In Lifestyle by Oluwaseun Samuel on the 13th, October, 2018

Meet Nima and Dawa – Conjoined twins’ journey of pain and patience

Surgeons were shocked.

They had been expecting twins, but were not prepared for this complication.

“They just sent me a photo to my mobile phone,” says paediatric surgeon Dr Karma Sherub.

“They said they didn’t know what to do.”

It was the first case of conjoined twins the doctors in Bhutan had encountered.

Nima and Dawa with The Royal Children's Hospital director of anaesthesia Dr Ian McKenzie.
Nima and Dawa with The Royal Children’s Hospital director of anaesthesia Dr Ian McKenzie.Photo: Royal Children’s Hospital.

It was considered so startling in the tiny Himalayan kingdom, which opened to the world only four decades ago, that the unexpected turn of events was initially kept a secret from their mother.

She would later worry her daughters, born by caesarean section on July 13 last year, would not be accepted by their community.

But in many ways the girls were just like other babies. Joined at the torso, they otherwise looked normal and healthy.

They also received the same names that every set of twins in Bhutan, boy or girl, is bestowed with.

“All the twins in Bhutan are called Nima and Dawa. Nima means the sun and Dawa means the moon,” Dr Sherub said.

“The sun becomes before the moon, so Nima is the one that is born first, and Dawa is the moon that comes after the sun.”

Dr Karma Sherub had never seen a case of conjoined twins in his home country of Bhutan before Nima and Dawa were born.
Dr Karma Sherub had never seen a case of conjoined twins in his home country of Bhutan before Nima and Dawa were born.Photo: Joe Armao

Nima and Dawa Pelden arrived in Melbourne last week following months of negotiations to get them to Australia and fundraising by the Children First Foundation.

The 14-month-old sisters are thought to be connected by a shared liver, skin and muscle.

A marathon day of surgery aimed at separating the pair was scheduled for Friday at The Royal Children’s Hospital, but it was called off the day before over concerns the toddlers were not ready.

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Twins Nima and Dawa are anaesthetised for their MRI at The Royal Children's Hospital last week.
Twins Nima and Dawa are anaesthetised for their MRI at The Royal Children’s Hospital last week.Photo: Supplied

They will now stay on at the Children First Foundation’s retreat in Kilmore, where they are receiving further treatment and nutritional support. It is understood the surgery has been postponed for at least a week.

Dr Sherub, who has cared for twins since their birth, flew in from Bhutan this week, sitting down for an interview with The Age.

After the girls were first born, the medical specialist said he did not have any imminent concerns for their survival.

Nima and Dawa with their mother Bhumchu Zangmo.
Nima and Dawa with their mother Bhumchu Zangmo.Photo: Supplied

He said that they stayed at the National Referral Hospital two weeks longer than was normal, but only to allow the family to adjust to the unexpected complication. While a scan had picked up that their mother Bhumchu Zangmo was expecting twins, it was not known that they were conjoined.

As they got older, Dr Sherub became worried that the health of one twin could put the other peril if they were to get sick or die.

The surgeon had contacts in Melbourne having spent time in the city as the winner of a medical scholarship in 2016, and he contacted them when the twins were a few months old, setting in motion the chain of events that would lead them to Australia.

He said the first-born twin, Nima, was now the most active and dominant twin, and was raring to take life on.

Dawa was the quieter one, and did not cry as much.

“After the separation, they might take time to catch up with some of their milestones. Especially Dawa, as she has not been moving much, a few of the muscles on her limbs are not developed, because they have not been used,” Dr Sherub said.

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“Nima is just now trying to stand up and walk. She’s struggling because Dawa is holding her back.”

Dr Sherub said the twins had taught him a lot.

“I think all the doctors have learnt every day from their patience.”

The surgery and recovery are estimated to cost at least $350,000 and the state government pledged to cover surgical costs, with other funds raised to go towards the girls’ Australian rehabilitation and return home.

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