IN TEARS: Madam Sandhya Shrestha grieves for one of her twin daughters, Ganga, who died last week in a Kathmandu hospital. Her other daughter Jamuna comforts her (next image) by giving her a peck on the cheek. -- ST PHOTOS: LIM WUI LIANG

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It took seven hours and visits to three hospitals before the seriously ill girl could be admitted for treatment.

By then, her breathing had become so laboured that doctors could only promise the family that there was 'some hope'.

The eight-year-old died of pneumonia two days later, on July29.

Ganga and her twin, Jamuna, born joined at the head, were separated in Singapore in 2001 in a 97-hour effort involving more than 100 doctors and nurses.

The operation left Ganga, originally the chirpier of the two, with brain damage and Jamuna unable to walk.

IN DEBT 'We didn't have the money. Our bank balance is empty. We had to borrow 10,000 rupees to pay the hospital.' ... more

Following up on their care in Nepal has been Dr Basant Pant, a neurosurgeon who has been the girls' attending physician since their return from Singapore.

Last Sunday, when Ganga's breathing became weak, the family headed to one of the city's general hospitals, arriving there at past midnight.

But its wards were full and, after a four-hour wait with no treatment, the family was told to try a children's hospital.

There too, there was no room or treatment available.

While still at the waiting room, some help finally arrived.

Dr Pant had sent a doctor from the private hospital where he works, with medicine for the girl.

He said she needed a ventilator to assist in breathing, as the other two hospitals did not have any ICU available.

As Ganga's condition was serious, he later had her admitted to the Kathmandu Model Hospital. But she did not pull through.

Her death has also left the family in debt as they could not raise the full 25,000 rupee (S$544) deposit needed for hospitalisation.

'We didn't have the money. Our bank balance is empty. We had to borrow 10,000 rupees to pay the hospital,' said Mr Arjun Shrestha, the girls' grandfather.

His monthly pension of 10,000 rupees pays the rent and utilities for their small two-bedroom apartment.

The monthly 8,000 rupees Madam Sandhya Shrestha gets for teaching is used for daily expenses.

'Every month I get the money. After we pay what we owe, there's no money left,' she said.

Her husband Bhushan visits them occasionally.

He earns less than his wife, and though he tries, he is not able to help them much financially.

Now with Ganga gone, all their hopes are pinned on the surviving twin.

Dr Keith Goh, one of two neurosurgeons who undertook the massive operation to separate them, said that having no skull causes poor blood circulation and affects the child's health.

It is also why she has little schooling.

'The small children like to touch her head. They think it's funny. But Jamuna gets very frightened,' said her mother, explaining why the girl has not been to school at all this year.

Dr Goh hopes to bring Jamuna to Singapore to have an artificial skull built.

The problem is cost. While the doctors will waive their fees, as they have always done for the twins, the surgery would still come to around $20,000.

There is also the cost of bringing the family to Singapore and their lodging.

SGH, custodian to $58,000 - the amount remaining from generous donations from the public in 2001 that paid for the initial treatment - prefers Jamuna to be treated in Nepal. It is willing to send doctors to help if necessary.

Said a tearful Madam Sandhya: 'I have already lost Ganga. I don't want to lose Jamuna too.'

salma@sph.com.sg