Saudi Arabia’s historic Hisma range reveals signposts to ancient past

The mountains are about 1,000 meters above sea level, and are located east of the Hijaz range. (Article photos/Twitter: Wael Al-Khalid)
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Updated 21 May 2021
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Saudi Arabia’s historic Hisma range reveals signposts to ancient past

  • Archaeological remnants are common in mountains, which formed part of trading route for camel convoys

MAKKAH: The Hisma mountains, west of Tabuk in northern Saudi Arabia, are home to Arab inscriptions carved by the Thamud and other ancient tribes dating back more than 2,600 years.
Archaeological remnants are common in the mountains, which formed part of a trading route for camel convoys and were well known among traders because of their ship-like formation.
Salma Hawsawi, a professor of ancient history at King Saud University, told Arab News that the Kingdom is rich in archaeological evidence of ancient civilizations that prospered in the varied geography and climate offered by various regions.
“Saudi Arabia includes plains that narrow and expand, mountain heights, and plateaux and deserts with oases,” she said.
The region’s geographic and climatic differences led to a diversity of civilizations, Hawsawi added.
At various times the Hisma mountains also have been known as the Hisma Sandy mountains, the Hisma plateau and the “Ship” mountains.
These mountains are about 1,000 meters above sea level, and are located east of the Hijaz range, and are bordered by Al-Sharat mountains to the north, Wadi Araba to the northwest and Harrat Al-Rahat to the south.

“The area was distinguished by features that encourage human settlement such as the abundance of water, fertile ground, favorable climate and trade routes,” Hawsawi said.
“It was one of the most important areas where people settled since the dawn of time,” she added.
“The Thamud people inhabited the area, and it was said that it was the home of the Shuaib people who were mentioned in the Qur’an. The area was also linked to the Babylonian civilization in Mesopotamia.”
According to Hawsawi, the Tabuk region was mentioned in classical sources by the first-century Roman astronomer and geographer Ptolemy, who compiled lists of cities and countries known at that time, determined their borders, and documented important information about their people and relationships with each other.
The region was mentioned in Yaqut Al-Hamawi’s “Mu’jam Al-Buldan,” as well as in fifth and sixth-century poetry.
Hawsawi said that the Hisma mountains are home to Thamudic inscriptions dating back 2,600 years and Arab inscriptions that pre-date the Islamic period.
“There is hardly any area without Thamudic inscriptions, as well as inscriptions in the Hasami dialect, an Arabic dialect similar to the Nabataean dialect which is the first Arabic writing whereby the letters are attached to each other,” she said.
“These inscriptions abound, and we mostly find proper names or prayers documented by people who passed through the area, which was a station for trade convoys and travelers. The old trading route goes from south to north to the Levant.”
The Hisma mountains have become part of the history and civilization of the peoples who lived there, and the diverse inscriptions in the region reveal a historical heritage and shed light on an important aspect of the Arabian Peninsula’s past, Hawsawi said.


Saudi-European talks to strengthen cooperation in environmental fields

Updated 25 November 2024
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Saudi-European talks to strengthen cooperation in environmental fields

  • Saudi minister of state discussed with EU security and political officials strengthening existing work on dealing with climate change

RIYADH: Saudi Minister of State for Foreign Affairs Adel Al-Jubeir met with European officials on Sunday in Riyadh, Saudi Press Agency reported.
Al-Jubeir, who is also the Saudi climate envoy, held talks with Delphine Pronk, the Chair of the EU Political and Security Committee, and Luigi Di Maio, the EU Special Representative for the Gulf region.
They discussed issues surrounding climate change and the cooperation between Saudi Arabia and the EU in environmental fields, SPA added.
They discussed ways to strengthen their existing cooperation on tackling climate change and the recent development in foreign policy in Europe and the Middle East.
Saudi Arabia maintains a strong dialogue with the EU, and both parties share close views on several foreign policy issues, including the Saudi-led Arab Peace Initiative for the Middle East, which aims to create a prosperous region for all its people and end the cycle of conflict.
The EU and Saudi Arabia are also linked through trade relations, which made the EU the Kingdom's second trading partner after the volume of trade exchange between Riyadh and Brussels peaked at $80 billion in 2023.


