Drive against cousin marriages

February 13, 2010

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The Seeds of Education, Policy & Legal Awareness Association has launched an awareness drive “Save a life, Save a Generation” to control cousin marriages which can pose health risks. In this regard, the NGO also officially launched a website ( during a press conference here at Lahore Press Club. Speaking on the occasion, Ammara Farooq Malik, the President of SEPLAA said, “At least 10 per cent of Pakistan’s population or one in every 10 people is a thalassemia minor carrier. At this estimated rate, the number of thalassemia cases will be doubled to over 200,000 in the next 10 years.”

Kissing cousins and the knot

March 14, 2009

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Marrying a member of your family may not sound appealing to some, but for others there are no complaints, even though medical issues linger

Albert Einstein, Charles Darwin, Franklin Roosevelt and HG Wells share a common link, one that goes beyond the obvious fact that these men were exceptional in their respective fields. They all married their first cousins.

And that’s the path 23-year-old Ayesha Riyaz Nadaf’s family chose for her. Her parents were elated when she consented to marry her father’s sister’s son, the reasoning being that she would be well-looked after in her new home.

“When I was single, I received plenty of marriage proposals, but my parents accepted my husband’s offer immediately. My parents knew that I would be happy living with my aunt’s family, and that they would take care of me,” says Ayesha. And unlike other brides, there was little adjustment post-marriage. Ayesha is very attached to her in-laws; she knows their likes and dislikes, and has interacted with them all through her childhood and teenage years. “They’re not strangers. This wouldn’t have been the case if I had married someone outside the family. My parents also live close by, and that is an added advantage,” she says.

While many cultures, especially in the West, baulk at the thought of marrying within the family, the situation is slightly different in India. Our law accepts unions between first cousins, if the family and community members have given their consent.

But keeping it in the family is a risky business, and comes with its share of medically-related problems, say doctors. Children of non-related couples have a two to three per cent risk of birth defects, as opposed to those of first cousins, where the risk is as high as six per cent.

“If there are any genetic disorders existing in the family, then it is not advisable to marry within the family,” says Dr Anshu Kulkarni. She says that there may be varied disorders involved in the progeny of first cousins who get married, such as medical illnesses, colour-blindness, haemophilia, and thalassemia, to name a few.

Dr Nikhil Datar, a consulting gynaecologist at Nanavati Hospital, concurs. “On one level, it is a union no different from other unions. But from the medical perspective, there could be an increase in the genetic abnormality of the offspring,” he says. Due to inbreeding, two autosomal recessive traits come together; they become dominant. In short, they can be easily transmitted to the next generation. “The chances that the offspring will suffer from genetic abnormalities are high,” says Datar.

Ayesha and her family are aware of these problems, which is why she consulted a doctor, and later a gynaecologist, who gave her the go-ahead to start a family. “I have a four-year-old daughter, and a four-month-old son. They’re healthy children, and there’s nothing wrong with them,” she says proudly.

While Ayesha’s parents approved the match, it was a different story for 28-year-old Pushpasheel Thakar, a practising lawyer. He fell in love with his first cousin, and married her despite opposition from the families. “Initially, our parents didn’t agree to our marriage, but they had to give in. We didn’t face any problem from society either,” he says.

For Thrity Dadabhoy, head of corporate communications at WLC College, marrying a first cousin was no big deal. “As our community is small, unions with first cousins are quite common. In fact, my grandparents were also first cousins, and were the children of twin brothers,” she says. “Though we were cousins, we did not correspond much as our families were not very close to each other. We met in Delhi because we both worked there, and we fell in love. The rest, as they say, is history,” she says.

But unlike in South India, and matrilineal communities, where inter-family marriages are accepted, in the North, these are rare occurrences. “In Delhi society, this is rare, and I faced a lot of censure,” says Thrity. “When I was engaged, people would pass comments and say: ‘How can you get married to your cousin?’ They didn’t take it

But despite being happily married for 28 years, with three healthy daughters, Thrity does not recommend people marrying within the family. “In those days, there was little awareness. Now that it is a known fact that one’s offspring might suffer from medical complications, I’d advise against marrying your first cousin.”

