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MICHAEL MOSLEY: These two divers
appear to move as one.
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That's because the two were once one.
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This woman is expecting three babies.
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For them to survive,
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her womb must stretch to almost
1,000 times its normal size.
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And these brothers are remarkable...
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conjoined identical twins,
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their fate decided before their
mother even knew she was pregnant.
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Their stories are part of your story,
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the story of what makes you human.
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You are the most fascinating creature ever
to have drawn breath on this planet...
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...and the reason
lies under your skin.
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Hidden deep inside you
is a wonderful, dynamic world...
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...where vast forests of cells
capture light...
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...where tiny movements
trigger fierce electrical storms...
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...and raging torrents of blood
feed your brain.
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This is a fantastic voyage through
the most complex organism on Earth.
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the human BODY
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It all begins with your creation...
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...and the unlikely sequence of events
that led to your birth.
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how life begins
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We've used sophisticated
imaging technology
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to illustrate the latest
medical research...
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...revealing some surprising things
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about what it takes
to produce a new life.
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We'll journey with millions of sperm
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on their long and dangerous
race towards the egg...
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...see how trillions of cells
self-assemble into a human face...
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...and show why being here at all
is against the odds.
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We start with Diane
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and the story of her
improbable pregnancy.
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- WOMAN: Right...
- MAN: Ooh.
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MAN: That's it. Good. (CHUCKLES)
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- WOMAN: That's quite nice, actually.
- MAN: Is it?
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If I do that,
it stretches my legs more.
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You've got to stay like that
as long as you can.
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I know.
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Diane got pregnant
three times and all at once.
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She's carrying triplets.
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If you can hold the back of my calves
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and then push my legs forward for me.
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Unusually, Diane's body produced
three eggs at the same time.
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DIANE: "This relieves strain
in the lower back,
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opens the shoulders
and strengthens the legs. "
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When it came to the end of the scan,
she said:
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"Well, just before I
show you the screen,
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just to let you know
there's more than one. "
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So me and Mike said:
"Oh, twins? That's lovely! "
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She went:
"No, no, there's three. "
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I even said to her:
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- "Are you sure? "
- Yeah.
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''Of course I'm sure,
they're on the screen!''
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DIANE: Just read it to me again.
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The prospect of three babies
came as a big shock.
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- You burst out crying.
- I started crying
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for about 30 seconds solidly,
hysterical crying.
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And then it turned to laughter,
hysterical laughter.
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Mike had his head in his hands.
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- Head in his hands!
- He was like this.
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It's incredibly rare for a
multiple pregnancy like this one
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to happen naturally.
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All three babies are
growing inside Diane
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completely independently
of each other.
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Apparently, I released three eggs
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and Mike, he had three separate sperm
that fertilised all three eggs.
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They've all got their own placentas
and they're all in separate sacs,
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so they've all got their own
little bedroom. (CHUCKLES)
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Producing three eggs in one go
naturally is rare,
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but it's even more surprising
that all three were fertilised.
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When a man ejaculates, he produces
on average over 250 million sperm.
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Enough, at least in theory,
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to populate the UK, France,
Germany and most of Spain.
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There needs to be so many
because getting sperm to egg
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is fiendishly difficult.
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The first hurdle
comes immediately after sex.
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Unless the time is right,
the sperm will be trapped and die.
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That's because,
for most of every month,
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the entrance to her womb
is blocked by mucus.
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For the sperm to progress,
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they have to arrive when the
woman is ready to get pregnant.
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Timing is everything.
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Once a month, the woman's
body offers them a helping hand.
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Hormones soften the mucus
blocking the sperm's progress...
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...ingeniously transforming it from
a barrier into a chemical rope ladder.
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Even so, it's tough going.
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To make the climb,
the sperm need to be fit and strong.
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The deformed, the lazy and
the dead are left behind.
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Men produce an awful lot of sperm,
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but they also produce
an awful lot of duds.
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Take this group of rugby players.
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They're all fit,
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healthy,
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virile,
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the perfect age for breeding.
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They've each supplied us
with a sperm sample.
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Now they've a chance to see its
quality up on the big screen.
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- Sample 1.
- Let's see it, let's see it!
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- That one's going crazy!
- (LAUGHS) That's a massive sperm!
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- That is massive.
- That's huge!
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- Oh, it's got two tails!
- Oh, it has got two tails.
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Nice! Two tails!
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Massive nose,
they've all got big noses!
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They're right.
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Many of James's sperm
are very strange-looking.
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He has lots with two tails
that can't swim at all.
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As well as being deformed,
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the majority of James's sperm
seem reluctant to move.
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Ooh, sample 1.2!
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- Oh, ooh, hello!
- Not many there.
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That one in the middle,
what's he doing?!
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- Whose do you reckon that is?
- I reckon that's...
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Despite first appearances,
Adam's sperm aren't much better.
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Many of his are lifeless,
lazy or directionless.
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Adam! Who'd have thought?
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That's surprising.
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Hello! Here we go!
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- This is a good one.
- Good speed, good speed.
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- I think this is yours.
- They're very good.
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- They're really going for it.
- They're going for it.
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Look at those lads go! Come on, boys!
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- Good swimmers.
- Pleased with that.
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They are good swimmers,
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but, sadly, many of them don't
seem to know where they're going.
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In fact, none of these guys
has anything to worry about.
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They are all perfectly normal.
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Around 85% of the sperm
that men produce are useless,
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one reason we produce so many.
