Consanguineous marriage is the marriage of blood relatives, usually between second cousins and closer. Although this type of marriage, today, is stigmatised and frowned upon in the West, it still accounts for about 10% of all marriages worldwide.
Consanguinity rates in the United Arab Emirates have increased from 39% to 50.5% over the last generation. When comparing the last two generations it was found that the parents of consanguineous marriages are more likely to arrange the same type of marriages for their children. Statistics for the UAE indicates that this type of marriage accounts for 54.2% of all marriages in Al Ain of which first cousin marriages make up 28.2% of this total. In Dubai the numbers are 39.9% and 20.7% respectively. The increase in the consanguinity rate, on the other hand, is higher in Dubai with a 10.42% increase, compared to the 7.49% in Al Ain.
A report by the Dubai-based Centre for Arab Genomic Studies (CAGS) in September 2009 found that Arabs have one of the world’s highest rates of genetic disorders, of which nearly two-thirds are linked to consanguinity. Children born from these unions have an increased risk of suffering from the following: congenital malformations and anomalies, mental retardation, disability, still births, early childhood deaths, increased frequency of recessive disorders, learning disorders, psychiatric morbidity, central nervous system anomalies, epilepsy, Down syndrome, and even cancer. Some scientists, like Professor Alan Bittles of the Centre for Comparative Genomics in Australia, claim that many studies exaggerate the risks. He states that birth defects only rises from 2% in the general population to about 4% in first cousin unions, and adds that, “You can’t just compare the health of those children born of cousins but the comparison must be made within the tribes as well as between them, as some disorders are unique to particular tribes,” he said. “To stop consanguinity affecting health, you’d not only need to stop first cousin marriage but people in the same clan too, which is highly improbable and going against centuries of tradition.”
The Ministry of Health rates genetic diseases as the fourth-highest cause of death in the country. There are 270 different kinds of these in the UAE alone, of which about 60 per cent are recessive disorders that can be caused by consanguinity. In 2009 pre-marital genetic testing for couples with a family history of genetic diseases in cases of blood disorders like sickle cell anaemia and thalassaemia,was made compulsory.
In 2001 Iran took the dramatic step of amending the law to allow selective pregnancy termination, up to 15 weeks, for thalassaemia, which resulted in a 70 per cent decline in incidence of the condition. This is rather interesting, especially seen against the light that Islam forbid abortion. Dr al Gazali, who conducts research at the UAE University, and who is an expert in genetic research in the region, would like to see the Government here also take some action, albeit not so drastic. The introduction of pre-implantation diagnosis is an option that has proved popular in Saudi Arabia, and which does not conflict with Islamic law. The procedure allows couples who are deemed at high risk for certain genetic diseases to use in-vitro fertilisation. The foetus can then be tested for abnormalities at one of the earliest stages, when it is still between four and eight cells. If any abnormalities are detected the cells can be discarded and couples can try again for a healthy child. If the foetus is found to be healthy, the cells are then implanted into the female’s womb for a regular pregnancy.
Becoming aware of the health risks these marriages encapsulates, one wonders why there is such an increase in them in some countries. The following reasons are often given for their popularity: keeping cultural values intact; ensuring compatibility between spouses while ensuring a closer relationship between the wife and her in-laws; the preservation of a family’s wealth, while strengthening family ties. In a culture where marriages are still arranged and young people cannot freely socialize with the opposite sex, it is much easier to marry someone you already know instead of a stranger. Marriages to foreigners are not encouraged. Nationality is passed on through the male, and if an Emirati woman should marry a foreigner neither her husband nor children would be eligible for UAE citizenship.
This is a sensitive issue that evokes strong emotions and reactions from people. Even though this is an ongoing debate, many feel that high school children should be informed about the health risks as well as the importance of genetic testing in order for them to make informed decisions one day.
** Further reading:
* A report on an interesting debate concerning consanguineous marriage that appeared in The National newspaper on 27 March 2012.
* Wikipedia article on Cousin Marriage