ONE of the conjoined Nepalese girls who underwent a lengthy operation here seven years ago to separate her from her twin died yesterday in a Kathmandu hospital.

Ganga Shrestha, eight, fell ill on Monday and was admitted to intensive care. Diagnosed with meningitis, or an inflammation of the brain lining, she was given antibiotics, but the treatment failed to quell the bug.

The girl and her twin, Jamuna, born joined at the head, touched all of Singapore when they came here for treatment in late 2000, months ahead of the 2001 operation.

Singaporeans responded to their plight with overwhelming generosity - more than $660,000 was raised from public donations, and the doctors who were on the surgical team waived their charges.

During the surgery - a 97-hour effort by more than 100 doctors and nurses - Singaporeans and Nepalese rallied behind Mr and Mrs Shrestha.

The surgery, which involved separating the girls' entwined brains and major blood vessels, also made news around the world, not least because some doctors overseas said it could not be done.

The operation - which left Ganga, originally the chirpier of the two, with brain damage and Jamuna unable to walk - stirred debate here.

Some argued that public sympathy was misplaced and that it would have been better to let the girls die; others accused the Shresthas of coming here to milk donations from the public, a charge the family refuted.

For years, the girls survived in Nepal, though with some difficulty.

In 2005, they returned to East Shore Hospital, where neurosurgeon Keith Goh, a lead surgeon in the first operation, practises.

Fluid had accumulated in Ganga's head, doubling its size. To drain it and ease the pressure on her brain, a tube called a shunt was put in. Jamuna's weak right leg was also treated, and the girls returned to Nepal.

But on Monday, Ganga was admitted to hospital by Dr Basant Pant, the neurosurgeon who had accompanied her and her sister home after their operation.

A saddened Dr Goh, who told The Straits Times he knew of her illness, said: 'In Singapore, we often forget children in developing countries really struggle to live. I will always remember her feisty spirit...At least now, her spirit is free of her disabled body.'

Meanwhile, Jamuna, the surviving twin, still cannot walk and drags herself around using her arms.

Schools in Kathmandu have refused to enrol her because part of her brain is still unprotected by bone, and principals fear playground accidents.

Jamuna, who was always very caring towards her sister, is distraught, said her grandfather, Mr Arjun Shrestha. The girl finds it hard to accept her twin is gone and cannot stop crying, he added.

Neither can Ganga's mum. Madam Sandhya Shrestha, 31, kept repeating between sobs over the phone: 'Ganga is gone.'

salma@sph.com.sg