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00:10:02,880 --> 00:10:06,060
Though some men
produce far more than others.
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00:10:06,070 --> 00:10:07,890
Oh, what? Monumental?!
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00:10:07,900 --> 00:10:11,130
- What does that mean?
- Oh, my God!
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00:10:11,140 --> 00:10:13,850
Oh, my God! Oh, my God!
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00:10:13,860 --> 00:10:15,470
- It's pretty crowded.
- I'm pretty all right with that.
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00:10:15,480 --> 00:10:20,260
Oli's sample, it has to be said,
is impressive.
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But however many you produce,
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00:10:23,820 --> 00:10:31,070
only 1% will make it from the
vagina to the next stage, the cervix.
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00:10:32,580 --> 00:10:37,460
And there's no guarantee
that any of them will survive for long.
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Sperm are foreign to a woman's body
and are treated as unwanted invaders.
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Her immune system
is triggered to kill them.
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Once they enter the cervix,
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they are in a
labyrinth of dead ends.
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Perfect for an ambush.
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00:11:14,100 --> 00:11:19,020
White blood cells attack the
sperm from all directions.
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00:11:32,780 --> 00:11:37,490
By the time any survivors reach
the safety of a Fallopian tube,
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of the original 250 million,
there could be as few as 20 left.
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It might seem odd,
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but it's actually an incredibly
effective selection process.
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And it clearly works
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because humans can be
extremely successful breeders.
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I'm Christi Cason and I'm 39,
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and I'm about to have a baby
14 months after my last one.
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Christi's body had barely
recovered from childbirth
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when she got pregnant again.
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Are you nervous,
excited about this one?
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DAVE: Yeah, I'm confident.
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But, yeah, nervous too.
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Christi has been getting pregnant
almost yearly for the past 20 years.
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CHRISTI: We also have Laura - two,
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Morgan - three,
Walker - five, Trevor - six,
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00:12:38,660 --> 00:12:42,250
Rebekah - seven, Emma - eight,
Harper - ten,
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00:12:42,260 --> 00:12:46,530
Kaylee -11, Gage -13, Bailey -14.
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Oh, my gosh!
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Austin who's 16,
Dalton - 18, Chad -19,
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and Jessica who is 21.
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MICHAEL: This will be Christi's 16th baby.
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She's spent the majority
of her adult life pregnant.
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If you tot it all up,
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Christi has been continuously pregnant
for over 12 years.
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It would seem that the only time
Christi can't get pregnant
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is when she is pregnant.
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I mean, the furthest
spacing is 22 months,
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and our closest spacing is 13.
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So you guys can go
back and do the math.
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Christi and Dave
clearly love having children,
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and for them, the more the merrier.
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You try and...
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when you're actually trying,
you practise.
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Right. He's all about practise.
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Although Christi is currently pregnant
with their 16th child,
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she is already planning another.
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00:14:08,230 --> 00:14:10,420
I guess our family's
just not complete yet.
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In a little while, will I go,
"I want to have another," you know?
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Do the whole experience again.
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And Christi might be surprised
to learn just how much she's in control.
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00:14:28,820 --> 00:14:31,820
We have recently
discovered a neat trick.
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Women take charge of those few sperm
who have survived the selection process.
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One by one, they are lured into
the soft walls of the Fallopian tube...
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...and powered down.
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They're alive, safe, but fast asleep.
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The woman now has up to five days
to supply an egg from her ovaries.
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It's a clever system
and it has to be
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because, unlike sperm,
eggs are in limited supply.
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A woman is born with all
the eggs she will ever have.
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It's a strange thought,
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but the egg that led to you
started life inside your grandmother.
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That's because the egg you came from
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was first formed inside
your mother's embryo
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00:15:44,580 --> 00:15:49,590
when she was developing as
an embryo inside her mom.
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00:15:50,210 --> 00:15:55,330
When your mother was born,
she had all her eggs already in place.
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00:15:55,660 --> 00:15:58,870
And one of them became you.
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00:16:02,780 --> 00:16:05,250
The precious egg that became you
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00:16:05,260 --> 00:16:09,590
was stored inside your
mother's ovaries for decades.
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00:16:10,720 --> 00:16:16,850
Then, when its time came,
it rose to the surface and ripened.
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00:16:20,140 --> 00:16:25,300
As soon as an egg is ripe
it's released from the ovary...
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...and gently wafted
into the opening of the Fallopian tube.
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00:16:49,390 --> 00:16:51,440
Once the egg is ready and waiting,
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00:16:51,450 --> 00:16:55,480
it's time to wake up
the sleeping sperm.
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00:17:06,020 --> 00:17:09,020
Sending out a powerful
chemical beacon,
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00:17:09,030 --> 00:17:13,360
the egg guides the sperm towards it.
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00:17:26,540 --> 00:17:30,350
The sperm are now in
a race to the finish.
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00:17:33,520 --> 00:17:40,040
They have come a long way,
but there can only be one winner.
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00:17:55,970 --> 00:18:01,900
The competing sperm break off the
cloud of cells that surround the egg.
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00:18:05,560 --> 00:18:08,110
They struggle to burrow in
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00:18:08,120 --> 00:18:13,910
until, finally, one pushes through
the soft shell underneath.
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00:18:14,900 --> 00:18:18,100
This is a critical
moment for the egg.
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00:18:21,300 --> 00:18:23,810
If a second sperm gets in,
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00:18:23,820 --> 00:18:26,820
the egg won't survive.
