In Bamako, Malian surgeons separate twin girls who began life sharing a single bladder

Two newborn daughters of the Berthé family came into the world joined at the bladder and colon. At Gabriel Touré University Hospital in Bamako, a Malian team carried out the country's first separation of conjoined twins. The girls now lie in two separate beds.

The doctor's name has not been made public, but the surgeons in Bamako remembered the diagnosis. "Without a scanner, without MRI, with just ultrasound: truly it is art," said Professor Yakaria Coulibaly, head of paediatric surgery at the hospital. Because the diagnosis came early, the delivery could be planned. After a full-term pregnancy, the couple's fourth, the girls were born by caesarean section.

They shared more than the ultrasound had shown. Beyond the bladder and the colon, the sisters had one abdominal wall between them. There was also a fistula, an abnormal passage connecting their organs. Hospital director Professor Thierno Madani Diop brought together paediatric surgeons, anaesthetists, intensive-care specialists, cardiologists, radiologists, pharmacists and theatre staff. By the accounts of Malian outlets, every one of them was Malian.

The operation took about two hours, and roughly ten practitioners stood at the table. Each baby weighed about 2,500 grams. Coulibaly gave the credit to the colleagues whose work is least visible. The hardest part, he said, fell to the anaesthesia team, keeping two tiny bodies stable through a single operation. "They did the heavy lifting."

Each girl now has her own bladder and urinary tract. The separation could not give them both a colon, however. Only one of them has one, and her sister will need medical care for the rest of her life. Whether a separation succeeds depends on which organs the twins share, and here the surgeons had to decide how to divide what was there. The girls do not yet have public names. Doctors expect them to stay in hospital for about a month.

Health Minister Assa Badiallo Touré, a physician who holds the military rank of Colonel-Major, came to see the newborns. The ministers of Religious Affairs and of the Promotion of Women, Children and Family came with her. She called the surgery "truly a feat."

Coulibaly used the moment to speak about the future. Malian hospitals, he said, need better surgical equipment so that complex cases no longer have to be sent abroad. Until now, a family like the Berthés might have had to look beyond the country's borders for help. This time the diagnosis was made in Sikasso and the operation was done in Bamako, and the two sisters are recovering close to home.