His determination to help the newborns was fuelled by a touching moment when he locked eyes with one of the tiny boys a few days after the birth.

“He looked straight into my eyes, and he had that expression in his face like he was trying to say, ‘I just want to live,'” Mr Ruh recalls.

“It was a powerful moment and I’m determined to get them through.”

Charity says it cannot help because of ‘low likelihood of survival’

Mr Ruh, the parents and the doctors in PNG are anxious for the twins to be separated — a highly specialised procedure that in theory would give Tom and Sawrong the best chance of survival.

However, there is some uncertainty about whether the twins would survive the surgery.

The Rotary Oceania Medical Aid for Children (ROMAC), a charity which helps children from developing countries receive treatment in Australia and New Zealand, said it was not able to provide support.

It said it had made enquiries about the twins’ treatment but could not help due to the complexity of the case.

“It became clear that the twins’ condition was extremely serious, with a very low likelihood of survival,” ROMAC chair Glenys Parton said.

“With great regret, we advised that ROMAC would not be able to assist were a referral to be made.

“These situations are deeply distressing for everyone involved, and decisions not to assist are made only after careful consideration and with heavy hearts.”

Conjoined boys born in PNG bound for Australia for medical treatment

In short:

Conjoined twin boys born at a small hospital in rural PNG have been flown to Port Moresby.

One of the doctors who helped deliver them says he initially did not expect them to survive but they are now “doing well”.

Conjoined twins delivered at a rural hospital in Papua New Guinea have been flown to Port Moresby ahead of an expected journey to Sydney.

The boys, who are yet to be named, were born at Braun Hospital in Finschhafen in Morobe province on Friday.

Kovei Umba, one of the doctors who helped deliver the twins, said he initially did not think the boys would survive, but they had started breastfeeding.

“They are doing well,” he said.

Fatima Kevin, the mother of the twins, said her doctor saw there were two heads and two heartbeats before she was discharged from her normal clinic on Wednesday last week.

“On Friday, my water broke and they had to do a caesarean operation for me to have my babies,” she said.

The doctors had not been expecting the twins to be conjoined.

“After the operation, the baby who came first turned black, and they were struggling to get him, and they realised they were joined twins,” Ms Kevin said.

Rare occurrence

Conjoined twins are rare — estimated to occur only once in every 50,000 births and once in every 200,000 live births.

Many are stillborn or die soon after they are born.

Dr Umba said the twins were a surprise.

“Even the mother was surprised,” he said.

Merolyn Koi, a midwife who helped deliver the twins, said it was a “big deal” for Braun Hospital.

“Helping with the birth of conjoined twins is something we have never expected or experienced here at the hospital,” she said.

The boys are conjoined at the lower part of their torsos but have separate limbs.

After their birth, they were stabilised and flown to the larger Angau Memorial Hospital in Lae.

The small Braun Hospital is about three hours by boat from Lae, the provincial capital.

Dr Umba said the hospital did not have an intensive care unit or the facilities to look after babies that needed critical care, so they stabilised the twins and evacuated them to Lae.

On Wednesday, they flew with their parents to Port Moresby for further medical care.

Praise for medical team

John Rosso, the Deputy Prime Minister of PNG, is also from Morobe province, where the twins were born.

He congratulated the doctors, hospital staff and medivac team involved in the birth and flight of the twins.

“I ask all Papua New Guineans to continue keeping these twin boys in our thoughts and prayers, as their doctors navigate the delicate journey that lies ahead in their very young lives,” he said.

The twins are undergoing scans in Port Moresby while their travel to Sydney is arranged.

The ABC has been told that discussions are taking place between doctors in Port Moresby and Australia but it’s unclear if charity Rotary Oceania Medical Aid for Children (ROMAC) will be involved.

The organisation helped bring conjoined twins — girls Eusthocia and Eaustina — from PNG to Melbourne for an operation for the first time in 1996.

ROMAC co-founder Barrie Cooper said in 2021 the girls “were joined from the top of their breastbone to the belly-button, and they shared a liver”.

“We knew that if they weren’t separated, one of them would die, but thanks to the amazing skills of the surgeons at the hospital, we had a happy ending,” Mr Cooper said.