217
00:18:31,810 --> 00:18:35,310
It must quickly protect itself.
218
00:18:36,060 --> 00:18:38,580
Under the shell,
tiny granules detonate,
219
00:18:38,590 --> 00:18:42,610
hardening and making
the egg impenetrable.
220
00:18:54,580 --> 00:18:58,320
A new life is under way,
221
00:18:58,330 --> 00:19:03,670
but the road ahead
is long and treacherous.
222
00:19:12,380 --> 00:19:13,410
Hello.
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00:19:13,420 --> 00:19:16,690
Diane is now 21 weeks
into her pregnancy.
224
00:19:16,700 --> 00:19:21,490
Oh, thank you for ringing.
Things are going very well, thank you.
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00:19:21,900 --> 00:19:28,090
Today she's come with her partner,
Mike, for a state-of-the-art 4-D scan.
226
00:19:28,520 --> 00:19:31,520
All right, if you'd like to
come through this way.
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00:19:31,960 --> 00:19:37,050
Afternoon to you. We're going to do
a scan for your three babies, I believe.
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00:19:37,060 --> 00:19:42,900
It's a chance for them to see their
babies clearly for the very first time.
229
00:19:45,220 --> 00:19:49,410
There's quite a mixture of arms
and legs to try and work out here.
230
00:19:50,540 --> 00:19:54,940
Diane is having two boys and a girl.
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00:19:56,140 --> 00:19:58,050
- Oh, look.
- Brilliant.
232
00:19:58,060 --> 00:20:00,370
That's amazing.
233
00:20:00,380 --> 00:20:02,050
SONOGRAPHER: So we can see baby...
234
00:20:02,060 --> 00:20:06,300
Each of the triplets
is in their own amniotic sac,
235
00:20:06,310 --> 00:20:10,450
developing completely
independently of each other.
236
00:20:10,760 --> 00:20:13,600
SONOGRAPHER: A little ear
coming round there.
237
00:20:18,720 --> 00:20:20,770
They're all very close. (LAUGHS)
238
00:20:20,780 --> 00:20:23,370
They are very, very close.
239
00:20:24,300 --> 00:20:26,220
To get to this point,
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00:20:26,230 --> 00:20:32,050
the triplets already had to overcome
some significant hurdles,
241
00:20:33,460 --> 00:20:37,710
not least of which
was going from one cell to two.
242
00:20:45,040 --> 00:20:51,210
Within hours of fertilisation,
the cell inside the egg divides in two.
243
00:20:54,080 --> 00:20:58,460
Both of these then divide,
making four cells.
244
00:20:58,920 --> 00:21:00,720
Then eight,
245
00:21:00,730 --> 00:21:03,920
16 and so on.
246
00:21:04,660 --> 00:21:07,660
Except it's not that straightforward.
247
00:21:08,300 --> 00:21:12,530
70% fail within the first six days,
248
00:21:12,540 --> 00:21:15,540
before the woman
even knows she's pregnant.
249
00:21:18,260 --> 00:21:21,450
You made it against the odds.
250
00:21:21,460 --> 00:21:24,930
Your cells managed to stay alive
251
00:21:24,940 --> 00:21:29,480
and went on to create your body.
252
00:21:32,460 --> 00:21:36,930
In some cases, on rare occasions,
253
00:21:37,180 --> 00:21:42,140
one embryo becomes two humans.
254
00:21:54,780 --> 00:22:00,620
Around one in every 250
early embryos will split...
255
00:22:02,280 --> 00:22:05,980
...growing into
near replicas of each other.
256
00:22:08,300 --> 00:22:11,300
Identical twins.
257
00:22:21,140 --> 00:22:23,350
- Ready?
- Yeah.
258
00:22:23,700 --> 00:22:24,800
Go!
259
00:22:27,380 --> 00:22:30,870
This quirk of nature has
given synchronised divers,
260
00:22:30,880 --> 00:22:35,690
Helen and Carol Galashan,
a distinct advantage.
261
00:22:37,300 --> 00:22:40,210
Being an identical twin definitely
helps with synchronised diving.
262
00:22:40,220 --> 00:22:42,470
We don't really have to try
with the synchronised part.
263
00:22:42,480 --> 00:22:45,070
That part comes quite naturally to us.
264
00:22:47,660 --> 00:22:51,980
The twins started out life
as just one fertilised egg.
265
00:22:51,990 --> 00:22:57,930
But some time in the first 12 days,
their single embryo split in two.
266
00:23:00,400 --> 00:23:05,970
Although they are identical twins,
they aren't completely identical.
267
00:23:05,980 --> 00:23:08,680
We actually think
we're mirror-image twins.
268
00:23:08,690 --> 00:23:11,070
Like we fold our arms
the opposite ways.
269
00:23:11,080 --> 00:23:12,710
Our hair parts the opposite way.
270
00:23:12,720 --> 00:23:14,190
Even like when we're diving,
271
00:23:14,200 --> 00:23:18,500
the first foot I put on is my right
foot, Carol's is the left foot.
272
00:23:21,380 --> 00:23:23,610
Identical twins
actually come from one egg...
273
00:23:23,620 --> 00:23:25,950
- That's split, isn't it?
- ...and that splits into two
274
00:23:25,960 --> 00:23:28,230
and non-identical
twins from two eggs.
275
00:23:28,240 --> 00:23:31,510
So the way we see it is like we were
actually one person and then we split.
