Premarital Screening, Anyone?

Published June 22, 2010
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As Oman observes World Sickle Cell Day this week for the first time (June 19th), and as wedding season starts with pomp and grandeur in Dhofar, I feel obliged to shed light on the issues of hereditary blood disorders and premarital testing. It is no secret that hereditary blood disorders are as common as your regular flu in Oman. The three main inherited disorders are Sickle Cell Disease (over 6% of Omanis carry it), Thalassemia (2% of the population), and finally, according to the Oman Hereditary Blood Disorders Association, 25% of Omani males and 10% of females are G6PD patients. Carriers of these three disorders tend to be more clustered up North but these disorders also exist in Dhofar due to intermarriage. And that isn't all! I won't go into the horrific local statistics on children with disabilities and birth defects.
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In Oman, where marriage between first cousins is the norm and where over 58% of the population carry hereditary blood disorders, it's simply logical that premarital screening should be mandatory. Yet despite the disturbing statistics, it still isn't! Many people I've spoken to around Salalah have never even heard of premarital screening or tend to falsely believe the tests are needed simply to determine whether one of the concerned parties is HIV positive or infertile. Naturally, they aren't keen on having such tests done for fear of public shame and embarrassment. Furthermore, a large percentage of Omanis aren't aware of the fact that disorders such as Sickle Cell Disease are hereditary. Little do they know!
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Pre-marital screening is a group of tests for couples who plan to get married. Though not advertised at all, to the best of my knowledge these tests can be done easily at any one of Oman's major hospitals. Many couples may both look and feel healthy, but are actually silent carriers of infectious or hereditary diseases. For couples considering marriage (especially when they are relatives!), pre-marital screening is imperative in identifying potential health problems and risks for themselves and their future children. Couples in a consanguineous marriage run the risk of having children with genetic birth defects such as Down’s syndrome and autism. This can be prevented! It is vital for these couples to be screened in order to help them to understand their genetic background and, if necessary, take precautions or needed treatment.
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However, many of you know as well as I do that getting young people to undergo pre-marital screening is going to be a hell of a struggle. In most cases, the couple haven't really spent time discussing marriage together since many marriages are arranged. Furthermore, testing is a sensitive topic. Many men are too proud and the tribal system doesn't really support the idea. In fact, many families think that it's taboo and tend to believe that marriage is made in heaven and no test is going to break up a marriage simply because both parties are Thalassemia carriers! Also, any couple who are madly in love and want to get married aren't going to appreciate it when a doctor informs them that there are blood issues involved and it would be wise to think again. However, as far as I'm concerned, and as far as children are concerned, love does not prevail in these cases. Nor does tribalism or pride!
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Our children need to be educated about these issues in school, and the health officials, we hope, will conduct vigorous campaigns encouraging citizens to undergo premarital screening and promote better health. In the end, it's worth it. It is of utmost importance that local media publications highlight these issues and urge Omanis and expats alike to take hereditary disorders more seriously. Premarital testing can prevent 60 percent of birth defects and nearly 100 percent of commonly inherited blood disorders like Thalassemia and sickle cell anaemia.
 

If you know someone with a blood disorder then you will agree with me that there's nothing worse than seeing a five year old child hospitalized, in pain and on morphine while trying to get through a sickle cell crisis. Whoever is in favor of making premarital tests mandatory in Oman raise your hand! Both mine are up!

And The Chaos Begins ...

Published June 8,  2010

Driving through the streets of Salalah during the month of June can be a nightmare. Traffic jams at all times of the day and night in addition to occasional foot cramps and strained ankles due to hours of inching up and down the town's main streets can only mean one thing. The sight may be rather alarming to any newcomer, but all us locals know exactly what this means: preparations for the wedding season have only just begun!
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The shopping scene is utter chaos. It's almost impossible to drive anywhere near the fabric shops, the tailors, the beauty salons, and the shops dominated by females. Quite often, you have to park several blocks away from your goal and make your way on foot through tightly parked lineups of cars. They are all, to a fault, inhabited by sulky husbands with one or more babies on their laps, waiting patiently (or not) for their wives and daughters to emerge from the shops, tripping along in their high heels, laden with wedding accessories.
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If you find room to force your way in to any of the many 'women's necessities' shops (each one an absolute no man's land), what you'll see may well scar you for life. A pushy crowd of inhabited black abayas crammed together like tinned olives in an attempt to get a look at the latest fake Swarovski crystal beads. Or perhaps a six person deep lineup of women at the hair extension counters fingering the latest honey blonde wigs (an ugly but very popular current trend in Dhofari wedding fashion). Dare I forget to mention the exhausted Asian shopkeepers rolling out interminable yards of cloth, while individually counting out the hundreds of tiny beads that will be sewn into elaborate decorations on the traditional velvet wedding dresses?
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Of course, the underlying purpose of all this fuss is that mothers must view prospective brides for their sons at the wedding parties, and their daughters must view each other and fight for the position of the most beautiful girl, or the most talented dancer. This wedding fiasco starts in May with people trying to set their wedding dates so they don't clash with other tribal weddings. The scheduling also depends on whether they can rent a 'wedding house' or either one of Salalah's two hotel ballrooms for the proposed date. Women fight for invitations, even to the weddings from outside their tribes. The topic of discussion at work and social gatherings revolves around 'How many weddings will you be attending this July and August?' The answer can range anywhere from five to ten or more, I kid you not! (And for the men, it's many more, sometimes up to ten a week, but that's another story!)
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Once the women have established which weddings they will attend, they go into something of a frenzy trying to book separate henna, hair, and makeup appointments for each one of those weddings. Let me tell you from experience, this is not an easy process. Try to imagine the permutations! We are talking about many thousands of women here, and it's not that big a town. The next step is figuring out what to wear. Obviously, for most women, it's too expensive to produce a new dress for each wedding; however, it's also unthinkable in Dhofar to even consider wearing the same dress to two weddings. The women therefore must go to great lengths to find fashionable dresses to wear, either by adjusting old dresses, tailoring new ones, borrowing from relatives, or heading to any one of Salalah's numerous dress-rental shops. It's such big business now, women even run businesses from their homes, exchanging exotic dresses for a fee.
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Preparing for wedding season in Dhofar is an exhausting and stressful process for all the women involved, from the bride, to both the families of the bride and the groom, as well as all the female wedding guests. Despite the fact that most women here deem such extraordinary preparations to be necessary, I pray that all this madness becomes a dying trend in the years to come. I look forward to the day when simplicity is introduced to Dhofari weddings and when men don't have to go into debt any more to financially support the demands of the female members of their families. However, in the meantime, the chaos continues …