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tv   Our World  BBC News  September 25, 2019 3:30am-4:01am BST

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members of the democratic party in in the us congress have announced a formal impeachment inquiry into president trump, accusing him of seeking help from a foreign government to smear a political rival. nancy pelosi, speaker of the house, accused him of violating the constitution. he's called the move a "witch hunt" and "harrassment". the uk's highest court has ruled that borisjohnson‘s decision to suspend parliament was unlawful. the prime minister says the verdict is wrong, but will respect it. a major operation is continuing to bring more than 150,000 people back to the uk after the collapse of thomas cook. around 16,000 passengers were repatriated on tuesday. emergency flights are set to continue for another ten days.
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the labour leaderjeremy corbyn has addressed his party's conference in brighton a day earlier than scheduled in response to the supreme court ruling. mr corbyn called on borisjohnson to resign as prime minister and insisted that labour was more than ready with a range of policies for government. 0ur chief political correspondent vicki young reports. # 0h, jeremy corbyn... he wants to be prime minister. they're desperate for him to be prime minister. and many here think that day has just come closer. it's been a difficult conference forjeremy corbyn, but today he got plenty of new material for his hastily rescheduled speech. tomorrow, parliament will return. cheering the government will be held to account for what it has done. borisjohnson has been found
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to have misled the country. this unelected prime minister should now resign. cheering and there was more. he thinks he's above us all. he's part of an elite that disdains democracy. i will tell you this. i don't think he is fit to be prime minister. applause so what is mr corbyn going to do next? he could hold a vote of no—confidence in borisjohnson, but for now, he's reluctant to act. this crisis can only be settled with a general election. that election needs to take place as soon as this government's threat of a disastrous no—deal is taken off the table. cheering labour's disagreements over brexit have been on full
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display at this conference. they agree they want a second referendum, but mr corbyn‘s top team is split over whether they should say now that they'll campaign for remain. labour will end the brexit crisis by taking the decision back to the people with a choice — a credible leave alongside remain. that is not complicated. labour is a democratic party that trusts the people. but it's policies mr corbyn wants to focus on. labour would scrap prescription charges and introduce free personal care in england. there would be a £10 living wage and a huge renationalisation programme, plus a new system to provide affordable drugs for the nhs. and we will create a new, publicly—owned generic drugs manufacturer to supply cheaper medicines to our nhs. mr corbyn said he wanted to put government on the side of the people. go forward to win an election for the people of this country. cheering things are going badly
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for the prime minister, but it's not been plain sailing for the labour leader either. here, the crowds absolutely adore him, but back in parliament he's a much more divisive figure. he can't unite the opposition parties behind him, and that makes getting rid of borisjohnson a whole lot harder. butjeremy corbyn‘s convinced there's an appetite for change. need all the children vicki young, bbc news, brighton. now on bbc news, safa and marwa are twin girls who were born joined at the head, then brought from pakistan to london's great 0rmond street children's hospital for a series of highly complex operations. their story now, in our world. safa and marwa are identical twins joined at the head. their family, from pakistan, want doctors to separate them. great 0rmond street in london is one of the few hospitals in the world
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with the expertise to do it. this is safa's brain, that's marwa's brain. what we need to achieve is effectively untwist the brains, and that is difficult, pretty difficult to do just in your head. but it is perilous. the bbc was given unique access to chart the complex medical and ethical choices made... this is the day, the moment of truth, and everything hasjust got to be perfect. ..in the hope of giving the girls independent lives. safa and marwa are 21 months old and were born in pakistan. they have come to london's great 0rmond street hospital with their mother zainab, grandfather and uncle, and are under the care of neurosurgeon 0wasejeelani. it is clearly very difficult to go through life when you are joined
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together like that, so it does make a very persuasive case in favour of doing the surgery. the family are very clear on that. clearly, life being separate is very much better than life together. if we felt there was not a very, very high chance that we could do it safely, we would be thinking about whether we should do it or not. i think the whole team feel that there is an excellent chance of a successful separation here. the twins' father died just before they were born, and then it took more than a year of fundraising before a donor stepped in to cover the medical costs.
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safa and marwa are what's known as craniopagus twins, which meansjoined at the head. their skull is one long tube. the twins share many key blood vessels. separating these will be a major challenge. both twins' brains have a distorted appearance. one half is pointing up into the other girl's skull cavity. every last detail of the twins' extraordinary anatomy has been recreated digitally. plastic surgeon david dunaway will be in charge of rebuilding the girls' skulls after neurosurgeon 0wasejeelani has separated the twins' brains. they showed me how 3d modelling has helped them to prepare. this hemisphere, which is the right hemisphere of the brain, is standing up, so this is actually projecting into the other child's skull. what we need to achieve is to effectively untwist the brains, and that's difficult, pretty difficult to do just in your head.