276
00:23:31,520 --> 00:23:33,830
So we're like one
person in two bodies!
277
00:23:35,580 --> 00:23:39,530
Being an identical twin
certainly has its perks,
278
00:23:40,080 --> 00:23:43,630
but becoming one also has its risks.
279
00:23:45,300 --> 00:23:50,560
Occasionally, the dividing embryo
fails to separate completely.
280
00:23:56,800 --> 00:23:58,850
Who the heck is that now?
281
00:23:59,000 --> 00:24:00,220
Hello.
282
00:24:01,980 --> 00:24:08,550
Brothers Ronnie and Donnie Galyon
are a stark example of what can go wrong.
283
00:24:14,660 --> 00:24:16,270
That guy's got heat!
284
00:24:17,090 --> 00:24:19,840
The baseball-loving Galyon brothers
285
00:24:19,850 --> 00:24:23,830
are the world's oldest
living conjoined twins.
286
00:24:28,420 --> 00:24:30,390
We're the Galyon Siamese twins.
287
00:24:30,400 --> 00:24:32,750
My name is Ronnie.
288
00:24:33,700 --> 00:24:35,540
Donnie.
289
00:24:35,830 --> 00:24:39,970
Ronnie and Donnie grew from an
embryo that started to split
290
00:24:39,980 --> 00:24:42,380
but never separated entirely.
291
00:24:42,830 --> 00:24:46,220
The brothers have been
joined ever since.
292
00:24:56,380 --> 00:25:02,310
Theirs is a condition that scientists
are only now beginning to understand.
293
00:25:07,300 --> 00:25:13,130
The dividing embryo must complete its
split within two weeks of conception,
294
00:25:13,140 --> 00:25:15,930
or it never will.
295
00:25:15,940 --> 00:25:18,470
It's not a genetic condition.
296
00:25:18,480 --> 00:25:23,700
What happened to Ronnie and Donnie
could have happened to anyone.
297
00:25:23,940 --> 00:25:26,190
- That's another hit!
- Come on!
298
00:25:26,200 --> 00:25:30,650
This is Jim, Ronnie and
Donnie's younger brother.
299
00:25:35,970 --> 00:25:41,350
The twins come from a large and
otherwise physically unremarkable family.
300
00:25:47,260 --> 00:25:50,490
This hospital here was called
St Elizabeth back in the day.
301
00:25:50,500 --> 00:25:54,850
It was actually St Anne's maternity
ward on this far end here.
302
00:25:54,860 --> 00:26:00,040
That's where Donnie and Ronnie and
the other seven of us siblings were born.
303
00:26:02,240 --> 00:26:08,330
Back in 1951, their mother
didn't even know she was having twins.
304
00:26:12,540 --> 00:26:16,470
JIM: Donnie came out head first
and being pliable as newborn babies,
305
00:26:16,480 --> 00:26:18,290
they were very flexible.
306
00:26:18,300 --> 00:26:22,170
Ronnie was actually twisted
and came out breech, feet first.
307
00:26:22,180 --> 00:26:27,110
And it wasn't till they were halfway
birthed that Dr Cord realised that...
308
00:26:27,120 --> 00:26:28,100
RONNIE: He delivered twins.
309
00:26:28,110 --> 00:26:30,590
He was delivering not
only twins, of course, but...
310
00:26:30,600 --> 00:26:32,730
Siamese twins.
311
00:26:32,740 --> 00:26:34,740
We was born the shape of a 'U'...
312
00:26:34,750 --> 00:26:37,100
Donnie was born head first.
I was born feet first.
313
00:26:37,110 --> 00:26:39,680
So he's 2 minutes older than I am.
314
00:26:41,600 --> 00:26:45,090
The places where Ronnie and
Donnie are joined together
315
00:26:45,100 --> 00:26:50,340
were determined by which cells
of their early embryo remained in contact.
316
00:26:58,440 --> 00:27:01,440
That's better. That's better
than going to Coney Island!
317
00:27:01,480 --> 00:27:04,480
Ronnie and Donnie are joined
from the chest to the groin.
318
00:27:05,940 --> 00:27:11,910
They each have a heart, liver,
stomach and their own arms and legs.
319
00:27:14,900 --> 00:27:19,930
But they have to share
a rectum, bladder and penis.
320
00:27:21,360 --> 00:27:24,890
Their whole life
depends on teamwork.
321
00:27:24,900 --> 00:27:28,810
- Excuse me.
- Go ahead, head in there. Do your thing.
322
00:27:29,520 --> 00:27:31,430
This is my foot,
this is my brother's foot.
323
00:27:31,440 --> 00:27:33,410
It's called a leg, silly.
324
00:27:33,420 --> 00:27:36,360
And this is his hand,
this is my hand.
325
00:27:36,370 --> 00:27:39,530
- Arm. Arm.
- Same the other side.
326
00:27:39,540 --> 00:27:41,660
And our bellybutton's on this side.
327
00:27:41,670 --> 00:27:43,800
There's only one.
328
00:27:44,480 --> 00:27:50,370
At 59 years old, Ronnie and
Donnie are biological marvels.
329
00:27:50,820 --> 00:27:54,600
Right now, they are the oldest known
living set of twins in the world
330
00:27:54,610 --> 00:27:55,690
and they're proud of that fact.
331
00:27:55,700 --> 00:27:59,740
But they're going for the top record
of the longest ever living.
332
00:28:08,500 --> 00:28:12,350
Ronnie and Donnie
are clearly extraordinary.
