Cousin Marriages and Congenital Defects

by Mohammed Asmal, MD-PhD

Taken at face value, the recent statement by British Minister Woolas about the worrisome rate of congenital defects in British Pakistani newborns and its association with the practice of cousin marriage would seem to be a statement of concern for the public health of his constituents.  Unfortunately in today’s climate of escalating inter-religious tension, the statement has been misinterpreted by some as “Islamophobia”, while being used by others as ammunition for Muslim-bashing.

The knee-jerk over-reaction of the Muslim Public Affairs Committee to label MP Woolas an Islamophobe does not do justice to the intent of the MP’s statment.  Even worse, however, the Sunday Times provocative headline:  “Inbred Muslimsdeforming births”, grossly distorts Mr. Woolas’ words, re-framing a legitimate public health discussion into a racist indictment against an already alienated community. 

Let’s take a step back, and look at the way words have been twisted to change a potentially productive dialogue into a highly confrontational one. Consanguinity refers to procreation between blood relatives.  The term “inbreeding”—which is not used by the MP, but was emblazoned across the Sunday Times—is used in animal husbandry and animal laboratories, and is highly offensive when used to describe human beings. 

Consanguinous marriage is hardly unique to Pakistani Muslims.  The MP never appears to have implied that.  It is practiced among people of South Asian descent belonging to other religions as well.  It has been practiced widely in the past, and still to some extent, among other cloistered religious communities, such as Mormons and the Hasidic Jews.  There is little dispute in the medical community that consanguinity is associated with an increased risk for hereditary disorders.  The adverse effects of consanguinity have perhaps best been studied amongst Ashkenazi Jews, accounting for the almost unique occurrence of many lethal childhood diseases such as Tay-Sachs and Niemann Pick Disease, as well as the greatly increased occurrence of adult diseases such as hereditary breast cancer associated with the BRCA mutation, in this population.  Historically, European royal families have provided us with perhaps the best examples of the dangers of consanguinity in the mental retardation of the Hapsburg’s and the hemophilia of the Russian czars. 

Even if there is accumulating evidence, as the MP states, that rates of congenital defects in children of consanguinous Pakistanis are disproportionately high, and educational measures are undertaken to discourage the practice of inter-cousin marriage, the public health impact of ending consanguinous marriage in the British Pakistani community would be minuscule compared to the impact of an anti-smoking campaign, a legal ban on indoor smoking, restrictions placed on alcohol sales in pubs, or a campaign to eliminate images of graphic sex or violence from juvenile-accessible media.

Discouraging inter-cousin marriage would be to the advantage of the Pakistani community for its own long term health.  However, only the most boorish of racists would use the tragedy of congenital birth defects for political gain.

Mohammed Asmal, MD-PhD

BACKGROUND NOTES ON THIS ISSUE:

‘Inbred Muslims deforming births’ - MP http://www.news.com.au/story/0,23599,23194806-38199,00.html

Comment breeds antagonism ** http://commentisfree.guardian.co.uk/david_shariatmadari/2008/02/breeding_antagonism.html

Recessive disorders http://www.hhmi.org/genetictrail/e110.html

Fury Over MP’s Muslim ‘Inbreeding’ Claim http://www.dailyrecord.co.uk/news/newsfeed/2008/02/11/inbred-muslim-claim-fury-86908-20315572/

Muslims in denial over inbreeding MP says http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=513520&in_page_id=1770

Race row over birth defects http://www.independent.co.uk/news/uk/politics/race-row-over-birth-defects-claim-780690.html

Arranged marriages under attack http://www.inthenews.co.uk/news/politics/arranged-marriages-under-attack-$1200608.htm

Inbreeding ‘causing rise in birth defects’ http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/inbreeding-causing-rise-in-birth-defects-780562.html

This issue has come up before - 2005 http://news.bbc.co.uk/1/hi/programmes/newsnight/4442646.stm

Cousin marriages increase healthcare costs 2007 http://hiberniagirl.blogspot.com/2007/10/importing-immigrants-with-costly-health_16.html

First-cousin Marriages Affect Infant Mortality, But Not As Much As Short Birth Intervals http://www.sciencedaily.com/releases/2007/09/070925132335.htm