Twin sisters separated after 24 hour head surgery are now learning to sit, eat and speak on their own

For the first time, twin sisters Hiyab and Wuhbto are working on milestones as individuals. The 2-year-olds, who were born joined at the head, are recovering after a cranial separation surgery in Missouri that lasted more than 24 hours.

A multidisciplinary team at SSM Health Cardinal Glennon Children’s Hospital in St. Louis carried out the operation in February 2026. More than six months later, hospital officials say the girls are continuing their recovery, with doctors describing the procedure as one that opened possibilities that did not exist while they were conjoined.

Hiyab and Wuhbto traveled from Ethiopia to the United States in March 2025 to prepare for the surgery. Their care involved specialists from multiple medical fields for what hospital leaders described as a highly complex cranial separation.

What life looks like now

After the operation, the sisters began rehabilitation at Ranken Jordan Pediatric Bridge Hospital in Maryland Heights, Missouri. There, they are receiving intensive therapy aimed at mobility, communication and daily living skills.

Hospital officials said the girls can now take part in individualized therapy programs. They are learning how to sit upright, eat, speak and socialize, with standing and walking also part of the goals ahead.

Dr. Joanna Kemp, the hospital’s lead neurological surgeon, said it is still too early to know what the twins’ long-term development will look like. But she said the separation has created new opportunities for their growth and independence.

The effort brought together both Missouri hospitals along with several international nonprofit and community partners, forming the broader support system behind the twins’ treatment and recovery.

What craniopagus separation means

Conjoined twins are identical twins whose bodies remain physically connected during very early development in the womb. In the rare form known as craniopagus, the connection is at the head. The degree of sharing can vary a lot. Some children may share scalp and skull, while others may also share blood vessels, protective tissue around the brain, or parts of brain structure.

That is why separation surgery is considered among the most complex operations in medicine. The main challenge is not simply dividing bone and skin. Surgeons must map how blood flows, protect brain function, and plan how to safely close and rebuild the skull and scalp afterwards. Care often involves many specialists working together, including neurosurgeons, plastic and reconstructive surgeons, anaesthetists, imaging experts, intensive care teams, and rehabilitation therapists.

Why recovery takes so long

Separation is only one stage of treatment. After major cranial surgery, children often need a long period of rehabilitation because they may have to build or rebuild skills such as head control, sitting, swallowing, eating, speaking, and coordinated movement. Some skills can be delayed by the shared anatomy itself, and some by the long hospital stay, weakness, pain, or the brain adjusting after surgery.

Progress is often gradual rather than linear. Physical therapy can help with posture, balance, and strength. Occupational therapy can support everyday tasks and play. Speech and language therapy may help with communication, feeding, and swallowing. Families are usually taught exercises, positioning, and ways to encourage development at home, since repetition in daily routines matters as much as formal therapy sessions.

What families can do

When a child is facing very complex surgery, it helps to ask early about the full care pathway, not only the operation. Useful questions include: who is coordinating care, what rehabilitation will be needed, how feeding and communication will be supported, what warning signs to watch for after discharge, and what kind of follow up is typical.

Practical support matters too. Hospital social workers, early intervention services, developmental therapists, and parent support groups can help families navigate appointments, equipment, schooling, and emotional strain. Keeping a simple notebook of medications, therapy goals, new symptoms, and small milestones can make day to day care easier and give clinicians a clearer picture of progress.