Ohio twins born conjoined at the spine can now both walk

Born entangled at the hip and spine in a rural Ugandan village in September 2014, Acen and Apio Akello left local doctors stunned.

With nothing more than rudimentary medicine for miles around, it looked like the girls – the first children of 19-year-old Ester – would face a life of disability and pain.

However, surgeons managed to reach the expert separation team at Nationwide Children’s Hospital in Columbus, Ohio. 

What followed was a year of fundraising to get the girls and Ester to the United States.

Their surgery was intensely complicated, involving an entire team of neurophysiological surgeons tasked with separating each nerve to ensure the girls would be able to be independent after.

Now, just 16 months later, they are walking – and their surgeon Dr Gail Besner believes all of their medical woes are behind them. 

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Incredible: This is Acen and Apio, living separate lives in almost perfect condition a year after separation surgery at Nationwide Children’s Hospital in Ohio. Pictured with their mom Ester

Born entangled at the hip and spine (shared skin pictured) in rural Uganda in September 2014, Acen and Apio Akello left local doctors stunned. Ester (pictured) had never left her village

Lead surgeon Dr Gail Besner pictured with the girls before the surgery – her fourth separation

During surgery: The girls were labeled with colors so surgeons could identify who got which part of the anatomy. They had a team of nerve experts making sure both girls would be fully independent afterwards

The girls’ astonishing progress left their mother and the medical team in tears, defying all the risks that could have followed surgery – including walking issues and colorectal incontinence.  

‘When I first saw them walking independently, I would say it was one of the happiest days of my life,’ lead surgeon Dr Besner told Daily Mail Online on Tuesday.

The girls had been going through daily physical therapy, with routine consultations from the surgical team to check everything was going well. 

Then, shortly after their second birthday in October, they arrived in Dr Besner’s office – and both pushed themselves up onto their feet.

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‘I couldn’t believe my eyes,’ she said. 

‘I really think they will be fine from now on. I think they will do beautifully.’ 

Now the family are en route back to Uganda. 

‘It’s always been a goal of Ester’s to get home,’ Dr Besner explained. ‘So it’s been really a precious gift to be able to give her that.’

‘I really expect them to have a normal life.

‘When they get off that plane in Africa, they are going to walk off it and not be carried.’  

Reflecting on their two years together, Dr Besner said watching Ester grow has been just as powerful as monitoring Acen and Apio.

The girls had been going through daily physical therapy, with routine consultations from the surgical team to check everything was going well. They walked shortly after their birthday

‘When I first saw them walking independently, I would say it was one of the happiest days of my life,’ lead surgeon Dr Besner (pictured with the girls) told Daily Mail Online on Tuesday

Dr Besner believes all of their medical woes are behind them as they head home to Uganda

‘Ester was only 19 when she had these babies.

‘She had never been out of her village, let alone out of Africa. She didn’t speak a word of English. In fact, she speaks a very specific dialect that only three people in the United States can speak.

‘When she got off the plane, she entrusted me – a total stranger – with her babies. She had no idea what was going on. 

‘Luckily we found a translator – a science grad student who happened to be in Ohio and happened to have grown up 20 miles from Ester.

‘But by the time Ester was going home, she was capable. She could understand everything you said, she can have a full conversation. And she looks after these girls all the time, single-handedly. She is completely self-sufficient, it’s incredible.’

Proving her skill, Ester was captured on film thanking Dr Besner at the airport. 

The surgical team included more than 30 people and was led by Dr Besner, the hospital’s chief of pediatric surgery. Pictured: reconstruction after the separation

Acen and Apio pictured in their bed after being separated

Reflecting on their two years together, Dr Besner said watching Ester grow has been just as powerful as monitoring Acen and Apio. Ester and Dr Besner pictured on the day of surgery

Specialists had to carefully un-twine the spinal cords of the two girls as technicians monitored the nerve functions to see which nerves belonged to Acen and which ones belonged to Apio

‘It’s amazing,’ Ester said, hugging Dr Besner as they prepared to board a flight to Uganda.

The surgical team included more than 30 people and was led by Dr Besner, the hospital’s chief of pediatric surgery.

Conjoined twins occur once in about every 200,000 pregnancies, and Nationwide has now successfully separated four sets of these twins.  

Specialists had to carefully un-twine the spinal cords of the two girls as technicians monitored the nerve functions to see which nerves belonged to Acen and which ones belonged to Apio.

After that their soft tissue was divided, followed by the reconstruction process.

Then, the two officially became separated.

‘The surgery is going to be very helpful to the children because then they will be bale to feed on their own and they’ll be able to grow up like normal children,’ said Akello. 

The two girls have obviously become very close over the course of the past year, and given the way they were joined would often hold hands. 

‘It’s just the cutest little thing,’ said Dr Besner.