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Pakistan: Cousin marriages create high risk of genetic disorders

Ghafoor Hussain Shah is a 56-year-old teacher and father of eight children in Pakistan-administered Kashmir. According to tribal customs in Pakistan, Shah said he is expected to arrange the children's marriages within his extended family.

However, Shah knows about the potential risks of genetic disease prevalent in children from inter-family marriages. He married his maternal cousin in 1987, and three of their children suffer from disorders.

Shah told DW his son's brain did not develop to a normal size. One of his daughters has a speech disorder and another has hearing problems.

"My biggest regret is that they could not get education," he said. "I am always worried about them … who will look after them after my wife and I are gone?" he added.

Despite the risks of genetic disorders, Shah said there is enormous social pressure to adhere to customs calling for cousins to marry. Anyone who refuses to offer their children for marriage within the family risks being ostracized.

Shah said he had to marry off his one son and two daughters to close relatives. His family's medical history includes cases of blood disorders, learning disabilities, blindness and deafness. Doctors have said inbreeding could be to blame.

Pakistan's 'genetic mutation' problem​

According to a 2017 report on genetic mutations in Pakistan, the "heterogenous composition" of Pakistan's population, including high levels of "consanguinity" has led to a prevalence of genetic disorders.

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The report introduces a Pakistan "genetic mutation" database, which identifies and tracks different types of mutations and the disorders they lead to. According to the database, more than 1,000 mutations have been reported in 130 different kinds of genetic disorders found in Pakistan.

Huma Arshad Cheema, a pediatrician specializing in genetic disorders, told DW that Pakistan has a huge burden of generic disorders due to inbreeding.

She said specific disorders can be pinpointed to particular castes and tribes where inter-marriage is common.

One of the most common genetic disorders seen right now in Pakistan is the inherited blood disorder, Thalassemia, which keeps red blood cells from absorbing oxygen.

Genetic testing and pre-natal screenings for hereditary disorders are not widely available in Pakistan, Cheema said, adding that many health facilities also lack the capacity to treat genetic disorders.

Why do cousin marriages continue?​

Karachi-based health expert Seraj ud Daulah said that the practice of cousin marriages in Pakistan can be traced to Islamic religious doctrines.

"I asked clerics to help create awareness about genetic diseases, asking them to explain to people how cousin marriages are contributing to the rise in genetic diseases," Daulah told DW.

However, he said the clerics he spoke with flatly refused, claiming that such marriages are in accordance with Islamic Sharia law and the traditions of the Prophet Mohammad.


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Shah said many families in Pakistan go through with consanguineous marriages because they believe it is called for by their Islamic religion. Even if the government were to make such marriages illegal, it would be met with fierce resistance, he added.

Tribal and caste systems are deeply rooted in remote areas of Pakistan. Cheema said that the caste system, particularly among the Arain people living in Punjab province, is especially rigid and leads to many inter-family marriages. She said several genetic disorders are commonly found in this community.

In Pakistan's western province of Balochistan, the southern region of Sindh, and in the northwestern provinces, tribal systems dictate family life.

Ghulam Hussain Baloch, a resident of Balochistan, told DW that marrying outside of your tribe is considered a major social taboo. The situation in Sindh is not much different, where marriage outside one's clan or tribe could lead to murders and tribal clashes.

Health officials respond​

In March 2020, the government in Punjab formed a task force aimed at preventing genetic diseases. The children's hospital in Lahore is now offering free genetic screening services in cooperation with Germany's CENTOGENE diagnostics company and other international organizations.

Cheema said pre-natal screening will help parents decide whether to terminate the pregnancy in cases where lethal disorders are detected. Early detection can also aid treatment of a child born with a hereditary disorder.

"We have screened 30,000 families in Pakistan with suspected genetic disorders," an official from Punjab's health department told DW on condition of anonymity.

Health expert Daulah, however, said that more needs to be done to change people's mindsets on the danger of having children with close family members.

"In religious matters, people have blind faith and they do not want to listen to any logic," he said.

"Perhaps if the government asked all clerics to spread awareness about the rising number of genetic disorders, and its connection with cousin marriage, then perhaps more Pakistanis would pay heed," he added.

Source: https://www.dw.com/en/pakistan-cousin-marriages-create-high-risk-of-genetic-disorders/a-60687452

The government and doctors throughout Pakistan should start a nationwide campaign against cousin marriages to end this sick tradition and menace once and for all. We can see examples of the effects of such judging by posts of certain members on this forum, imagine how much more worse it will become down the line if this continues.


This is how Patwaris are created ….
 
That is solid advice. Our society does not develop young people quick enough. Men in thier early 20s are financially unstable, mentally immature, emotionally immature. They need to be further developed at this age so that they can match thier physical maturity and get married early.
It is bad advice exactly due to the things you've mentioned, he has no understanding of the man's situation or even current age so why give such advice? From his messages, he seems like a teen... Hence why I said I hoped it was a joke.