Rhea Pravin Tembhekar, a clinical psychologist and marriage counsellor, feels that if both parties are educated, and are aware of the risk their children face, it will have a negative psychological impact on the couple, more so the woman. “Sometimes, if two cousins love each other, their families frown upon their relation and may not want them to get married. If they still continue the liaison, they will carry with them a feeling of guilt and shame,” she says.

She cites an example: “I handled a case where the cousins were secretly involved in a sexual relationship, and the girl was very nervous at the time of Rakshabandhan. She was very embarrassed and didn’t want to present her cousin with a rakhi. When the family is against it, and if the cousins do not confide in each other, it may lead to complications.”

Such issues, she says, have to be handled sensibly and tactfully. In some pre-arranged unions, accepting a cousin as a spouse, takes a lot of adjustment. Dr Kulkarni says,

“One is born and brought up in the same family as the cousin, and both parties have to be mentally prepared for a major shift in family roles.” But Rhea says that she had noqualms about her life-partner being a close family member.

Family conflict, of course, will always exist, and marrying within the family may lessen it — but only up to a point. Says Thrity: “Getting married to a cousin also calls for a certain amount of adjustment. It is like any other marriage, compromise is a part of it.”

Love, understanding, adjustment and compromise — these facets of a marriage — within or outside a family, will always remain constant.

Red Cross secy offers his blood and toil for thalassemia

March 12, 2009

Courtesy by: TimesofIndia
Ahmedabad: On 26/7, Mahesh Trivedi was a busy man. Till 2 am, he was managing things at Red Cross as people, many first-timers, rushed in to donate blood for the blast victims.

But, his real mission in life is tackling thalassemia and exhorting people to donate blood. Gregarious and blessed with a hearty sense of humour, the honorary secretary of Red Cross Society, Ahmedabad, is a popular man and this helps him spread his message.

“Before getting married, couples should first take a thalassemia test. If both are thalassemia minor, the girl should tie a rakhi to the boy instead of them exchanging rings,” he joked recently while addressing students of MG Science College. His light take on the grave subject had the youngsters in splits, but would also have led them to ponder.

Trivedi, 69, who retired as controller of examination of an Industrial Training Institute (ITI), delivers at least 90 lectures a year in schools and colleges in the state.

“I have been associated with Red Cross since 1969. After retirement, I decided to work full-time ,” says the man who doesn’t believe in wasting a moment.

Red Cross recently launched a project to prevent birth of thalassemia major children by 2020 in collaboration with Ahmedabad district panchayat. The idea is to eradicate thalassemia from the state. Trivedi is playing a major role in the project, the key to which is raising awareness levels.

This year, Ahmedabad Red Cross celebrates the silver jubilee of its blood transfusion services for those afflicted with thalassemia. So far, it has adopted more than 700 thalassemia major children. They are provided blood without replacement, free blood transfusions and oral tablets. And, if any child is in trouble , it’s Trivedi who is contacted.

“This kind of devotion is rare. Others are inspired by him because he sets an example by his own actions . He’s the right man to promote blood donation, as he has himself donated 117 times,” says Mukesh Patel, president of Red Cross Society, Ahmedabad.

Hereditary diseases are threatening in-bred families, warn doctors

March 12, 2009

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SANA’A, Aug. 6 — Yemeni doctors warn that hereditary diseases caused by “getting married into relatives” represent a major danger to Yemeni society.

Though many Yemenis prefer marry into same family with their relatives for considerations related to tribal and social heritage, doctors said that the practice should be discontinued, following reports about a family of 200 people all carrying the same hereditary disease.

Saba News Agency reported last week that a “family living in a difficult situation” in the Bait Murad region of Hajja governorate, is suffering due to a disease that caused the death of 25 of its members in addition to permanently debilitating another 12 family members. The report said that this hereditary disease is also threatening the rest of the family’s members.

