ROSARIO, Argentina – It took three surgeries and hundreds of man-hours but Ervina and Prefina, two-year-old conjoined twins from the Central African Republic, were successfully separated in the pope’s pediatric hospital in Rome, the institution announced Tuesday.

Joined at the skull, the sisters were born with what doctors at the Vatican-owned Bambino Gesu Pediatric Hospital called “one of the rarest and most complex forms of cranial and cerebral fusion.”

The separation took 18 hours and involved 30 specialists, and was completed a month ago, on June 5. The hospital says both girls are doing fine and they’re expected to be able to make a full recovery, although the risk of infection is still present. The girls will have to wear special helmets for a few months to prevent damage to their skulls.

The twins were born June 29, 2018, in Mbaiki, a small town in the Central African Republic. When they were stable enough to make the trip, they were transferred to the capital, Bangui, where they were cared for in a hospital built with the help of the Bambino Gesu, a project started after Pope Francis visited the war-torn country in 2015.

Conjoined twins Ervina and Prefina. (Credit: Bambino Gesu.)

In Bangui, the family met with Mariella Enoc, the director of the Bambino Gesu, who made the decision to transfer the girls to Rome to see if a separation was possible, and a special taskforce was created. Tests showed the twins to be generally in good health but that one sister’s heart was working harder to maintain the “physiological balance of the organs of both, including the brain.”

The girls had “distinct” personalities, the hospital said, Prefina being vivacious and playful, and her sister Ervina more serious and prone to quietly observing her surroundings.

The team of specialists included neurosurgeons, anesthesiologists, neuro-radiologists, plastic surgeons, engineers, and physiotherapists. Separating the skull bones wasn’t the most complicated challenge: It was separating the shared network of blood vessels bringing blood from the girls’ brains to their hearts, the hospital said in a statement.

(Credit: Bambino Gesu.)
(Credit: Bambino Gesu.)

The first two surgeries took place in 2019 and created independent vascular networks for the girls, with the final operation last month completing the separation.

“It was an exciting moment: A fantastic, unrepeatable experience,” said Dr. Carlo Marras, the head of Neurosurgery of the Bambino Gesu and of the chief of the team that separated the twins.

“It was a very ambitious goal and we did everything we could to achieve it, with passion, optimism and joy. By sharing each step, studying every single detail together,” he said.

Ermine with her daughters, Prefina and Ervina. (Credit: Bambino Gesu.)

The twins celebrated their second birthday on June 29, and were able to look at one another for the first time as their mother held both in her arms during a small party thrown at the hospital.

The successful separation was announced on Tuesday in Rome, at a press conference with Enoc, Marras, and Ermine, the mother of Prefina and Ervina, who couldn’t hide her joy: “They can run, laugh and study.”

In the photo, from left: Mariella Enoc, President of the Bambino Gesu Pediatric Hospital; Carlo Marras, head of Neurosurgery; Ermine, mother of the twins. (Credit: Bambino Gesu.)

“Ervina and Prefina were born twice. If we had stayed in Africa, I don’t know what fate they would have had,” Ermine said.

“Now that they are separated and doing well, I would like them to be baptized by Pope Francis, who has always taken care of the children of Bangui. My little ones can now grow up, study and become doctors to save other children,” she said.

Follow Inés San Martín on Twitter: @inesanma