They were born conjoined: Ethiopian twins separated by a 24‑hour operation

Ethiopian twin sisters Hiyab and Wuhbto, born conjoined at the head, were separated by a grueling operation lasting more than 24 hours carried out in the U.S. state of Missouri. After the surgery performed at SSM Health Cardinal Glennon Children’s Hospital in St. Louis, the twins were enrolled in a comprehensive rehabilitation program to acquire independent living skills.

Treatment Process from Ethiopia to the United States

Hiyab and Wuhbto, born with the rare condition of cranio‑pagus, were brought from Ethiopia to St. Louis in March 2025. Expert teams monitored the twins for about a year as part of the preparation for surgery.

More than 300 hours of planning meetings were held for the operation, regarded as one of the most complex surgical procedures in the medical world. The surgery, which began on 24 February and lasted longer than 24 hours, involved over 30 surgical team members throughout the operation.

Skull Repairs Are Being Performed in Stages

The treatment process did not end after the twins were separated. Hospital officials announced that the cranialoplasty operation performed to restore the integrity of Wuhbto’s skull had recently been successfully completed.

Hiyab is also scheduled to undergo a similar skull repair. The health status of the two‑year‑old twins is being closely monitored by a team of more than 100 healthcare workers.

Rehabilitation for Independent Living

After the operation, the siblings, who were placed on a multidisciplinary rehabilitation program at Ranken Jordan Pediatric Bridge Hospital, are learning to move independently from each other for the first time in their lives.

Experts say the twins are working on basic skills such as sitting, standing, walking, eating, and speaking. It is also reported that the siblings have begun to experience activities that they could not previously perform together, such as playing games with each other, independently.

While it is noted that rehabilitation will be long‑term, the medical team continues its efforts to help the twins adapt to independent living.

Kraniopagus Cases Are Quite Rare

Twins born with their heads fused together are among the most rare cases in the medical world. According to medical data, cranio‑pagus twins occur in about one per 2.5 million live births, accounting for less than 6% of all conjoined twin cases.

In such cases, the fact that vital structures such as the skull and the blood vessels around the brain may be interconnected between the twins makes surgical intervention extremely complex.

It is noted that only 62 surgical procedures have been performed worldwide to separate cranio‑pagus twins. The operation of Hiyab and Wuhbto also falls among these rare, high‑risk surgeries.