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for surgeons it is massively helpful, actually being able to touch and hold things makes so much difference to understanding how things are. we spent a long time looking at these models and going through the what—ifs. numerous models of the twins' brains and shared skull have been created using this 3d printer. the whole process takes two days. this one will help surgeons plan how best to divide the layer of skin on the girls' skull once they are separated. and they're not only using physical models. this is surgery without scalpels. absolutely incredible. this is exactly what we wanted. virtual reality has helped the team plan how to divide the twins'
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shared arteries and veins. it works, it really works. and so now we can see a whole lot more information, a level of detail we've not been able to access previously. this is clearly the way of the future. we're using this technology for a highly complex case, but many other routine operations that we do, brain tumours, blood malformations, so on and so forth, the rest of those malformations, this would be hugely, hugely beneficial for those cases as well. 0k, have we got everyone here? yeah? so we have one case for the list today, safa and marwa, two kids, one case. the surgery is so complex it will happen in three stages over several months. and the twins won't be physically
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separate until the final operation. the aim of the first operation is to separate the twins' shared arteries. at present, each child is supplying the other‘s brain with blood. one, two, and three. what we're doing now is, the two arteries that are going from one twin to the other, so we can see the artery, but to do anything to it we'll use the microscope.
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so the artery from safa going to supply marwa's brain has been clamped. but every time this is done, there's a risk of brain damage. ok, so the brain's looking good. the twins have been in theatre now for more than seven hours. and there are still several hours of this operation to go. so far, everything is going to plan, and both girls are doing well. while one team works on the twins, another, led by david dunaway, constructs a frame made from pieces of the girls' skull which can be detached in subsequent operations. this central segment will be our rigid keel to hold the head together. what we need to do is make sure that the twins are rigidly together.
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being older, they're pretty active, and so whatever we do really has to be strong enough to resist the twisting and bending forces that they'll be putting on their heads. the first operation lasts 15 hours. zainab has seven more children back in pakistan, aged five to 16. all of them were born at home, but with this pregnancy she was advised to deliver in hospital. it was not until five days after delivery by caesarean section that zainab was introduced to her daughters, initially by photo. zainab says the twins have distinct personalities.
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after a month, the twins are back in theatre. this is safa's brain, it looks happy... this time the surgeons will separate the shared network of veins that drain blood from each twin‘s brain. but disturbing this equilibrium could also do permanent damage. a portion of each twin‘s brain is being supplied by the other twin. so there is a real risk of causing a stroke at the time of the surgery, that is something that is weighing heavily on us. there could be something down there that i can't see at the moment.
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the more the surgeons try to divide the vessels that link and nourish them, the more unstable the twins become. we're going to have to take ventilation down. 0k? down? marwa's heart begins to fail. we are not stable, but we are less unstable. good enough for me. the anaesthetists manage to stabilise the girls so the operation can continue. because marwa is clearly the weaker twin, the surgeons decide to give her a key shared vein. the operation lasts 20 hours.
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so i'm relieved, i'm relieved. i mean there was a chance we were going to... ..potentially lose marwa during the surgery. it's been a big operation, but hopefully if they wake up as we hope they will, it's gone well. yeah. but shortly after surgery, safa suffers a stroke. there was a period on tuesday evening where... we felt that we were very close to losing safa and that she stayed in that critical state for... for 48—72 hours after the surgery. it was a very difficult time
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for the girls, their families and the entire team looking after them. in a break from their work at great 0rmond street, the two lead surgeons are in ireland to meet another set of twins. it's eight years since they last saw ritaj and rital. it's hard to believe that these sisters, born in sudan, were once joined at the head. thank you! you are very welcome. back then the surgeons feared the girls might die unless separated.
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and this was rital and ritaj just one month after surgery. each parent able to hold a child in their arms. i hope that they will get a normal life and be treated as normal human beings. their father is now a doctor in ireland. we are now sitting here with two healthy twins, just like what i hoped at that time. so it's a great moment in my life as well. so the dream came true? exactly, yeah. i'm a very proud dad now. rital has some learning difficulties. by the long—term outcome of the twins' separation has been hailed as a major success. the surgeons believe it's because it was done in the first year of life. what we put the two kids through and the brains through is a lot. and the younger brains
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and the younger circulations are better adapted. everything is easier. a one—year—old's regenerative capacities are so much better. the skin heals better, it stretches better, the bone grows in better. they're setting up a charity so that funds are available to pay for early intervention in future cases and for research into the best way to separate conjoined twins. it's january 2019. i think the last two months after their last operation on the brain has been a little bit of a stormy time for safa and marwa. they've had ups and downs with infections and temperatures, and marwa's heart is having to work quite hard for both of them, and that's causing her a few challenges. but they're hanging in there. and they're both reasonably well.