333
00:28:12,720 --> 00:28:16,930
But when you realise what goes
into building a human body,
334
00:28:16,940 --> 00:28:22,530
it's remarkable that things
go right as often as they do.
335
00:28:32,060 --> 00:28:37,690
When your cells first began to multiply,
they clustered randomly together,
336
00:28:37,700 --> 00:28:43,250
but after the second week they
began an astonishing transformation.
337
00:28:45,650 --> 00:28:48,810
Every living creature on
Earth goes through this.
338
00:28:48,820 --> 00:28:51,580
It's called gastrulation.
339
00:28:52,320 --> 00:28:56,270
It's easily seen in frog embryos.
340
00:28:56,520 --> 00:29:01,390
The cells begin to
self-assemble into a body.
341
00:29:02,840 --> 00:29:07,790
This is the key moment when those
individual little cells decide,
342
00:29:07,800 --> 00:29:13,920
if you like, to become heart,
brain, guts, or muscle.
343
00:29:18,100 --> 00:29:23,380
It's a wonderfully elegant
way of constructing life.
344
00:29:28,280 --> 00:29:33,970
After three weeks of constant growth,
you had a tiny beating heart.
345
00:29:35,000 --> 00:29:36,950
Though you still looked very similar
346
00:29:36,960 --> 00:29:41,880
to the embryo of any other mammal,
bird or amphibian.
347
00:29:44,460 --> 00:29:49,050
But by ten weeks,
you looked unmistakably human.
348
00:29:49,060 --> 00:29:51,070
You had developed your face.
349
00:30:03,280 --> 00:30:05,610
It tells the world
what you're feeling,
350
00:30:05,620 --> 00:30:08,620
who you are and
where you come from.
351
00:30:22,420 --> 00:30:25,870
We've taken data from scans
of a developing embryo
352
00:30:25,880 --> 00:30:29,170
so we are able to show you
for the very first time
353
00:30:29,180 --> 00:30:32,740
how our faces don't just grow,
354
00:30:32,750 --> 00:30:36,050
but fit together like a puzzle.
355
00:30:37,220 --> 00:30:41,780
The three main sections of the puzzle
meet in the middle of your top lip.
356
00:30:42,170 --> 00:30:46,490
Sometimes, permanent
gaps are left behind.
357
00:30:55,600 --> 00:31:02,730
Around the world, one in 700 babies
are born with what are called "clefts".
358
00:31:04,680 --> 00:31:07,680
Here in India,
they are all too common.
359
00:31:13,320 --> 00:31:19,050
Plastic surgeon Per Hall is a volunteer,
part of an international medical team
360
00:31:19,060 --> 00:31:24,450
who have come to north-east India
with the charity Operation Smile.
361
00:31:30,600 --> 00:31:35,530
The team are here to put right
where nature went wrong.
362
00:31:38,200 --> 00:31:41,790
Can we have a look inside your mouth?
Can you open up? Good girl.
363
00:31:41,800 --> 00:31:44,110
Oh, that's really good.
So the palate's normal.
364
00:31:44,120 --> 00:31:48,220
OK, so it is just the cleft lip,
and if you look at that,
365
00:31:48,230 --> 00:31:50,060
the muscles just need
bringing together.
366
00:31:50,070 --> 00:31:53,990
You see how they bunch up there,
waiting to come across into here?
367
00:31:54,000 --> 00:31:58,900
The gap in Kamana's lip was left
when the two sections of her face
368
00:31:58,910 --> 00:32:01,590
failed to fuse in the womb.
369
00:32:02,320 --> 00:32:06,030
And the condition can
be much more severe.
370
00:32:06,040 --> 00:32:08,120
All right,
so she's got a cleft palate
371
00:32:08,130 --> 00:32:10,830
that goes all the way
through right to the back.
372
00:32:10,840 --> 00:32:14,910
Eight-year-old Majoni
has a cleft lip and palate.
373
00:32:14,920 --> 00:32:17,240
This is more than just
a cosmetic problem.
374
00:32:17,250 --> 00:32:20,240
This is a functional problem
for speech and swallowing.
375
00:32:20,250 --> 00:32:23,190
She'll be able to say ''m'' and ''n''
and maybe ''g'' sounds,
376
00:32:23,200 --> 00:32:26,200
but none of the sounds that you need
your tongue to come forward
377
00:32:26,210 --> 00:32:28,880
or to stop air coming out of your nose,
will she be able to make.
378
00:32:28,890 --> 00:32:32,590
So when she tries to talk, people
will probably think she's a bit stupid.
379
00:32:32,600 --> 00:32:36,680
But actually, she's not.
She's completely normal intelligence.
380
00:32:38,720 --> 00:32:44,110
Clefts are so common because, for the
sections of the face to fuse correctly,
381
00:32:44,120 --> 00:32:48,910
they must meet at precisely
the right time in the womb.
382
00:32:48,920 --> 00:32:53,880
For the palate, the time window
is only a matter of hours.
383
00:33:09,480 --> 00:33:11,230
See you tomorrow.
384
00:33:13,160 --> 00:33:15,330
It's OK. It's OK...
385
00:33:15,340 --> 00:33:21,610
In the next ten days, Operation Smile
hope to perform 250 cleft operations,
386
00:33:21,620 --> 00:33:26,790
and put right the numerous
mistakes that nature has made.
387
00:33:26,800 --> 00:33:29,190
Here's an example
of how the face forms.