Saudi FM arrives in Italy to attend G7 ministerial meeting

Updated 24 November 2024
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Saudi FM arrives in Italy to attend G7 ministerial meeting

RIYADH: Saudi foreign minister Prince Faisal bin Farhan arrived in Italy on Sunday to participate in an expanded ministerial meeting of the Group of Seven (G7) countries in Fiuggi, Saudi Press Agency reported. 

The meeting will discuss the current situation in the Middle East, SPA added.

During his stay in Fiuggi, Prince Faisal will hold a number of discussions that will address regional and international issues.


Saudi fund chief receives Tajikistan’s deputy prime minister

Updated 24 November 2024
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Saudi fund chief receives Tajikistan’s deputy prime minister

  • Saudi Ambassador to Tajikistan Walid Al-Rashidan was among the officials in attendance

RIYADH: CEO of the Saudi Fund for Development Sultan Al-Marshad received First Deputy Prime Minister of Tajikistan Hokim Kholiqzoda and his accompanying delegation in Riyadh on Sunday.

During the meeting, the Saudi fund’s development projects were discussed, as well as ways to enhance development cooperation between both sides, the official account wrote on X.

Saudi Ambassador to Tajikistan Walid Al-Rashidan was among the officials in attendance.

Kholiqzoda’s visit included a tour of the Saudi fund’s exhibition center, which showcases the organization’s 50-year journey, including notable development projects and their impacts on the lives of beneficiaries.

 


World’s first International Conference on Conjoined Twins kicks off in Riyadh

Updated 24 November 2024
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World’s first International Conference on Conjoined Twins kicks off in Riyadh

  • Top World Health Organization official commends Saudi Arabia’s efforts in the field

RIYADH: The inaugural International Conference on Conjoined Twins kicked off in Riyadh on Sunday. 

The event unites leading medical experts, humanitarian organizations, and families from around the globe to share vital insights, discuss innovative separation techniques, and forge collaborative pathways in the pursuit of improved lives for conjoined twins. 

Riyadh Gov. Prince Faisal bin Bandar delivered a speech on behalf of King Salman celebrating the achievements of the Saudi Conjoined Twins Program, which has become a global leader in the field.

“Since 1990, 143 cases of twins from 26 countries have been reviewed by my dear colleagues, who have successfully separated a total of 61 pairs of twins to date,” he said. 

Prince Faisal added that it is the only program globally specializing in separating conjoined twins, making it one of the largest humanitarian medical programs in the world. 

He also highlighted a recent milestone: the UN General Assembly is considering an initiative by Saudi Arabia to designate Nov. 24 as the annual World Conjoined Twins Day.

In a video address, Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, congratulated Saudi Arabia on its leadership in organizing the conference.

“I commend Saudi Arabia for its leadership in organizing this important World Conjoined Twins Day Conference,” he said. 

This recognition would honor the medical and humanitarian efforts in this field and highlight the challenges faced by conjoined twins and their families. 

Ghebreyesus praised the initiative as a model for global collaboration in rare and complex medical cases. 

“The conference provides critical insights, from surgical innovations to long-term strategies, shaping rare initiatives. A broader platform and registry for congenital anomalies would benefit low and middle-income countries,” he said.

A keynote address was delivered by Dr. Abdullah Al-Rabeeah, advisor to the Royal Court and supervisor-general of Saudi aid agency KSrelief.

As the head of the multidisciplinary team for the Saudi Conjoined Twins Program, Al-Rabeeah provided insights into the occurrence and challenges associated with conjoined twins.

The history of conjoined twin separation reveals both the challenges and progress in medical science. 

“The first successful separation was by Johannes Fatio back in 1689 by using a constricting band for a set of Omphalopagus twins or those sharing liver and gastrointestinal organs,” he said.

With a 0.5 percent incidence rate, this early success involved “presumably, a small joining in the skin, probably a little bit of the liver,” said Al-Rabeeah. 

He added that a major breakthrough came in 1957 with the first successful separation of Craniopagus, or twins sharing one brain. 

Al-Rabeeah said that the epidemiology shows distinct patterns: “In Western countries, it’s been estimated that we get one conjoined twins in every 50 to 200,000 births.” 