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the next challenge for the surgeons is to ensure each twin will have enough skin to cover their skull when they're eventually separated. they do this by encouraging the skin to expand. the tissue expanders are balloons that sit underneath the skin, and they have a tiny little port attached to them through which we can inject saline. so the idea now is that we will gradually inject the tissue expanders, and they will blow up like a balloon, and the skin over the top of them will stretch. and it's a very, very effective technique of making more skin out of the skin we have available, so that when we come to separate safa and marwa, there's enough skin to cover both of their heads. these rare cases leave a lasting impact on the surgeons. if i may, i haven't asked david's permission to say this, but the last separation that we did, when the kids were finally separated, and everyone was overjoyed
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and so on and so forth, and people were happy, and i looked at david and he had tears in his eyes. and he denies it to this day, but he did at that time. yeah. ithink... everybody has been so invested in this for so long. it is a surprisingly emotional thing, i think, when they finally come apart. and when that experience of them actually leaving the operating theatre as two separate people is quite indescribable. at last, four months since the first surgery, the day of separation. two forceps. two brains laid out. so this is safa's brain, that's marwa's brain. if you do, give me a seven.
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little by little, the bone and the tissue which joins them is cut. so they are separate apart from that piece of dura. and then, after seven hours, the final connection is severed. fantastic. it's a very emotional moment. we've been working a long time to get them here. they've been through so many operations, and now it's worked. you still have four, five hours to do? yeah, we have to put them together now.
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so we've taken them apart, and now we have to reconstruct their heads. marwa is still in the operating theatre through here, while safa has been moved just next door. for the first time, the survival of each of the twins is not dependent on the other. and that'll make it easier for the two surgical teams and other vital signs. safa and marwa's brains used to have a distorted shape. but four months ago a plastic sheet was inserted between them, and by gradually tightening the pressure, it has largely corrected their appearance, essential before their skulls can be rebuilt. this means both teams can begin reconstruction. the patchwork of skull pieces are shared between theatres.
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so a piece for me, a piece for you. to have enough to cover their heads, each fragment must be divided in two. the skull is very usefully designed in three layers. so there is an inner layer of very thick, tough bone, an outer layer of thick, tough bone, and in between it the bone is like a honeycomb, so you can split the bone, it's half the thickness, but it means we should be able to cover nearly all of the head with bone afterwards. this shows the jigsaw of bone fragments that were pieced together to form the skull of marwa on the left and safa on the right. the gaps have been seeded with bone cells. and in the months to come, these should slowly close up. the final task of the 17—hour operation is to stretch the skin over their reconstructed skulls. it's a pretty amazing day, isn't it?
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everything is good. thank you. oh, what a day. they have been quite amazing throughout, actually. they're a great family, and i think they draw strength from one another. and they seem to be getting through it very well. we asked mum who she would pick up first, whether it was safa or marwa? and the answer was both — with support! so, uh, yeah... the road to recovery for the twins is slow, but four months after separation, safa and marwa are beginning to make progress.
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# hello, safa # hello, marwa # how are you today? # the twins have daily physiotherapy. it's hoped this will help them reach some basic milestones — learning to roll, sit, and hold their heads up. # twinkle, twinkle, little star # how i wonder what you are... # safa has not fully recovered from her stroke. we made the decision that the bulk of the common vessels go to marwa, the weaker twin. and because of the decision, safa suffered a stroke. so what i really want to see is the weakness safa has at the moment, and she has a weakness in her left arm and left leg, improves. so for me the big moment's going to be when she walks and when she uses her left arm properly, because, you know, i have given her that weakness, and for me that's a hard thing.
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nearly a year since they were admitted to hospital, the girls are leaving great 0rmond street. the family will stay in london until the twins are strong enough to return to pakistan. the donor who paid for the surgery is continuing to support them. they are clearly going to face some challenges. but i think, overall, it's a positive outcome for them. they are going to need support, but they have a chance of leading a happy life.
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whatever hurdles safa and marwa may face in years to come, they will at least do that as a separate, independent girls. twins still, but conjoined no more. hello there. well, we had some really heavy downpours yesterday, lengthy spells of rain and thunderstorms pretty much summed up the day's weather. he was one of those storms as it came to just near the bbc, oxford circus and the london area. next to our weather watch of ascending that in. more rain in the forecast as well but today. rain across southern coastal counties of english accompanied by gusty winds, 30—110 miles per hour as
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the rain in northern england and scotland, the winds were little bit lighter in the means it could be murky around some of the coasts and hills. through the rest of wednesday, our first batch of rain will tend to clear through. the weather comes down for a time and we see the next area of rain coming from the atlantic ‘s arena times does some up—to—date‘s weather. the rain and strong winds easily from southern coastal counties of england but wallowed by a few brighter spells and a scattering of showers, some of those could be quite heavy, especially in west scott and andrew northern ireland in the afternoon, more rain moving back in. not too cold, highs of 19 degrees.
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this is bbc news. welcome if you're watching here in the uk, on pbs in america or around the globe. i'm mike embley. our top stories: president trump faces a formal impeachment inquiry over allegations he asked a foreign power to help damage a political rival. senior democrat nancy pelosi says he's violated the constitution. the actions of the trump presidency revealed the dishonourable fact of president trump's betrayal of his oath of office, betrayal of our national security and betrayal of the integrity of our elections. the uk's supreme court rules borisjohnson‘s suspension of parliament is unlawful. he claims the verdict is wrong, but says he will respect it.

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