Conjoined Algerian twins: 'They have won the battle of their lives'

[Al-khiyal]

Benhaffaf twins leave intensive care after operation

May 5, 2010 -- Former conjoined twins Hassan and Hussein Benhaffaf have left intensive care following an operation to separate them in a London hospital. The five-month-old boys from Cork, Irish Republic, have been moved to a surgical ward. They underwent the 14-hour surgery last month. Doctors say they are pleased with their recovery and progress. Parents Angie and Azzedine Benhaffaf said: "We cannot believe we got our happy ending."

A statement from Great Ormond Street Hospital said the boys were breathing unaided and being bottle fed, and were placed in a cot together on Wednesday for the first time since the operation. Mr and Mrs Benhaffaf said: "We've enjoyed our first cuddles since their separation and they were worth the long wait. The boys were reunited for the first time and it was very emotional to see them back together, in each other's arms." They added: "Their sisters Malika and Iman are getting used to their brothers being apart and are looking forward to holding each of the twins."

The operation involved about 20 medical staff, including four surgeons and four anaesthetists, working in shifts. The team had previously dealt with 21 separations and nine inoperable cases. The brothers were born on 2 December at University College London Hospital and went home to East Cork in January, before returning to London for the operation. A special fund was set up in Ireland to help their parents cover medical costs.

[Al-khiyal]

Conjoined twins are apart at last... but together forever

May 16, 2010 -- One lovingly cradled in each parent's arms, these are the heartwarming pictures of Irish conjoined twins Hassan and Hussein after their amazing 14-hour separation op. For the first time since the boys' million-to-one-shot procedure, they are shown recovering from the major surgery it's hoped will give them a normal life. And while the brothers enjoy stretching out apart, we can reveal the miraculous pair are still fighting strong together. Loving mum Angie Benhaffaf, 36, from County Cork in Ireland, says: "They'll do everything, these boys. They're my little fighters. They'll do what other kids can do, probably even better. I think they're an absolute inspiration. Even now, they give so many smiles and cuddles, despite what they've been through."

For Angie and adoring dad Azzedine, 37, who also have two daughters, Malika, six, and Iman, two, it is the much-prayed-for end of months of tears and heartache that began with a grainy image of their boys. Joined at the chest, it was feared a 12-week scan - which doctors thought showed the brothers shared a heart and vital major organs - foretold their death. A later scan, on 24 weeks, showed the babies holding hands. But over the last five and a half months, with a painful birth, gruelling surgery, and an unbreakable will no one could have predicted, the battling boys personify nothing short of a miracle. And now, together, but no longer always side-by-side, the twins are almost ready to go home.

For their mum and dad, it's frighteningly good news. Angie admits: "When I think about the odds of what they've been through, it's scary for us. "We're just these ordinary people from ordinary backgrounds, but what the boys have been through is so overwhelmingly miraculous, it can be quite scary sometimes. I still remember the surgeon, the world leader in conjoined twins, telling me the boys have made an 'unusually quick recovery', words I'll remember forever and take to my grave. That's exactly what we want to hear."

It's now just over five weeks since the twins underwent 14-hour surgery to separate a shared chest and liver, on April 7, at London's Great Ormond Street Children's Hospital. The hospital boasts the world's foremost experts in conjoined twins, having handled 22 separation procedures to date. For the Benhaffaf twins, more than 20 medics, including four surgeons and four anaesthetists working in shifts, came together for the intricate procedure. So complex was the twins' bond, they shared a pelvis and liver. Their hearts were so close in their linked chest one pericardium sac encapsulated both hearts. Doctors had predicted, if the boys survived the surgery, they'd have to spend months in the Intensive Care Unit. Yet they were out by May 1 - just three weeks after the op. And now, despite having planned for up to a year in hospital, their parents expect to travel home possibly as early as next week.

Speaking exclusively to the News of the World mum, Angie and dad Azzedine today reveal their boys' amazing recovery, and the change the twins' separation will bring to their lives. And, with irrepressible humour, and a few tears, they admit there are even some things they MISS about having just one bundle of joy. Angie says: "The day of the surgery was terrifying. "We handed them over at 8.30am, and prayed until the amazing news at 11pm when we were told it had gone well. There was so much relief. People told me they thought I was going to collapse. All I remember when I saw them for the first time after that, at 2.30am that night in the Intensive Care Unit, is that my mouth just dropped. I remember saying to Azzedine before we got there that I needed a few minutes, for some deep breaths. Then we went over to these two cots, two, completely separate from each other, and I remember that my mouth dropped just wide open. I'll never forget how I looked. For the first time ever, we were looking at each other saying which one is which, because Hassan was always on the left and Hussein was always on the right. But as puffy and as swollen as their faces were from the surgery, we knew who was who. You could see what they'd gone through on their little faces. They were naked. There was an awful lot of tubes and machines, and ventilators. They had these bits that look like swimming floats over each of them. It was very frightening and very confusing to see them apart. Even though to most people, and society, it's strange to see them conjoined, to us as a family they were normal together and to see them apart just didn't seem normal. We'd had them at home, after birth, as conjoined twins, getting them stronger for the months before the operation. And now they were apart, as two little babies. And we cried."

