because the number of doctors keep reducing while that of patients are increasing. The World Health Organization recommends one doctor to 600 patients, but the ratio in Nigeria is one doctor to 6,000 patients.