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Tajikistan - Family Intermarriage Can Cause Birth Defects

A child being treated for a birth defect at a hospital in Tajikistan's Khatlon region.

A child being treated for a birth defect at a hospital in Tajikistan's Khatlon region.

 

By Farangis Najibullah and Orzu Karim – 21 March 2015

 

People in Tajikistan love their families, and it is threatening to destroy the nation.

That's the reasoning behind growing calls to ban marriages between first cousins, a long-standing practice that is common throughout the Central Asian country.

Proponents of the ban argue that the offspring of consanguineous marriages, or marriages between blood relations, run higher rates of birth defects and genetic illnesses that could ultimately prove to be the nation's undoing.

Detractors argue that the risks are exaggerated, that more scientific research is needed to make a clear link between consanguineous marriages and birth defects, and that a ban on consanguineous marriages would not solve the problem.

In the course of a few months, the debate has risen to a level that settling it is expected to be among the newly-elected parliament's first tasks.

Registration Efforts

While no bill banning first-cousin marriages has yet been drafted, support for such a measure has come in from the highest levels of government and health authorities have already begun to take action.

On March 17, the regional Health Department in the southern Khatlon Province announced that it had completed registering children born with disabilities, a process that included documenting whether their parents were related.

According to the figures, 9,700 persons up to the age of 18 were born with physical or mental disabilities in the province. Of them, 1,546 were the offspring of first cousins.

In the provincial capital, Qurgonteppa, nearly 25 percent of those registered as having been born with birth defects came from consanguineous marriages.

In addition to the registration effort, Khatlon health authorities have launched an awareness campaign that deploys teams of doctors to educate parents and young adults about the potential risks of consanguineous marriages to future generations. To give the campaign added weight, influential imams have been brought in by Khatlon authorities to help spread the word.

Rahmon Weighs In

The efforts in Khatlon followed a January speech by President Emomali Rahmon in which he expressed concerns about what he described as a "rise in marriages between blood relatives."

Addressing the outgoing parliament, Rahmon estimated that there were "about 13,000 disabled children in Tajikistan who rely on state support," and that many of them were born to consanguineous marriages. He then instructed the Health and Social Affairs ministries to work out viable options to prevent such marriages.

The speech rekindled debates that began in 2013 when Saodat Amirshoeva, a prominent former lawmaker and staunch critic of marriages among relatives, convinced parliament to draft a bill outlawing such unions.

The bill never made it to a parliamentary debate, and a working group set up to finalize the details was suspended indefinitely after a few meetings.

"Back then authorities said we didn't have the mechanisms and institutions in place to implement such a ban," Amirshoeva recently told RFE/RL's Tajik Service.

Rahmon's recent support gives the stalled initiative a lifeline, according to Amirshoeva.

She notes that "it's a tradition in Tajikistan that no one does anything until the president instructs it," concluding that his comments mean that Tajikistan has never been as close to banning marriages between cousins.

Religious Backing

Within days after Rahmon's speech, Tajikistan's Islamic Center head Faizullo Barotzoda backed what he called the "thoughtful initiative" by Rahmon aimed at "improving the nation's knowledge, health, capabilities, and quality of life."

But other religious figures have questioned whether banning marriages between cousins would solve anything.

Nuriddin Turajonzoda, an influential cleric, says the potential health risks are vastly exaggerated, saying that "studies show that only 3 or 4 percent of the disabled children were born to consanguineous marriages."

Turajonzoda has called for all couples to undergo government-sponsored genetic and medical screenings before their marriages are registered, adding that their union should be discouraged in the event the tests revealed potential health risks for their children.

He adds that "Islam doesn't either ban or promote cousin marriage" -- noting that Islamic scholars have historically encouraged young people to marry strangers in the belief that such marriages bring good children. "At the same time," he says. "We are against such a ban."

Worldwide, an estimated 1 billion people live in communities where consanguineous marriages are preferred. and such unions are common in Tajikistan and Central Asia.

The practice has long been associated with greater birth-defect risks, and various studies have considered consanguinity as a cause of birth defects. 

The most recent and largest study to date -- the Britain-based study "Born in Bradford" -- confirmed that children whose parents are first cousins are twice as likely to be born with birth defects.

Family Tradition

Ending the centuries-old tradition would not be easy.

In many cases, the marriages involve well-to-do families that don't want outsiders inheriting their wealth, and the unions are seen as more stable because they enjoy support from parents, relatives, and community.

Zebo Karimova, a housewife from Khatlon, knows from her family's experience that marrying cousins can lead to devastating consequences.

Karimova is a caregiver for her five-year-old grandson, Anisjon, who suffers from a rare and incurable genetic condition that has left him unable to walk.

Anisjon's parents were first cousins. 

Anisjon's father subsequently divorced his wife, blaming her for "giving birth to a sick child," and Karimova is wracked with guilt.

"I married off my daughter to my sister's son to have even closer family ties, but we didn't know there are health risks involved."

In southern region of Qurgonteppa, a former desert land where settlers were relocated by Soviet authorities in the 1930s, consanguineous marriages helped people retain their native traditions and dialects.

Breaking from tradition is frowned upon.

"My marriage nearly collapsed under pressures by my in-laws, who didn't want a stranger in the family," says Malika, who didn't want to give her full name.

Before banning marriages between cousins, she says, authorities should work on changing society's mindset. 

Written by Farangis Najibullah with reporting by RFE/RL Tajik Service correspondents Orzu Karim  and Tohir Safarov.