Tuesday, June 22, 2010

Premarital Screening, Anyone?

Published June 22, 2010
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.
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!
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.
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!
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!

1 comment:

  1. This is a really interesting post. I had no idea the statistics here in Oman were so high! Actually I read recently they are having the same problem in certain areas of the UK where intermarriage is common (mainly among the Pakistani population). They are finding large numbers of hereditary diseases and disability. Its definitely something people should be educated about because it may be avoided and I can't see any harm or shame in Premarital screening. By the way thanks for your comment, I missed the rain when I was in Salalah unfortunately but I'm hoping to be back soon, it's too hot in Muscat!! : )