[Al-khiyal]

Angie admits it was partly due to relief and exhaustion, but she also reveals the couple missed the beautiful babies born joined together almost five months earlier, and six weeks prematurely, on December 2. The loving mum recalls her first thought as she lay awake during an operation to open her womb and remove the twins was how good-looking her boys were. She remembers: "The doctor said, 'Show the babies to mum' - and I saw these two beautiful faces, as bloody and crumpled as they were, they were just both so handsome. Hassan had his arm round his brother, and it was so beautiful. You just don't expect them to come out of the womb like that, with one holding his brother. So when we cried after they were separated, it was relief and exhaustion, but also we missed them. When they were joined, they had this amazing thing when they started crying. They would start crying at the same time, and when they stopped they would stop at the same time. In unison. And it was the most beautiful chorus. Anybody who heard them loved it. They just did stuff when they were together that was so special. Kissing each other, stroking each other's faces, holding each other's hands when they were asleep. We do miss them together - but we know that together wasn't really an option." Angie even admits: "When I was handed Hussein last week to bottle feed him on his own for the first time, without Hassan, I felt awkward feeding one baby with a bottle. I was used to one head on my upper arm, and one on my forearm. I felt while feeding Hussein that I had this sad feeling that I miss them together." And the loving pair both joked that the babies were easier to handle when conjoined. Azzedine laughs: "It's true. It's more difficult now, for sure - there's two of them!" Angie adds: "We've come to the conclusion they were easier to feed joined, they were easier to hold joined and easier to clothe joined. We have to work harder now."

The laughter shows the joy of the parents at their boys' remarkable recovery - against the odds at every step of the way - and new future before them. Along with a shared pelvis, liver, and pericardium sac, the boys both had one good kidney each, which were kept, and one bad kidney, which was removed. The surgeons told Angie and Azzedine that their boys' chances were better than average, but that there was still a 20 per cent chance they wouldn't survive the procedure. Azzedine, often called Az, reveals: "I always go to the negative, not the positive. So I wasn't looking at 80 per cent survival, but at the 20 per cent chance. In my mind I always saw it as 50/50. My odds were lower. I never wanted to hope so much." The babies experienced setbacks, but where they were separated, their supple baby skin gradually stretched closed over a number of days. Angie says: "About five days after they were separated, I felt I could look at the wounds. My husband said I shouldn't. He said it would be too hard, and make me think about what they'd been through. But on one visit I went to leave and bent down to kiss Hussein goodbye and as I did, a light material over the wound blew up and I caught a glimpse of the wound. It was from his chest to his tummy, red raw. I'd seen it, and Az hadn't. Describing it to him I said that the wounds were open from chest to tummy."

And during the slow process, both boys did fall seriously unwell. Little Hussein's heart rate dropped dramatically, and then just as he got better, Hassan's lungs collapsed, leading to him being put on an oscillator. Angie, who first met her husband 13 years ago when he came here from his native Algeria on business, admits: "That was very serious." Yet within three and a half weeks, awkwardly due to the hard plastic tubes and machinery, the parents were able to hold their boys again. And within four weeks they were transferred to the surgical ward where they remain. Medics say their prognosis is very good. Their liver and pericardium sac are both expected to regenerate, while both boys will be able to live normal lives with one kidney each. Luckily, they were born with genitals and a bottom each, and neither needs extensive further operations or plastic surgery. Hussein sports a small plaster cast on his leg, as a simple aid to help straighten its position after five months supporting both boys. Neither will need medication, and both are suitable for a prosthetic limb, the only constant medical add-on they are expected to require throughout their lives. Angie explains: "They both naturally didn't have a leg. It was just how they grew in the womb, it just didn't form. We didn't find out from early scans, we didn't know until October. It was yet another piece of news that hit us for six. But as much as it killed us, I'm just glad they're alive, and we'll get them the best prosthetics. They will be growing so quickly they'll need to change that a few times each year. They reckon the first will be in a year from now when they're walking. It could be at a year old, but a year and five months is enough for them to be steady. By that point it will be everything they've ever known, which should help. It won't hold them back. I know they'll do amazingly well. I can see them running or whizzing around. I know they can do what other kids do, but probably even better. Football, running - they'll do it better than other kids. They'll do everything, these boys. I'm not going to treat them differently. I'm not going to make them feel like they have a disability and feel like they need mollycoddling. They've given me strength now, and I'll be there to give them strength later. I won't let anything stand in their way."

