“Operation Freedom” – Siamese Twins Separated by Hungarian Medical Team

Erika Papp Faber

“Operation Freedom” – Siamese Twins Separated by Hungarian Medical Team

“It would be impossible to separate these two”, thought dr. Csókay András, neurosurgeon, when he first encountered Rabeya and Rokaiya in Bangladesh in November 2017.  But then he consulted another neurosurgeon, dr. Hudák István, who suggested a pioneering approach, and together they worked out a protocol for the entire procedure.

Dr. Csókay is the leading physician at the Neurosurgical Department of Honvédkórház in Budapest, and co-founder, with plastic surgeon dr. Pataki Gergely, of Cselekvés a kiszolgáltatottakért alapítvány (Action for Defenseless People Foundation).  Purpose of the Foundation is to provide help for those who can do little or nothing to protect themselves due to their health or economic condition.  They volunteer to perform free surgery, at home and abroad, provide instruction and assist in the acquisition of medical instruments, specialized hospital furnishings and rehabilitation equipment.

The first phase of what became known as “Operation Freedom”,  separating Rabeya and Rokaiya, took place in Bangladesh a year ago.  At that time, 85% of the shared cerebral veins were separated in a series of three operations.  Dr. Csókay András, head of the team, who himself has developed several new techniques for treating brain and spinal injuries, stated, “Dr. Hudák István, who is world-famous for endovascular matters (using catheters in the brain) was the only one in the world capable of performing this unique procedure.”

Next came preparatory surgery in Budapest, in January of this year.  During the seven months the children (with their parents) were in Budapest, dr. Pataki performed a series of 44 surgeries, grafting a specific Hungarian-designed tissue-expanding implant system into the girls’ heads to stretch the skin and soft tissue.

As Dr. Csókay relates, he practiced, in autopsies,  the individual steps laid out by Dr. Hudák.  What helped them, he said, was the knowledge that people in Nigeria (where Cselekvés has a mission), and a million people in Hungary were praying for them.  (Clergy and Catholic media in Hungary had asked people to pray especially on August 1st and 2nd for success of the surgery.) 

Finally, a team of 35 doctors traveled to Bangladesh to perform the actual separation of the twins’ skulls and brains.  There were no textbook models to follow – the entire procedure was designed by the Hungarian doctors. With Dr. Csókay András as the team leader, and Dr.  Csapody Marcell leading the anesthesia group, the girls were finally separated from each other on August 1st and 2nd in a very intricate, 33-hour procedure.  In the course of the grueling operation, the team paused three times to pray, together with their Moslem and Hindu colleagues. 

In an interview with Hungarian TV, Dr. Csókay said, ”It is never the doctor who heals; the doctor only treats.  Only  God heals.” In another interview he added, ”Two of the neurosurgical innovations with which my patients recovered better, or for which I received recognition or prizes, occurred to me while I was praying the Rosary.  They did not come from myself.”

Rabeya came out of the induced coma first, and as of this writing (August 22nd) is smiling, speaking and eating on her own.  Her twin, Rokaiya, opened her eyes only some days later, and although she is currently fighting a special viral fever, is said to be in stable condition at this time.

During a press conference, Dr. Csókay stated that, during the surgery, they had been on a physical, mental and emotional rollercoaster.  At  times they thought they were losing the children.  They also experienced situations that they could not explain, such as a kidney function irregularity of one of the girls, which disappeared all of a sudden and the kidney began to work normally.  

He also related a heartwarming incident:  once the operation was over, the girls – both still under anesthesia – instinctively reached for each other’s hand! 

Some of the doctors on the team remained in Bangladesh afterwards for more volunteer neurological and plastic surgery as well as giving professional lectures.  They had taken along two tons of medical equipment and left most of it in Bangladesh as a donation.  The entire team will be returning there in three to six months, to carry out further surgery on Rabeya and Rokaiya.  However, this will not be the last intervention for the girls.  Secondary skull construction and other rehabilitation will probably take years. 

Dr. Csókay says, "We can't speak of success even now.  It's not the successful application of techniques that signify success, but when the patient says, it is better now than it was before."

We pray for the complete recovery of Rabeya and Rokaiya, and ask the Lord’s continued blessings on the Cselekvés team!

More about Cselekvés a kiszolgáltatottakért

Founded in 2002 on the inspiration of Mother Teresa, Action for Defenseless People has helped thousands since its inception.  According to their mission statement posted on the internet, “The essence of Cselekvés is that we try to help, in an active and direct way, here and now, at home and abroad, in proportion to our abilities.”  

They travel to areas hardest hit by a lack of doctors and by poverty to perform special surgical procedures.  Since in Third World countries there are many children who suffer from burns, dr. Pataki began the Bangladesh mission for restorative plastic and burn surgery in 2010.  In 2016, dr. Csókay was led to establish a neurosurgical mission in Nigeria. “Children’s deformities and injuries must be treated as fast as possible, because they are developing and their behavior is shaped by their physical possibilities.  For example, it is very important whether or not someone can use his hands, which will determine whether he will be able to work or will become a dependent person.”  They have separated, in many patients,  fingers which had grown together, put together injured faces, done plastic surgery.  

It is their firm belief that the greatest need must be addressed first; they have to help those who have the least chance for healing, where the greatest good can be achieved with the least amount of money.  Their work is supported by donations.

Quoting again from their mission statement, the doctors of Cselekvés perform their charitable work “according to the demands of our time, the highest value being a high level of professional preparedness, the humility necessary for the task, the strength of our teams’ faith in each other and in the local community – but perhaps most importantly, the real service of the person in need.”

As mentioned above, they have established missions in Bangladesh and Nigeria.  There they spend two weeks every year, performing some 70-80 neurological and plastic surgeries on needy patients, and on patients born with developmental disabilities who otherwise would have no chance for a normal life.

The funds they raise are spent on providing bandages and medical instruments for Hungarian hospitals; on electric hospital beds and other hospital furnishings; on health lectures; and on continuing professional education for medical personnel at home and abroad, to enable them to help as many people as they can.