Were Yemeni conjoined twins killed by Saudi-Houthi political rivalry?

Were Yemeni conjoined twins killed by Saudi-Houthi political rivalry?
Abdul Khaleq and Abdul Rahim died just two weeks after they were born. Their lives could have been saved if transport out of war-ravaged Yemen was available, medics say.
6 min read
18 February, 2019
Abdul Khaleq and Abdul Rahim died on Saturday February 9 [Photo: Al Thawrah hospital]
Conjoined twins Abdul Khaleq and Abdul Rahim died on Saturday February 9 in a Sanaa hospital while under artificial respiration.

Doctors had appealed for their treatment outside the war-ravaged country, but their pleas went unanswered. Saudi Arabian sources have since said they offered to transport the children for treatment, but medics at Yemen's Houthi-controlled health ministry say they received no such offer.

"The blessing is that I still have my twins' mother," says the father of the two-week-old boys.

Akram al-Bahshani, a 20-year-old resident of the capital's Al-Haymah Al-Kharijiyah district, had been receiving mourning relatives and friends for three days.

They gathered at the home of his uncle, Ahmed, to pay their respects. Akram and his wife have decided against returning to their home village, as she still requires regular hospital treatment.

Having conversations in the front room, the relatives gather under a photo of Ahmed's wedding. "Media did nothing for us," he said. "They just took pictures of Akram's sons until they died."

Akram married 18-year-old Um Abdul Khaleq in early 2018. The twins were born on Saturday 26 January. Their tragic death has shone a fresh light on the forgotten children of war.

Um Abdul Khaleq was five months pregnant when doctors at Al Kuwait Hospital in the family's village told the couple they were expecting twins, and that they were conjoined - with separate heads but a shared torso.

Born together, dying apart

Faisal Babli is the head of the pediatric centre at Al Thawra hospital. "Abdul Rahim died at 1:30pm," he told The New Arab. "Then we tried to save Abdul Khaleq's life, but he died in an hour."

It is normal, the doctor said, for the larger twin to die shortly after the more vulnerable child.
Akram, father of the twins (left), and his father received
mourning relatives for three days [Naseh Shaker]

Medics said the twins struggled to breathe in the two weeks after they were born and required artificial respiration.

We attribute the conjoined twins' death to the non-availability of facilities that most definitely should be available, but are not here now - like lack of medicines and medical personnel," Babli said.

Babli stressed that a lack of technical, human, institutional and financial capacity hamper their efforts to save lives of all patients in the hospital - not only the conjoined twins.

"There was a great hope the conjoined twins would survive," Babli noted. "But only if they were transported in a more timely manner."

The health ministry's spokesman, Yousef al-Hadhri, said the deaths reflected the health and humanitarian situation through which Yemen's children are living as a result of the war.

Transport abroad

Saudi Arabia's King Salman Aid and Humanitarian Relief Center said a Saudi team had been stood ready to treat the conjoined twins in Riyadh.

But Hadhri, spokesman of the Houthi-run health ministry, told The New Arab the statement was "only an attempt to whitewash".
Saudi Arabia's Al-Arabiya channel said arrangements were being made before Abdul Khaleq and Abdul Rahim died to transport them from Sanaa to the kingdom "as soon as possible".

But officials at Al Thawrah hospital in Sanaa, where the twins died, have a different interpretation.

Dr Abdul Latif Abu Taleb, the director of the Yemeni hospital, told The New Arab they had not received any official offer from Saudi Arabia - nor any other countries - to transport the tiny boys.

Dr Abu Taleb said the Saudi statement was a pre-emptive PR move, "before we accuse the Saudis of killing children and innocents directly or indirectly".

This statement is to avoid responsibility," Abu Taleb said. "[Riyadh] did not respond to us - even to provide a means of transportation like aircraft and other means to transfer them to another country."

Saudi healthcare authorities failed to respond to requests for comment by time of publication.

Dr Babli, the pediatric unit's head, said he was contacted unofficially through colleagues to help get the conjoined twins transported to Riyadh or Sweden - but without official contact, moving the children was impossible.

We had no official communication from [Saudi authorities] to transport the boys for treatment in Riyadh, but they reached me unofficially through colleagues and organisations," Babli told The New Arab. "Some colleagues have negotiated for me on transporting the twins to Aden [held by troops loyal to the Saudi-backed Yemeni president] and from there to another country," Babli said.

The problem was not in transporting the twins to Riyadh, but how the transport process would take place while the boys were in artificial respiratory."

He said transporting the conjoined twins to Aden could have taken 18 hours, and the boys would likely have died on the way.
"I notified them to bring aircraft to Sanaa International Airport to transport the twins, but they did not."

Sanaa airport is under blockade by the Saudi-led coalition in response to Houthi rebels shooting long-range ballistic missiles towards Riyadh. 

Babli said he requested through a negotiator for the pediatric centre to be provided with medicines and diapers while talks over the transport were ongoing. "She told me okay. She communicated with other side [Saudis], however, the second day she said they couldn't provide any humanitarian assistance, but they wanted to transport the boys."

Babli continued: "If it is hard for them to donate medical assistance for the twins and the centre, how can it be easy for them to transport them?" This shows the seriousness of the Saudi intentions, Babli added.

Medical neglect

Yemen's healthcare system is on the brink of collapse, with hospitals bombed and staff unpaid for the past two years. Meanwhile, 
Ahmed al-Bahshani, Akram's uncle, accused the hospital staff and all NGOs of dereliction of duty and negligence.
Hospital director Dr Abdul Latif Abu Taleb said medics had
achieved the impossible by saving the mother's life
[Naseh Shaker]

We provided them with all we have under the aggression, siege and the closure of Sanaa International Airport," the health ministry's Hadhri told The New Arab.

"We allocated to them the top three Yemeni professors to take care of them."

Dr Abdul Latif Abu Taleb, director of the al-Thwarah hospital, denied the hospital staff neglected the conjoined twins:

"We have done the impossible, that which can't be done. The opposite [of neglect] is correct; the mother of the twins came out of the hospital without complications.

"The hospital has provided them with help from A to Z."

Hope for survival

Speaking to BBC radio, the twins' father said their birth was "something extraordinary":

We were thrilled; this is something incredibly rare in history - to have conjoined twins. We were optimistic, but there was nothing we could do. It's all part of some higher plan."

The conjoined twins will continue to be very important to scientific research, Babli said. "They had two hearts, two stomachs, two gallbladders but one liver," Babli said. 

The twins had separate heads, but a shared torso. "There were different rates for blood circulation, especially in the chest. That [indicates] one child might be fine, the other not, if one needs medicine, the other not," Babli added.

While Abdul Khaleq and Abdul Rahim died in the media's spotlight, their family hope they will bring some international attention to Yemen's other children, who continue to pay the heaviest price of this war with many dying at home in silence, far from the lights of the world's media.

Naseh Shaker is a freelancer journalist based in the Yemeni capital, Sanaa.

Follow him on Twitter: @Naseh_Shaker