[Al-khiyal]

Little fighters come home

May 21, 2010 -- The red carpet was rolled out this afternoon for the 'Little Fighters' - twins Hassan and Hussein Benhaffaf - as they returned home for the first time since their separation operation. In a fitting homecoming for the five-month-old boys, they were flown to Cork Airport by the Irish Air Corps, whose pilots were also tasked with flying them over to London at the end of March. And the plucky duo were well prepared for their trip home, having been sent gifts of tiny Cork GAA jerseys. The twins were accompanied by their parents Angie and Azzedine and sisters Malika (6) and Iman (2). Several close family members were at the airport for an emotional reunion.

While the twins have recovered "exceptionally quickly" from their marathon separation surgery, they still require medical attention and are expected to be cared for at Cork University Hospital in the coming weeks. The Benhaffaf family had prepared to spend at least four months in London, as surgeons said the boys would need a long period of recovery in the Intensive Care Unit. Hassan and Hussein were joined from the chest to the pelvis and shared a liver, gut and bladder. However, following a 14-hour operation led by Cork-born Dr Edward Kiely, they recovered far faster than expected. Mr Kiely, one of the world's leading surgeons in the field of conjoined twins, has expressed his delight that his two most famous patients are finally returning home. He described the twins as "two very independent little boys with every chance of a great future". He also praised their parents for their "great courage" throughout the last few months. "It's an awful business when you might lose two children all at once, so it's an extraordinarily difficult time for them," he said.

Hassan and Hussein were not expected to survive after pre-natal scans showed that they were joined at the chest. Yet, they both thrived following their birth at University College Hospital in London. Their mother Angie dubbed them "Little Fighters", a moniker which proved suitable as they recovered speedily from their mammoth operation. Both boys have a limb that did not form fully in the womb and will be fitted with prosthetics when they are older. However, they are not expected to require any further surgery. A massive fundraising effort continues to help meet the huge costs of surgery and accommodation for the family in London. Azzedine, originally from Algeria, had to give up his job in recent months to be with his family.

[Al-khiyal]

'Little fighters' return to Cork after triumph of separation surgery

May 22, 2010 -- Twins Hassan and Hussein Benhaffaf returned to Cork yesterday amid jubilant scenes after the surgery to separate them in London last month. The five-month-old twins, who were conjoined at birth, were brought home with their family on an Air Corps Casa aircraft. An exhausted but visibly joyful Angie Benhaffaf – accompanied by her Algerian-born husband Azzedine – shouted “Up the rebels! Up Cork!” as she waved to family members and media who gathered behind a barrier close to the area where the aircraft landed at Cork airport. “Three cheers for the little fighters,” shouted an ecstatic Malika Benhaffaf (4), who with her two-year-old sister Iman, stayed in London through the twins’ operation and recovery period. The twins were discharged from Great Ormond Street Hospital for Children in London yesterday. After arriving in Cork at 2.15pm, they were taken to the paediatric unit at Cork University Hospital (CUH). They are expected to return home to Carrigtwohill in County Cork in a matter of days.

Taoiseach Brian Cowen was among those to welcome them home yesterday. Speaking in Ballina, he said: “It’s a very heart-warming story . . . to have the Air Corps to provide the facility to bring them home is just an indication [of] how all of us in the community are delighted that this has worked out for their family, for their parents and for themselves.” The family was met at the airport by Minister for Foreign Affairs Micheál Martin, who had visited the twins when they were born last December and has worked behind the scenes over the last few months to assist the family, even taking a call from Ms Benhaffaf during intense meetings at Hillsborough Castle. Mr Martin joked that the boys were “yawning and looking for food” when he greeted them at the airport. He paid tribute to the Benhaffafs, and spoke of the professionalism of medics involved in the UK and at CUH.

Among those waiting to see the twins was Shirley O’Leary, a sister of Angie Benhaffaf. “We never thought we would have them back so soon. Angie was so amazing. We all complain about so much in life and it is all relative really,” she said. “It has been almost a year and a half of stress. We are just looking forward to having a big party.” Mr and Ms Benhaffaf thanked the public for the support received over the last few months. In a statement, they said “all their prayers were answered” as they were coming home as a family of six.

Doctors at Great Ormond Street said they were astonished at the speed at which the boys had recovered from a gruelling 14-hour operation on April 7th to separate them. Consultant paediatric surgeon Edward Kiely said: “I see sick children and sick babies all the time, and you cannot help but be impressed by the courage of the parents and the courage of the children.” Mr Kiely said both boys would need one prosthetic limb each, but they were not expected to have to undergo any other medical procedures. The boys would go on to live normal lives, he added. “They have one leg each and obviously that is a problem, and they will never have known any different. Most children who are born like this – they adapt quite well to a prosthesis.”

Consultant paediatrician with CUH Deirdre Murray said Prof Jonathan Hourihane and the university hospital paediatric team had been liaising with the medical staff at Great Ormond Street regarding the boys’ care. “We’re delighted to hear that they done very well following their surgery, and we are looking forward to getting to know them,” she said. “We also know that their parents are looking forward to spending some quiet time with them as a family after a difficult few months.”