Bhutan's only pediatrician had only read about conjoined twins in textbooks before meeting fourteen-month-old sisters Nima and Dawa.
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It was a surprising challenge for Dr Karma Sherbub, who has been involved in the girls' care since day one and been instrumental in bringing them to Melbourne for life-changing surgery at the Royal Children's Hospital.
"They're more than just patients to me, they're like a family," Dr Sherbub told ABC Melbourne radio.
The girls were to undergo the delicate operation on Friday but the team overseeing their care has postponed it so they can receive extra nutrition.
While the sisters, who are joined at the torso, have responded well to treatment, clinicians say an extra period of nutrition support would place them in optimal health before operating.
With his home country lacking experience on this front, Dr Sherbub called on an Australian doctor friend and the twins were eventually sent to Melbourne for separation.
Since their arrival, the sisters have undergone extensive tests and scans and their surgical team has expressed confidence about the operation.
The pair share a liver and are believed to share part of a bowel but the extent of their combined functions will not be known until the surgery is underway.
Dr Sherbub will observe the operation, describing it a "lifetime experience".
Post surgery, the twins will stay in Melbourne one or two months to recover because as they are conjoined, some of their body parts are not fully developed.
"The muscles in their limbs have not been used so far, because they have not learned to crawl and do the usual stuff kids at this stage do," he says.
"They may need extensive rehabilitation and all the help they need to catch up on whatever they've lost."
Dr Sherbub expects to assume a supervisory role for the girls once they return to their Himalayan home.
He says he and the girls' family are "really, really thankful" for the support the community has shown.
The surgery and recovery are estimated to cost at least $350,000 and the state government pledged to cover surgical costs, with other funds raised to go towards the girls' Australian rehabilitation and return to Bhutan.
The girls will stay at the Children First Foundation retreat while being assessed by the hospital.
Australian Associated Press