388
00:33:29,200 --> 00:33:33,030
It's quite easy to kind of see
the maxillary segments
389
00:33:33,040 --> 00:33:34,970
or the ones that
come in from the side.
390
00:33:34,980 --> 00:33:37,810
And they're supposed to meet tissue
that comes down from the nose,
391
00:33:37,820 --> 00:33:40,230
the frontonasal process,
392
00:33:40,240 --> 00:33:42,200
and this seam has
just failed to happen.
393
00:33:42,210 --> 00:33:44,510
Now, this tissue it's a bit
like the keystone of an arch,
394
00:33:44,520 --> 00:33:48,730
that should be locked into that,
should be locked into this.
395
00:33:49,410 --> 00:33:51,630
The way your face comes together
396
00:33:51,640 --> 00:33:54,710
only really makes sense
when you understand that,
397
00:33:54,720 --> 00:34:00,200
strange though it may sound,
we are actually descended from fish.
398
00:34:00,940 --> 00:34:04,570
The side of your top lip,
jaw and palate
399
00:34:04,580 --> 00:34:09,960
started life as gill-like structures
on your neck.
400
00:34:10,220 --> 00:34:12,470
Your nostrils
and the middle part of your lip
401
00:34:12,480 --> 00:34:15,400
came down from the top of your head
402
00:34:15,410 --> 00:34:18,840
as your eyes moved in from the side.
403
00:34:21,240 --> 00:34:27,490
It is absolutely extraordinary
that this all happens in the womb
404
00:34:27,500 --> 00:34:30,470
some time between when we're
the size of a grain of rice
405
00:34:30,480 --> 00:34:33,490
or the size of a small chilli bean.
406
00:34:35,580 --> 00:34:36,980
To repair a cleft,
407
00:34:36,990 --> 00:34:41,870
Per will try to replicate
what should have happened in the womb.
408
00:34:42,820 --> 00:34:45,730
When the face comes together
in an unborn foetus
409
00:34:45,740 --> 00:34:48,740
there is no trace of a scar.
410
00:34:49,380 --> 00:34:53,750
The plates of tissue and muscle
fuse seamlessly.
411
00:34:57,310 --> 00:34:59,580
Of course, it would have been
a lot more sophisticated in the womb.
412
00:34:59,590 --> 00:35:04,010
We're just kind of making a scar
to join them together.
413
00:35:04,020 --> 00:35:06,240
So that's that one done.
414
00:35:07,040 --> 00:35:10,210
Per will return
to check on Kamana's progress.
415
00:35:10,220 --> 00:35:13,220
- She has the palate too?
- She has a cleft palate, yeah.
416
00:35:14,840 --> 00:35:16,310
It's OK, it's OK.
417
00:35:16,320 --> 00:35:20,850
Majoni has lived with her clefts
for eight years.
418
00:35:20,860 --> 00:35:25,190
Today is the first step
towards a new life.
419
00:35:26,980 --> 00:35:28,610
PER: I can see the beauty there,
420
00:35:28,620 --> 00:35:31,310
despite the fact that perhaps
others can't see that,
421
00:35:31,320 --> 00:35:34,070
because I know what
she could look like.
422
00:35:59,220 --> 00:36:02,190
They're always a bit bewildered
the day after surgery.
423
00:36:02,200 --> 00:36:04,910
There's all this kind of kerfuffle
going on on the ward.
424
00:36:04,920 --> 00:36:07,810
They've had a sort of...
a night of soreness,
425
00:36:07,820 --> 00:36:11,840
and then, you know,
it's all a bit too much.
426
00:36:13,500 --> 00:36:15,340
Hi, how are you?
427
00:36:15,350 --> 00:36:18,810
Do you want to have a look at
yourself in here? Can you see?
428
00:36:18,820 --> 00:36:20,320
Who's that?
429
00:36:21,010 --> 00:36:24,810
It's been a chance of a lifetime
for Kamana.
430
00:36:29,460 --> 00:36:32,460
Majoni had even worse problems.
431
00:36:33,260 --> 00:36:37,030
Have you seen your face?
Do you want to have a look?
432
00:36:37,280 --> 00:36:39,920
Look! That's you.
433
00:36:41,740 --> 00:36:46,850
Per has given her the prospect
of a far better future.
434
00:37:03,110 --> 00:37:06,810
Your time in the womb
was an extraordinary partnership
435
00:37:06,820 --> 00:37:09,820
between mother and child.
436
00:37:14,360 --> 00:37:19,040
A partnership
that was extremely one-sided.
437
00:37:24,260 --> 00:37:27,200
When you were just
a tiny cluster of cells,
438
00:37:27,210 --> 00:37:29,810
you attached to
your mother's womb.
439
00:37:29,820 --> 00:37:34,010
Within weeks, you had
tapped into her blood supply.
440
00:37:35,540 --> 00:37:37,370
As you extracted nutrients,
441
00:37:37,380 --> 00:37:42,090
you quickly grew into
a recognisably human foetus.
442
00:37:45,140 --> 00:37:50,430
From then on, it was all about
growing bigger and bigger.
443
00:37:52,900 --> 00:37:55,900
You took, your mother gave.
444
00:38:08,260 --> 00:38:10,530
It's all gone mushy.
445
00:38:12,740 --> 00:38:15,740
Diane is eating for four.
446
00:38:19,140 --> 00:38:22,110
She's not finding it easy.
