Rare PNG conjoined twins en route to Australia as case reaches 'critical' point

A rare set of conjoined twins are being urgently airlifted from Papua New Guinea to Australia, with doctors recommending they be separated as soon as possible.

Specialists from the Sydney Children's Hospitals Network arrived in Port Moresby this morning to help transfer the babies to Sydney.

The boys, Tom and Sawong, were born two months ago in remote PNG and were airlifted to Port Moresby for treatment.

They are joined at the lower abdomen and share a single liver and parts of their gastrointestinal tract.

The surgery needed to separate them cannot be performed in PNG.

After weeks of tense negotiations and earlier recommendations not to transport the twins overseas, the boys are expected to undergo highly complex surgery after they arrive Sydney.

Tom, the smaller twin, also has a congenital heart defect and only one kidney.

In recent days, Tom's health has deteriorated, prompting doctors to fast-track their transfer to Australia.

Polapoi Chalau, the chief executive of Paradise Private Hospital in Port Moresby, where the twins were being treated until today, said Tom had signs of low albumin, a protein important for balancing fluid levels in the body.

"I think we've just about reached that critical level now — something needs to be done," he said.

Twins will be 'supported by a large team' in Sydney

In a letter to doctors in PNG, the Sydney team said Tom had multiple congenital anomalies and his long-term survival was unlikely.

They said Sawong had a reasonable chance of survival after surgery.

"The reason for the early separation is that Sawong is working hard to support Tom. This is also why the team has recommended transfer as soon as possible," the letter said.

"The team has also recommended specialised transport to the facility with a specialised medical and nursing team."

In its letter the Sydney Children's Hospitals Network said the twins would be treated in its facility at Westmead.

"They will have multiple investigations including MRI scan and CT scans with contrast to delineate their anatomy and vascular supply," the letter said.

"A multidisciplinary team including liver surgeons, colorectal surgeon and urologists, specialised cardiac anaesthetists, cardiologists, neonatologists and interventional radiologists will then prepare for separation of the twins.

"They will be supported by a large team of nursing and allied health staff."

It said funding to support their care must be provided prior to the transfer.

The ABC understands Tom and Sawong's parents wrote to the PNG Government in recent days requesting funding for the medical treatment.

'They are a very special case'

The transfer to Sydney comes weeks after Port Moresby General Hospital doctors recommended against sending them overseas.

At the time chief executive Paki Molumi said the decision was taken after consultation with Australian doctors and because the likelihood of both twins surviving separation was extremely low.

"Taking all these factors into account, our team collectively agreed that it is in the best interest of the twins and their family to continue care here at the Port Moresby General Hospital," he said.

Shortly after that statement, the parents moved Tom and Sawong to Paradise Private Hospital, where they have been receiving care since mid-November.

Two weeks ago, a team of specialists from the Sydney Children's Hospitals Network flew to Port Moresby to assess the twins and recommended the boys be transferred to a specialist facility as soon as possible.

Dr Chalau said he was relieved the twins were finally being transferred to a facility where they could receive appropriate care.

"They are a very special case that we have in here, and with the limited resources that we have, that puts more pressure on us," he said.

"We're just providing the bare minimum that we can to keep the twins alive and then hopefully help comes in."

Dr Chalau said negotiating with the parents and other parties, including foreign governments, had been difficult at times.

"That's where the challenge is for the last three weeks, but I'm glad to say that things seem to be falling into place," he said.

Arrangements were also being made to send the twins to a major hospital Germany, where they had been accepted, but when Tom's health took a turn they decided to change course.

"The decision to go to Australia is, number one, it's closer to us," Dr Chalau said.

Parents are holding onto 'hope' despite long road ahead

Paradise Private Hospital co-owner Janet Sios said it had been an emotional time for the parents.

"The hope of the parents is that they must go down and get the best they can get. Hope is what they're holding on to," she said.

"We are excited to get them off the ground to Australia."

Ms Sios said she and her team were were hoping for the best outcome.

"Even if Tom doesn't make it and Sawong makes it, Sawong might be a prime minister one day, he might be even a doctor one day," she said.

"I go to sleep every night knowing I have a very good medical team that are taking care of them."

But Dr Chalau said there was still a long road ahead.

"Getting them overseas is just a start," he said.

"Surgery is just part of it, but the long-term care and rehabilitation is another thing."