Chang Chung-jen and Chang Chung-yi, the 7/2-year-old Siamese twins recently separated in a historic operation, walked out of the National Taiwan University Hospital to start a new life at the Lourdes Home for Children in suburban Taipei May 6.

The Siamese twins, joined at the ischium (pelvis), were born to Chang Yi-sheng, a day laborer, and his wife in Kaohsiung in December 1976. They were taken care of at the Chungshan Hospital in Taichung until last June, before they were taken to Taipei and admitted to the NTU hospital on June 18. A team of doctors separated the twins in a 12-hour operation on Sept. 10 last year. They marked their third birthday last December in the hospital ward.

Chang Chung-jen and Chang Chung-yi are only the 13th Siamese twins to be joined at the ischium. Of three previously attempted operations, one was successful, one failed, and only one twin survived in the third.

Staff at the National Taiwan University Hospital organized a farewell party for the twins, attended by their parents, grandmother, younger sister and aunts and cousins. During the party, Dr. S. P. Yang, superintendent of the hospital, told the guests that the separation operation could only be called 50 percent successful. It would be a 100 percent success only when the twins grow up and take up a useful role in society.

The twins woke up early on the morning of May 6, and asked their nurse where their mother was. It was the first time that their mother, Mrs. Chang Li Yueh-lan had seen them since the complex 12-hour operation took place. After thanking the doctors and nurses who performed the operation and provided after-care, Mrs. Chang was reunited temporarily with her children. They seemed to know she was their mother, and constantly asked her to hold and caress them.

As they left the hospital, the twins greeted well-wishers gathered in front of their room to see them off. When they arrived at the Lourdes Home at 10:30 a.m., accompanied by their nurse "Auntie Huang Man-tzu," Dr. Chen Wei-chao, who headed the team of surgeons, and members of their family, the twins were greeted warmly by children lined up in two rows. Chung-jen and Chung-yi looked a little nervous, but gradually became accustomed to their new home.

They share an apartment room complete with a toilet and bathroom, and furnished with a bed, a small desk, a cabinet and a shoe box. Above all, the children at the Lourdes Home are taught to lead an independent and self-reliant life. They will certainly be well-educated and polite when they grow up.

By the second day of their stay, the twins had almost forgotten their desire to go back to their "home" at the NTU hospital. When they started their classroom lessons with some 30 children, they scribbled meaningless characters at first before losing patience and trying to eat their snacks. They were a bit disappointed that the teacher did not pay special attention to them as their former teachers at the NTU hospital had done. When the class was over, Auntie Huang, put on their artificial legs so they could go for a walk in the garden. The sight of other children riding on swings and the sound of the organ seemed a little strange to them.

Auntie Huang hopes they will receive normal education from kindergarten, through primary and middle school to university. She said: "Their disabilities do not prevent them from gaining the necessary knowledge to be able to dedicate themselves to society and the country. I do not support the idea that they should merely learn a handicraft to support themselves."

On the third day, the twins went to school on their own. When Auntie Huang received them at noon, Chung-jen seemed reluctant to leave the classroom. Auntie Huang was happy to see how rapidly they had adapted to their new environment.

The twins will have to return to the NTU hospital once a week to have their artificial bladders cleaned and their intestines pumped. Auntie Huang's daughter, a nurse at the Mackay Hospital, will also perform the operation, necessary until they are at least five years old, on another occasion each week.

On the eve of Mother's Day on May 10, the teachers at the Lourdes Home sent carnations to all the children, including the twins. After school, the two at once presented their flowers to Auntie Huang, who in turn told them to give them to the sisters at the Lourdes Home.

Then Auntie Huang changed their clothes and took them home to spend the weekend with her three children and other members of her family. "If we had enough money, we would adopt the twins ourselves," said Mr. Huang. The twins felt at ease after receiving an initial welcome from the dog. "A normal family and school life will teach them how to adapt to society," said Auntie Huang.

When the Lourdes Home hosted a party to celebrate Mother's Day, the twins sang and laughed with the other children. One of the highlights of the party came when the twins drew lots and won a puppy dog and a small car as prizes.

No one is happier than Auntie Huang with the twins' progress. As she takes care of them round-the-clock, she has become their surrogate mother. "In the past, they were temperamental and could not get along with other children. Now they have many friends," she said.

After a week, the children in the Lourdes Home no longer regarded them as a curiosity, and the twins settled down in their new environment. Chung-yi often joins the other children in play. Chung-jen has taken up painting. Although they both have about the same IQ, Chung-yi picks up new things quickly, but his interest soon wanes. Chung-jen is slower, but he is patient and perseverant. Chung-jen is shy and prefers to stay with adults; Chung-yi loves to play with children of his own age. Auntie Huang said confidently: "They are not invalids. Chung-yi will be able to walk with his artificial legs, without using a stick. Besides, who knows what medical science will come up with in the next 20 years? They should be able to lead a more or less normal life." Each twin is fitted with an artificial leg, which requires adjustment once every three to six months as they grow. A doctor predicted a new artificial leg will have to be fitted every two to three years.

At present, the biggest problem is perhaps finance. The NTU hospital footed the entire bill for the operation, amounting to about US$44,000. Some US$11,000 needed for the services of special nurses was paid from donations amounting to US$61,000. But the need for money will continue as the twins grow up.

Kaohsiung Mayor Wang Yu-yung sent a letter to the hospital saying that the city government will provide an allowance for the twins to pay for their medical and living expenses. The National Science Council has provided US$28,000 to allow the National Taiwan University to continue its research into the twins' case. The best way is perhaps to help the twins' father find a good job so they can lead a normal family life.

Though they have suffered, the twins are now prospering. Auntie Huang and all the medical personnel involved are convinced that the labor and money spent has been worth-while.

[Picture Caption]

Left: Chang Chung-jen and Chang Chung-yi playing with toys donated by people from all walks of life at the Lourdes Home. Right: The twins share biscuits with children at the Lourdes Home.

Above: The twins walk with the aid of their artificial legs. Right: Auntie Huang Man-tzu accompanies the twins during a painting lesson.

The twins gradually adapt to their new environment.

Auntie Huang's dog has become a pet for the twins.

The twins share biscuits with children at the Lourdes Home.

The twins walk with the aid of their artificial legs.

Auntie Huang Man-tzu accompanies the twins during a painting lesson.

The twins gradually adapt to their new environment.

The twins gradually adapt to their new environment.

Auntie Huang's dog has become a pet for the twins.