CAIRO, Egypt – Mohamed is the curious one. He grabs a cookie and inspects a visitor's camera, all while asking for some paper and a pen to draw.
Ahmed, his brother, sits back and takes it all in. But he's only biding his time. Soon he'll be shrieking with laughter as he drives his boy-sized toy car around the spacious living room of his parents' flat.
Ahmed and Mohamed Ibrahim, born joined at the crowns of their heads and separated almost three years ago during a 34-hour operation in Dallas, are 5 years old on Friday. They are lively and rambunctious boys, much like any other boys their age – no less than a miracle to their father.
"I don't believe I have them in my home and they are doing so well," Ibrahim Mohamed Ibrahim, 33, said through a translator as he watched his boys, tan and tall for their age, scoot across the floor.
After their successful separation in October 2003 by a team from Neurosurgeons for Children, and after reconstructive surgery and two years of physical therapy, the twins returned to Egypt in November.
"Now they are doing great," said Dr. Mamdouh Aboul-Hassan, the attending physician in Cairo who first contacted Dr. Kenneth Salyer and the World Craniofacial Foundation in Dallas for consultation on the twins' case.
"Mohamed has been progressing marvelously, walking on his own and having good movement with his hands, though his right hand is still a bit weak," Dr. Mamdouh said. "While Ahmed has some weakness in his limbs, he is improving but still walking with a walker, and his hands are moving fine."
'I was astonished'
The twins were a rarity in medical science, afflicted with a condition found in only 1 in 2 million live births.
"I was astonished when I first saw them, " the doctor said, "because I'd never seen such a case."
The twins still must wear custom-made helmets to protect their heads as they heal, but Dr. Mamdouh believes that by the end of the year they won't have to wear the headgear all the time.
The boys attend classes twice a week at an international school in Giza, site of the Great Pyramids.
While Mohamed is physically stronger, Ahmed has a greater awareness of his surroundings and is better at memorizing, said their mother, Sabah Abu el-Wafa, 27.
Asked what he learns at school, Ahmed sings a ditty in Arabic and Mohamed bounces to the rhythm before they both dissolve in laughter and shouts of "Bravo!"
The boys, who spoke their first words in English, are now speaking Arabic as well.
They remember their days in Dallas fondly, Sabah said. "They keep telling me let's go home; they think they are only here on a trip and are going back to Dallas."
Sabah takes them for physiotherapy two hours a day, five days a week and then leads them through doctor-prescribed exercises at home each day.
The boys have the potential to lead full lives, Dr. Mamdouh said, but will need long-term physical therapy and follow-up care and might need adjustment of their head shape in the future.
Soon the family will be moving into permanent quarters – a new furnished flat in a more exclusive area of Cairo – provided by Ibrahim's employer at a technical institute, where he is a property guard.
An older brother, Mahmoud, 8, and sister, Asmaa, 10, who have been attending school in their home village of Qena, 13 hours away, will join the family for good when the school term ends.
Together, finally
For Sabah, who is expecting her fifth child in August, it will be a day long wished for – the first time since the twins' infancy that the family will be living together under one roof.
"Life was difficult at first," she said, but she credits the people of Dallas for making things easier.
"We can never forget how supportive they were," she said, "especially the doctors and even their families.
"Tell all the people in Dallas I love them, and thank them for everything."
Tina Pania, assistant international editor, visited Egypt as part of the International Reporting Project at Johns Hopkins University.
TINA PANIA / Dallas Morning News Staff
With smiles full of mischief, Egyptian twins Ahmed (left) and Mohamed Ibrahim consider Dallas their home. "They think they are only here on a trip," their mother said.
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