The disease, which was unknown at the time of publication, began appearing in the family in 1932. This find attracted the attention of a group of doctors who said that the disease is a “dominant inheritance” that increased due to marriage between family members.

The occurrences have dramatically increased among the third generation of the family’s members.

A dominant hereditary disease is one in which the infection of males and females, as well as children and adults, are similar. According to doctors, the family’s disease may be “hereditary cerebella-spinal dystrophy,” which infects the cerebellum in the brain and leads to the inability to move or talk. It also affects the spinal cord and causes atrophy in the limbs of sufferers.

Doctors said that in the case of dominant hereditary diseases, “solutions are complicated and difficult,” pointing out that the treatment process may take dozens of years. They confirmed that the only solution to such health problems is through a “commitment to pre-marriage DNA testing for the expected couple.” They suggested that already-married couples should conduct test on their fetus during the first months of the woman’s pregnancy to make sure the child will not be harmed.

Mohammed Murad, 24, the only person in the family to hold a high school certificate, said that the first infection in the family was reported about 70 years ago and that the disease originally only affected family members who were over 40 years old. However, during the last 10 years, many of the occurrences of the disease were reported among children.

Hereditary diseases spreading in Yemen

Although there are no statistics regarding hereditary diseases in Yemen, Dr. Najib Ghanim, the Chairman of Health and Population Committee in Parliament, said that hereditary diseases of various forms spread in Yemen among people who get married to their relatives, something commonly acknowledged throughout the world. The most common hereditary diseases in Yemen are Thalassemia and Sickle Cell Anemia, which both affect the production of blood cells.

“As a result of the risks of hereditary diseases, the Safe Motherhood Project adopted health in Parliament in cooperation with the Ministry of Health tried to oblige both people in the expected couple to get premarital tests before making the marriage contract to ensure they are disease free,” said Ghanim, adding that the project wasn’t approved by the Parliament “as some members objected some terms in the law that contain sanctions.”

He stressed that Yemeni society should be educated and made aware of the dangers of hereditary diseases as well as the importance of pre-marital testing in order to prevent the expected couple from passing on any potential hereditary diseases to their children. “If the tests prove the couple carries a hereditary disease, they shouldn’t get married to each other as the risk of potential infection will be more than 50 percent,” He further pointed out that Yemen’s Thalassemia Association registered 850 affected families in Sana’a alone.

Dr. Ali Al-Meeri, the Vice-dean of Sana’a University’s Faculty of Medicine, said that the university has specialized centers to study such phenomena and to document all cases in the country.

He added that other countries have hereditary diseases, but Yemen still suffers from a lack of social awareness about these issues.

Al-Meeri confirmed that an education campaign should be launched in order to inform people about hereditary diseases and their risks.

Consanguineous marriages and endemic malaria: can inbreeding increase population fitness?

March 12, 2009

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The practice of consanguineous marriages is widespread in countries with endemic malaria. In these regions, consanguinity increases the prevalence of alpha+-thalassemia, which is protective against malaria.

However, it also causes an excessive mortality amongst the offspring due to an increase in homozygosis of recessive lethal alleles. The aim of this study was to explore the overall effects of inbreeding on the fitness of a population infested with malaria.

Methods: In a stochastic computer model of population growth, the sizes of inbred and outbred populations were compared. The model has been previously validated producing results for inbred populations that have agreed with analytical predictions.

Survival likelihoods for different alpha+-thalassemia genotypes were obtained from the odds of severe forms of disease from a field study. Survivals were further estimated for different values of mortality from malaria.

Results: Inbreeding increases the frequency of alpha+-thalassemia allele and the loss of life due to homozygosis of recessive lethal alleles; both are proportional to the coefficient of inbreeding and the frequency of alleles in population. Inbreeding-mediated decrease in mortality from malaria (produced via enhanced alpha+-thalassemia frequency) mitigates inbreeding-related increases in fatality (produced via increased homozygosity of recessive lethals).

When the death rate due to malaria is high, the net effect of inbreeding is a reduction in the overall mortality of the population.

Conclusions: Consanguineous marriages may increase the overall fitness of populations with endemic malaria.

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