Growing Apart

Conjoined twin sisters successfully separated in Haiti

(Left to right) Michelle, Marian, and Tamar Bernard rest in the same crib days after the twins' separation. Image: Diane Sherman for Partners In Health

(Left to right) Michelle, Marian, and Tamar Bernard rest in the same crib days after the twins' separation. Image: Diane Sherman for Partners In Health

An international team of 18 surgeons, anesthesiologists and nurses led by Henri Ford HMS ’84, recently collaborated in separating conjoined Haitian twins, the first such operation ever performed in Haiti.

Marian Dave-Nouche Bernard and Michelle Dave-Nouche Bernard, were born on Nov. 24, 2014, connected at the abdomen. The girls were separated after a seven-hour surgery on May 22 at the Mirebalais University Hospital in rural Haiti.

Ford said the “girls were doing fantastic” following the surgery and were ready to be discharged 12 days after the operation. He said they were expected to make a full recovery and go on to lead healthy lives.

The twins, who were part of a set of triplets, were born with their sister, Tamar.

Ford is the Haitian-born surgeon in chief at Children’s Hospital Los Angeles and vice dean for medical education, professor and vice chair for clinical affairs, Department of Surgery, Keck School of Medicine, University of Southern California. Mac Lee Jean-Louis, director of surgery at University Hospital, helped lead the surgical efforts.

The surgical and medical team included caregivers from Children’s Hospital Los Angeles, GHESKIO Centers, Hospital Bernard Mevs–Project Medishare and University Hospital.

Because the hospital was able to provide the necessary surgical and medical infrastructure and integrate it with the local health system, it was possible to perform the surgery in Haiti, rather than flying the infants to an American hospital, the physicians said. Part of the process of preparing for the surgery included training local clinicians in the specialized postsurgical care the twins would require.

As the international team was assembled, Michelle Morse, deputy chief medical officer for Partners In Health in Haiti, coordinated the team’s collaborative efforts from Mirebalais.

Morse is also an HMS clinical instructor in medicine at Brigham and Women’s Hospital and an affiliated member of the HMS Department of Global Health and Social Medicine.

Mirebalais University Hospital, a state-of-the-art teaching hospital on the outskirts of Port-au-Prince, officially opened its doors in April 2013 to help meet the dire health care needs in Haiti that were worsened by the 2010 earthquake that destroyed many of the nation’s hospitals, clinics and clinical education facilities.

To address the nation’s serious health care needs a coalition of nongovernmental, governmental, corporate, foundation and academic partners worked together to build the new hospital.

Partners In Health, a global health delivery nonprofit co-founded by Paul Farmer, the Kolokotrones University Professor at Harvard and chair of the HMS Department of Global Health and Social Medicine, led the coalition.

Partners In Health operates University Hospital in partnership with Haiti’s Ministry of Health.

At the hospital’s opening Farmer said that the site would be a place "where we can treat the sick, transmit knowledge to a new generation of caregivers and carry out research on the effectiveness of new models and methods for global health delivery.”