Two two-year-old sisters born joined at the head in Ethiopia saw each other face to face for the first time this month after surgeons in St. Louis completed a 24-hour separation operation. The craniopagus twins separated during the February 24-25 procedure at SSM Health Cardinal Glennon Children's Hospital are now recovering and learning to do the ordinary things of childhood, from sitting up to playing with each other. The hospital announced the successful outcome on September 16, calling the surgery one of the most complex and rare pediatric procedures performed in the United States.

The girls, Hiyab and Wuhbto, were born with craniopagus, a condition in which twins are joined at the skull. Because they faced in opposite directions for nearly two years, they could hear each other's voices but had never seen each other's faces. Their parents were unable to obtain visas to travel from Ethiopia, so the girls arrived in St. Louis in March 2025, shortly before their first birthday, accompanied by a guardian. A team of about 30 medical specialists then spent almost a year studying their condition and planning the operation, according to the hospital's September 16 news release.

The final separation began on the morning of February 24 and stretched into the early hours of February 25, a 24-hour marathon in the operating room. Surgeons worked through roughly six staged preparatory procedures over the preceding year, slowly disentangling shared blood vessels and expanding skin tissue so that critical blood flow to both brains stayed protected. The procedure followed about 300 hours of planning. Leading the team was Dr. Joanna Kemp, an associate professor of neurosurgery at Saint Louis University, who became the first woman neurosurgeon in American history to complete a craniopagus twin separation. Only about 8 to 10 percent of board-certified neurosurgeons are women, and such cases arise roughly once a year worldwide, she noted. It was only the second surgery of its kind in the St. Louis area; the first was performed in the 1980s.

A global relay of care

The girls' journey depended on a network of organizations spanning two continents. World Pediatrics, a global health charity, managed guardianship and consent, coordinated international logistics, and built the volunteer caregiver network around the sisters. Lola Children's Home cared for the girls in Mekelle, Tigray, before the trip. Ronald McDonald House Charities provided lodging for their guardian in St. Louis, and Ethiopian Airlines supplied the specialized transport needed to bring the girls to Missouri. Ranken Jordan Pediatric Bridge Hospital cared for the girls before the surgery and now leads their rehabilitation, offering therapies designed to help them sit, stand, walk, eat, speak, and socialize. Wuhbto has already undergone a cranioplasty to complete the repair of her skull; Hiyab is scheduled for the same procedure this fall, the New York Post reported.

Separation was not simply a choice. Doctors determined that leaving the girls conjoined posed significant long-term health risks and that the care they would need could not be managed in their home country. The rarity of the condition explains why so few surgeons have attempted it: according to the National Library of Medicine, head-joined twins occur in about one in 2.5 million live births and represent less than 6 percent of all conjoined twin cases. Of 69 well-documented craniopagus cases worldwide, only 62 separation attempts have ever been made.

What comes next

The craniopagus twins separated at Cardinal Glennon remain in the middle of an extensive medical journey. Their care teams say the sisters are beginning to take part in individually focused therapies for the activities of daily living that were impossible while they were joined, including therapies to eat, speak, and play with other children, including each other. More than 60 clinical team members remain involved in their recovery. The milestone also spotlights how far pediatric medicine has come in repairing conditions once considered untreatable, a theme echoed in other recent medical advances covered on GenZ NewZ's health reporting. For Hiyab and Wuhbto, the months ahead will bring more surgeries, more therapy, and the slow work of growing up apart for the first time in their lives.