447
00:38:24,980 --> 00:38:27,430
DIANE: Although I'm supposed to be
eating a lot more,
448
00:38:27,440 --> 00:38:29,520
especially in the third trimester,
449
00:38:29,530 --> 00:38:33,060
I physically can't, because
there isn't enough room.
450
00:38:35,820 --> 00:38:38,210
At the moment
I've got a real, big craving for milk
451
00:38:38,220 --> 00:38:41,390
and I can easily
get through two pints a day.
452
00:38:43,140 --> 00:38:44,310
Spinach as well.
453
00:38:44,320 --> 00:38:49,510
I'm loving anything vegetable at all.
Spinach is my favourite.
454
00:38:56,860 --> 00:39:03,360
MICHAEL: Diane's uterus has stretched to
almost 1,000 times its normal size.
455
00:39:05,620 --> 00:39:08,620
She feels fit to burst.
456
00:39:20,500 --> 00:39:23,930
The funniest bit for me
is watching them move.
457
00:39:24,340 --> 00:39:26,950
It's mesmerising.
458
00:39:29,420 --> 00:39:31,200
I think, at the moment,
459
00:39:31,210 --> 00:39:34,650
triplet two and triplet three
are aware of each other,
460
00:39:34,660 --> 00:39:37,730
because they are head to head.
They're literally there.
461
00:39:37,740 --> 00:39:41,500
Triplet number one,
I think he thinks he's an only child.
462
00:39:41,510 --> 00:39:43,900
I don't think he thinks he's got
brothers or sisters,
463
00:39:43,910 --> 00:39:48,280
but he'll soon find out when
they're all born and sharing a cot bed.
464
00:39:50,660 --> 00:39:57,410
We humans nurture our babies
inside the womb for nine long months.
465
00:39:59,090 --> 00:40:02,280
This is a very risky thing to do.
466
00:40:02,290 --> 00:40:07,220
As you approached birth,
your mother's life was in great danger.
467
00:40:13,120 --> 00:40:19,210
Humans die more frequently in childbirth
than any other creature on Earth.
468
00:40:22,440 --> 00:40:26,860
Having children is particularly
dangerous here in Rwanda.
469
00:40:27,680 --> 00:40:32,990
One in every 260 births
results in a woman's death.
470
00:40:33,800 --> 00:40:37,600
Come e take your photo...
471
00:40:39,760 --> 00:40:46,320
26-year-old Nkosi' and husband
Samuel are expecting their first child.
472
00:40:48,030 --> 00:40:51,200
I'm about 4 monts pregnant.
473
00:40:53,160 --> 00:40:57,900
I'm very happy, we are ready.
474
00:40:59,640 --> 00:41:02,590
Like all humans,
when the time comes,
475
00:41:02,600 --> 00:41:06,720
Nkosi will find it difficult
to give birth on her own,
476
00:41:07,510 --> 00:41:12,370
but her closest maternity clinic
is a two-hour walk away.
477
00:41:17,400 --> 00:41:21,840
Today, she's making that journey
to meet a visiting medical team.
478
00:41:21,850 --> 00:41:27,000
They are bringing a form of technology
that's never been seen here before.
479
00:41:28,570 --> 00:41:31,490
It could save many lives.
480
00:41:38,700 --> 00:41:42,310
Excited mothers-to-be
have come from miles around
481
00:41:42,320 --> 00:41:46,080
to be scanned
and find out vital information.
482
00:41:50,580 --> 00:41:53,580
Nkosi thinks she is
four months pregnant.
483
00:41:59,520 --> 00:42:01,840
But there's a surprise for her.
484
00:42:02,990 --> 00:42:08,170
The head... the head circumference
is 21 weeks, five days.
485
00:42:09,530 --> 00:42:14,010
The measurements show that Nkosi is a
month-and-a-half closer to giving birth
486
00:42:14,020 --> 00:42:16,310
than she had guessed.
487
00:42:18,500 --> 00:42:20,830
It's critical information.
488
00:42:20,840 --> 00:42:25,440
Now she can make sure she's
near help when her time comes.
489
00:42:37,040 --> 00:42:39,860
By the time you were
ready to be born,
490
00:42:39,870 --> 00:42:44,840
your head had grown almost
as big as your mother's pelvis.
491
00:42:45,060 --> 00:42:48,580
A big head to house a big brain.
492
00:42:50,000 --> 00:42:54,720
A brain that needs
all the time it can get to mature.
493
00:42:56,960 --> 00:43:01,180
But Diane's triplets
will never reach full term.
494
00:43:01,550 --> 00:43:05,690
They've now stretched her uterus
as far as it will go.
495
00:43:07,000 --> 00:43:09,490
Diane has gone into labour...
496
00:43:10,140 --> 00:43:12,850
nine weeks early.
497
00:43:14,280 --> 00:43:18,010
Over the last 12 hours she
started to contract regularly,
498
00:43:18,020 --> 00:43:21,820
and despite analgesics,
we can't control those contractions,
499
00:43:21,830 --> 00:43:25,600
and the cervix is now opening,
so she's going into labour.
500
00:43:25,760 --> 00:43:28,880
- D-day... C-day!
- Yeah.
501
00:43:29,430 --> 00:43:34,560
Having triplets greatly increases
the dangers of childbirth,
502
00:43:34,570 --> 00:43:36,280
and Diane's doctors have decided
503
00:43:36,290 --> 00:43:39,470
to perform an emergency
Caesarean operation.