While it may be religiously advised, logic should also be applied, it is a bad decision to make with no financial stability/security, and mental immaturity; which is quite common between younger people, therefore not practical.
 
Don't leave it that late. Half your life will have passed away chasing money and status.

You will be closer to a grandfather to your kids than a father. Have children early whilst you are young enough to play with them, to challenge them when they enter thier youth, young enough to be relevant to them when they need your guidance.
True. Insh'Allah my parents will see into the matter.
 
It is bad advice exactly due to the things you've mentioned, he has no understanding of the man's situation or even current age so why give such advice? From his messages, he seems like a teen... Hence why I said I hoped it was a joke.

While it may be religiously advised, logic should also be applied, it is a bad decision to make with no financial stability/security, and mental immaturity; which is quite common between younger people, therefore not practical.
Thats why I mentioned my education and career needs to be sound first before doing any marriage.

Which woman will marry a man without a good career?
 
Maybe in rural areas, was it ever widespread in the first place?
It was a lot more common a few generations ago. A lot of women used to die at child birth which would lead each man to marry mutiple times in his lifetime. Marrying within extended family was seen as the easy way out.
 
It is bad advice exactly due to the things you've mentioned, he has no understanding of the man's situation or even current age so why give such advice? From his messages, he seems like a teen... Hence why I said I hoped it was a joke.

While it may be religiously advised, logic should also be applied, it is a bad decision to make with no financial stability/security, and mental immaturity; which is quite common between younger people, therefore not practical.
I didn't tell him to get married tomorrow did I? I told him to get married young.

As a father myself, I am of the opinion that all the material success of the world pales in comparison with the joy of raising my children. Having got married young I was able to expend my sexual energy in a halal way.

Getting married in your mid 30s is unnatural. You either repress yourself or you engage in haram.

This is why as a society we need to curtail our expectations of young people and focus of developing them so that they are able to marry young.

A few examples;
- no expensive weddings. Stop breaking the backs of young men with this fazool cost

- there is no shame in renting an apartment. You don't need a villa to get married.

- independence in a joint family system. Let them live thier life outside of yours. Just share your space, not every aspect of thier life. Daughter in laws and sisters are not replacement mums for the whole family.

- learn vocations and start earning early. Nothing wrong with 16 year old learning a trade. It should be the norm, instead of getting an arts degree.

- teach your kids how to budget, how to iron, wash, cook, clean. Your daughter should know how to put up a shelf and your son should knock how to make roti.

- Read about marriage, about your rights to each other, about parenting and have open discussions with your elders to learn from thier experiences.

I don't want anyone to be married before they are ready, but in our society the obstacles to "ready" are ridiculous.
 
Thats why I mentioned my education and career needs to be sound first before doing any marriage.

Which woman will marry a man without a good career?

I agree. Financial stability is very important. One advice I would give every educated young person like yourself is don't be afraid of hardwork.

Hustle whilst you are young and single. Learn a skill and freelance in it whilst you are studying. Allah rozi dene wala hai - you just try your best.
 
Its true, this is reason Saudi Arabia imposed medical law to marry with cousin and get permission on medical report from Ministry of Health

wat is it called i know in iran you can get yourself n so call spouse checked for child genetics then you can decide to marry.
 
Why not? i'd love to hear your justification for such
He might be meaning to say that if a married cousin couple observes a big enough gap between them throughout their married life the children (if any) are very less likely to inherit abnormal genes from both of them.
(May not hold true if the neighbour is also a cousin)
 
I didn't tell him to get married tomorrow did I? I told him to get married young.

As a father myself, I am of the opinion that all the material success of the world pales in comparison with the joy of raising my children. Having got married young I was able to expend my sexual energy in a halal way.

Getting married in your mid 30s is unnatural. You either repress yourself or you engage in haram.

This is why as a society we need to curtail our expectations of young people and focus of developing them so that they are able to marry young.

A few examples;
- no expensive weddings. Stop breaking the backs of young men with this fazool cost

- there is no shame in renting an apartment. You don't need a villa to get married.

- independence in a joint family system. Let them live thier life outside of yours. Just share your space, not every aspect of thier life. Daughter in laws and sisters are not replacement mums for the whole family.

- learn vocations and start earning early. Nothing wrong with 16 year old learning a trade. It should be the norm, instead of getting an arts degree.

- teach your kids how to budget, how to iron, wash, cook, clean. Your daughter should know how to put up a shelf and your son should knock how to make roti.

- Read about marriage, about your rights to each other, about parenting and have open discussions with your elders to learn from thier experiences.

I don't want anyone to be married before they are ready, but in our society the obstacles to "ready" are ridiculous.
Parents should also teach children how to make good quality Sindhi Briyani.
 
Is this really a proven fact - that cousin marriages lead to disorders ?
 

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