Inbreeding has been creating a series of health problems in children for decades in Pakistan. The problem is not limited to Pakistan as a country, but it is a concern among Pakistanis across the world. In a recent report in DW by S Khan, the author discussed how Pakistan is facing many medical challenges due to the high rate of cousin marriages.
In Pakistan, inbreeding is resulting in an unusually higher number of genetic disorders among children. Despite being aware of the consequences, cousin marriages are still a norm in many communities in the country.
They are aware but still practice cousin marriage
DW talked to one 56-year-old Ghafoor Hussain Shah who works as a teacher and has eight children. A resident of Pakistan Occupied Kashmir, Shah was married to his maternal cousin in 1987. Out of eight children, three suffer from disorders. One of his son’s brain could not develop to normal size. One of his daughters has hearing problems, while another daughter has a speech disability.
Despite being aware of what inbreeding could lead to, he has to follow the tribal custom and fine spouse for his children within his extended family. His family medical history includes an array of genetic disorders, including deafness, blindness, learning disabilities, blood disorders and more.
There are several cases like Shah in Pakistan. According to a report in Dawn, there is a village named Mian Kalay in Pakistan where inbreeding is a common practice. Mohammad Gul, a resident of Mian Kalay, has a 36-year-old daughter Salma Bibi who was born as a flaccid baby. She cannot walk properly and needs assistance from her family members as she is too weak to control her motor functions. Dr Kashif Ali Khan of Lady Reading Hospital, Peshawar, told Dawn that cases like Salma are hard to be treated as these rare genetic disorders.
Studies show a high rate of consanguineous marriages in Pakistan
In 2013, the University of Leeds, in association with the University of Bradford, published a study titled “Key factors in understanding differences in rates of birth defects identified” [Study] in which they discussed how consanguineous marriages were behind congenital disabilities in children in up to 77 per cent cases.
According to a study titled “Identifying Genes Responsible for Intellectual Disability in Consanguineous Families” [PDF] by Zafar Iqbal, the rate of consanguinity is very high in Pakistan (>60%). It further added 17% to 38% of the consanguineous marriages in Pakistan are between first cousins. The study stated it is one of the main causes of infant mortality in Pakistan. If the child survives, there is a high chance the child either would have a genetic disorder or would develop a health problem in the long run.
Pakistani institutions like Kohat University of Science & Technology maintain the genetic mutation database of Pakistan. It identifies and tracks different types of mutations and disorders caused mainly by inbreeding among Pakistani children. It has over 1,000 mutations on record in 130 different kinds of genetic disorders that are found in different regions, including Punjab, Khyber Pakhtoonkhwa, Balochistan, Sindh, Gilgit Baltistan, FATA, and Pakistan Occupied Kashmir.
According to experts, the most common genetic disorder found in children in Pakistan is Thalassemia, an inherited blood disorder that bars red blood cells from absorbing oxygen.
Religious leaders refuse to support health experts
Health experts in Pakistan have tried to convince clerics to spread awareness about genetic disorders and health issues linked to cousin marriages. However, the clerics bluntly refuse to provide any support. According to these religious leaders, inbreeding is in accordance with Islamic Sharia law and the traditions of Prophet Mohammad. The belief system is strongly in favour of inbreeding. So much so if someday the government decides to ban cousin marriages, it would face resistance from the public.
Cousin marriages beyond borders
The problem of inbreeding is not limited to Pakistanis living in Pakistan alone. Cousin marriages are common in Pakistani communities in other countries as well. According to a 2015 report in The Telegraph, Pakistani communities in Britain have an alarmingly high number of cousin marriages leading to genetic disorders in children. The report suggested such marriages are also common among Arabs and Africans living in the UK.
Another report from 2008 suggested Pakistani community is responsible for 3% of births in the UK. However, due to a high number of cousin marriages, the Pakistani community is responsible for 30% of the children born with recessive genetic disorders. The same report suggested 55% of Pakistanis living in Bradford were married to their first cousin.