504
00:43:39,480 --> 00:43:41,180
There'll be quite a crowd in here,
505
00:43:41,190 --> 00:43:44,890
so there's going to be
three teams of neonatologists.
506
00:43:44,900 --> 00:43:50,600
The babies will then go on an incubator
round to the special care baby unit.
507
00:43:51,660 --> 00:43:53,120
Diane and her triplets
508
00:43:53,130 --> 00:43:57,260
will have the best care that
modern medicine can provide.
509
00:44:10,300 --> 00:44:13,330
It was a rough night.
510
00:44:13,340 --> 00:44:15,520
I coudn't sleep.
511
00:44:16,240 --> 00:44:20,040
Nkosi's labour started
in the middle of the night.
512
00:44:20,050 --> 00:44:22,680
It's about 5 in the morning.
513
00:44:22,690 --> 00:44:26,390
We're ready to go to the clinic,
514
00:44:26,400 --> 00:44:29,590
where my wife will have the baby.
515
00:44:30,840 --> 00:44:34,030
Medical help is a
two-hour walk away,
516
00:44:34,040 --> 00:44:39,140
and Nkosi has no real idea
how close she is to giving birth.
517
00:44:51,880 --> 00:44:56,510
Relax your shoulders, so they're really
floppy. Really slide your shoulders down.
518
00:44:57,280 --> 00:45:00,630
She's got a spinal anaesthetic in, but they're
also going to put an epidural in as well,
519
00:45:00,640 --> 00:45:04,030
which will give her
pain relief afterwards.
520
00:45:04,040 --> 00:45:07,000
Are you all right? Comfortable enough?
Not too cold?
521
00:45:07,480 --> 00:45:11,190
- You're not cold?
- No. I'm just shivering a bit.
522
00:45:11,200 --> 00:45:13,680
Just cos of nerves, that's all.
523
00:45:22,720 --> 00:45:26,850
- Here she is, the lady of the moment!
- Sorry I'm a bit late!
524
00:45:30,280 --> 00:45:35,950
Nkosi's only pain relief comes from
the hormones her body is now producing.
525
00:45:35,960 --> 00:45:40,180
But these hormones also bring on
stronger contractions.
526
00:45:40,190 --> 00:45:42,790
We've gone through 1/3 of way.
527
00:45:42,800 --> 00:45:44,630
She must be exhausted.
528
00:45:44,640 --> 00:45:50,510
We need to take a motorbike.
529
00:45:51,380 --> 00:45:57,280
The race is now on to get Nkosi
to the clinic before she gives birth.
530
00:46:14,730 --> 00:46:17,630
There'll just be a bit of pulling
and pushing now, OK?
531
00:46:17,640 --> 00:46:19,810
- Yeah...
- That's fine.
532
00:46:19,820 --> 00:46:21,050
Lovely.
533
00:46:21,060 --> 00:46:23,440
Thank you.
534
00:46:32,980 --> 00:46:38,750
The final moments of childbirth are
the conclusion of a nine-month journey.
535
00:46:44,580 --> 00:46:49,950
It started with the coming together
of an egg and a sperm.
536
00:47:00,440 --> 00:47:05,860
There were many potential pitfalls
on that long journey...
537
00:47:06,360 --> 00:47:10,700
...but you beat the odds
when many didn't.
538
00:47:13,520 --> 00:47:19,330
Now, finally, it's time to come out
and face the world.
539
00:47:24,800 --> 00:47:27,110
Hello!
540
00:47:32,120 --> 00:47:34,980
She's gonna bring him
around to show you quickly.
541
00:47:36,000 --> 00:47:39,970
Here we go, you two. Here he is.
Isn't he beautiful?
542
00:48:02,470 --> 00:48:03,990
He's another breech baby.
543
00:48:04,000 --> 00:48:06,070
Yes?
544
00:48:06,080 --> 00:48:09,080
Hello... Isn't he lovely?
545
00:48:17,440 --> 00:48:18,890
This is the skinny minny.
546
00:48:18,900 --> 00:48:23,910
Here she is. She's lovely.
She's beautiful.
547
00:48:35,600 --> 00:48:37,730
It's like I've won the lottery.
548
00:48:42,880 --> 00:48:45,120
Born two months premature,
549
00:48:45,130 --> 00:48:49,750
the triplets needed
round-the-clock intensive care.
550
00:48:51,240 --> 00:48:57,870
Baby Emma Iridikunda arrived home
just two days after his birth.
551
00:48:59,080 --> 00:49:03,800
Little Nathaniel
is now the 16th Cason baby.
552
00:49:04,120 --> 00:49:07,120
He will probably not be the last.
553
00:49:08,960 --> 00:49:13,830
Now out of hospital,
the triplets have made great progress.
554
00:49:17,760 --> 00:49:21,250
It's astonishing that despite
all the challenges
555
00:49:21,260 --> 00:49:23,830
that go into creating a new human,
556
00:49:23,840 --> 00:49:29,020
a third-of-a-million babies
are born every single day.
557
00:49:29,030 --> 00:49:30,960
- And you think she'll be the boss?
- I think she will, yeah.
558
00:49:30,970 --> 00:49:33,740
- Bossing those two around?
- Yeah.
559
00:49:33,750 --> 00:49:35,710
I think she'll be...
560
00:49:39,440 --> 00:49:43,440
corrected for this release by:
Tio Beto from Brazil
561
00:49:44,450 --> 00:49:49,450
tiobetonh@gmail. com
... =Peace Through Anarchy=...
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