Safa and Marwa Ullah were born by caesarean section in January 2017 in Charsadda, Pakistan. Their mother, Zainab Bibi, had not known she was carrying twins. The girls were craniopagus: skulls and major blood vessels fused at the crown. About one in 2.5 million births are conjoined; only about 5 percent of those are joined at the head. Roughly 40 percent of craniopagus twins are stillborn or die in labour.

Their father died of a heart attack during the pregnancy. Local doctors said separation would likely cost one life. A Pakistani donor, later identified in coverage as businessman Murtaza Lakhani, funded travel and care at Great Ormond Street Hospital (GOSH) in London—one of the few centres with a record of craniopagus separation.

The sisters arrived at 19 months. Neurosurgeon Noor ul Owase Jeelani and craniofacial surgeon David Dunaway led a team of about 100. They used virtual-reality models of the shared vessels and bone. Three major operations ran from October 2018 to 11 February 2019: about 20 hours, then 11, then 15—more than 50 hours in theatre, plus smaller procedures for tissue expanders, grafts, and skull reconstruction. Shared veins had to be assigned; Marwa, the weaker twin, received a critical vessel. Safa later had a stroke. Both survived.

They left GOSH on 1 July 2019 to a London address with their mother, grandfather Mohammad Sadat, and an uncle, for daily physiotherapy. They had never seen each other’s faces until they were apart. In October 2020 they returned to Pakistan. Zainab said Marwa needed only a little support and that she hoped both would walk.

The viral caption’s “100 hours” overstates the official total of major operating time. The rest of the outline holds: fused skull and vessels, a London team of a hundred, staged surgery, two living sisters. Craniopagus separation remains among the rarest operations in paediatric neurosurgery. Safa and Marwa are one of the cases that proved it can be done—and that the work does not end when the last suture is tied.

Sources

• Great Ormond Street Hospital press release, 12 July 2019
• The Guardian / CNN / The New York Times, July 2019
• BBC News, October 2020: twins return to Pakistan
• The Times interview with Jeelani and Dunaway
• GOSH facts: incidence of craniopagus twins