Ethiopian twins successfully separated after rare cranial surgery in Missouri

In February, surgeons at a children's hospital in St. Louis completed one of medicine's most delicate undertakings: they separated two infant sisters who had been born joined at the skull. The operation on Hiyab and Wuhbto, identical twins from Ethiopia, consumed more than twenty-four hours and required a team of specialists working across multiple disciplines. Six months later, as the girls approached their second birthday, the hospital announced the surgery's success—not as a moment of triumph alone, but as the opening of a door that had been closed to them since birth.

The twins had traveled from Ethiopia to the United States in March 2025, about a year before their separation. They arrived as infants conjoined at the head, a condition so rare that it occurs in roughly one of every fifty thousand to one hundred thousand live births. When identical twins are born this way, girls are affected three times more often than boys. The surgery itself took place on February 24 and 25 at SSM Health Cardinal Glennon Children's Hospital. It was the kind of procedure that required not just surgical skill but coordination across institutions and continents—World Pediatrics, Ranken Jordan Pediatric Bridge Hospital, Lola Children's Home in Ethiopia, Ronald McDonald House of Charities, and Ethiopian Airlines all played roles in making it possible.

What matters now is what the girls can do. Before separation, certain things were simply impossible. They could not sit upright on their own. They could not eat independently or speak or play with other children. They could not do the ordinary work of being a child. Dr. Nick Holekamp, chief health transformation officer at Ranken Jordan, described the change in plain terms: the girls are now participating in therapies tailored to each of them individually. They are learning to sit upright. They are working toward standing and walking. They are eating and speaking and socializing. They are playing with each other and with other children. These are not small things.

The girls are currently receiving rehabilitative care at Ranken Jordan Pediatric Bridge Hospital in Maryland Heights, Missouri, where they have been since the surgery. Dr. Joanna Kemp, the head neurological surgeon at Cardinal Glennon, acknowledged at a press conference on Wednesday that it remains too early to predict their long-term development with certainty. But she framed what is knowable: the surgery has opened possibilities that would have remained closed. The girls now have a chance at independence, at the small and large milestones of growing up, that their condition would have denied them.

The announcement came more than six months after the operation, suggesting the hospital waited to speak publicly until the girls had begun to stabilize and show signs of recovery. That caution reflects the genuine uncertainty that surrounds any surgery of this magnitude on infants. Yet the fact of their survival, their movement toward independent function, and their ability to engage with the world as separate beings rather than as a single conjoined organism represents a significant medical achievement. What comes next—how their brains will develop, what their capabilities will be, what kind of lives they will lead—remains to be written. For now, the story is one of a door opening, and two girls learning to walk through it.