He added that, however, it is more prevalent in Southeast Asia and Africa, “presumably because identical twinning and twinning is (found) more in dark-skinned people in Africa and also in Southeast Asia, increasing the incidence.”

The survival statistics, Al-Rabeeah reported, entail that “60 percent of conjoined twins are stillborn, and those who live 40 percent of them will die in the first few days of life, and 70 percent of those who would survive will be females.”

He emphasized that the reasons behind this regional disparity remain unknown and require further research.

Throughout the conference, leading medical professionals presented their expertise on various aspects of caring for and separating conjoined twins. Topics included embryology, multidisciplinary team-building, antenatal care, and labor management. 

Dr. Nadia Al-Ghilan, from the maternal-fetal medicine department at King Abdulaziz Medical City, gave a presentation titled “Caring for Conjoined Twins: A Prenatal Journey,” describing the complex process of managing pregnancies involving conjoined twins.  

She said that caring for conjoined twins is a complex and delicate process as it requires meticulous prenatal planning and a dedicated medical team.

Al-Ghilan said that “this journey is filled with unique challenges, ethical considerations, and the utmost care to ensure the best possible outcomes for the twins and their family.” 

Early diagnosis, she stressed, is critical for effective prenatal referral, counseling, and planning for delivery and postnatal care.  

Al-Ghilan also underscored the importance of genetic testing in understanding the chromosomal health of conjoined twins. 

“Techniques like amniocentesis and chorionic villus sampling can help identify genetic abnormalities, providing valuable information for developing treatment strategies.”

The conference not only serves as a platform for scientific exchange but also fosters dialogue on building global partnerships to support conjoined twins and their families, particularly in low and middle income countries. The conference emphasized the importance of comprehensive care, from prenatal counseling to post-separation rehabilitation. 

For over 30 years, the Saudi Conjoined Twins Program has stood as a beacon of hope for families worldwide. The inaugural International Conference on Conjoined Twins is set to continue this legacy, inspiring further advancements in the care and treatment of conjoined twins globally. 


Doctor describes difficulties in separating twins joined at the skull

Baby girls Rital and Ritag Gaboura, two craniopagus twins, lie on a bed at Great Ormond Street Hospital in London.
Updated 24 November 2024
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Doctor describes difficulties in separating twins joined at the skull

  • “Conjoined twins are rare, as has been said, but ‘cranomalies’ are extremely rare,” Dr. Felice D’Arco said

RIYADH: A London-based medical expert at a conference in Riyadh revealed the difficulties in separating a rare form of conjoined twins in which the patients are joined at the skull.

Dr. Felice D’Arco, consultant pediatric neurologist at Great Ormond Street Hospital in London, spoke during the International Conference on Conjoined Twins on Sunday about the condition, which occurs in about one of every 2.5 million births worldwide.

“Conjoined twins are rare, as has been said, but ‘cranomalies’ are extremely rare,” he said.

For radiologists, this means there are no standardized CT and MRI scanning protocols in place for such complex cases, and very few recent cases from which to learn.

“We have protocols for everything, epilepsy, tumors, neurogenetic disorders, this is not the case for craniopagus twins because of their rarity,” D’Arco said.

Medical teams must be set in place, and there must be two of everything; two anesthetic teams, two sets of MRI monitoring, etc., the whole hospital staff is involved in what is considered as an operation taking place on two patients simultaneously, D’Arco explained.

While there is a need to standardize procedures, Dr. D’Arco acknowledged that every set of twins is unique.

“As a radiologist, you need to have the flexibility to change your protocol as needed.”

Therefore, he said, it is best to start with a series of questions relating to different critical parts of the body.

One potential issue is the bones. A dual source CT scan can inform radiologists which parts of the skull of each patient is infused, or “missing,” in the other.

Another problem is the relationship between the brains. D’Arco said that small breaches connecting the two brains, identified by 3D sequencing, present a risk that surgery will cause damage.

Considering the possible ethical and medical complications that could come up in cases in which one of the twins is at risk of dying, he said: “Sometimes you need to ask, can we separate without jeopardizing the lives of the children? These cases are complicated, baffling, and confusing.”