Dispatches today broadcast an investigation into first cousin marriages in the UK. The focus was on the British Pakistani community, where first cousin marriages are most prevalent. British Pakistanis make up around 1.5% of the population, but children born in this country to British Pakistanis account for around 33% of rare recessive genetic disorders. British Pakistani children are three times more likely to have learning difficulties. First cousin marriages in isolation don’t have a massive effect, but when they happen more than once the consequences can be severe, and this is the issue facing many British Pakistanis today.
Tazeen Ahmad, the presenter, was of British Pakistani stock and has a history of genetic disorder in her family; her grandparents were first cousins, three of her uncles were born deaf and five of her aunties died in their first few years. Ms. Ahmad focused on attitudes to first cousin marriage, why it was happening and what could be done about it.
There are a number of reasons for first cousin marriages continuing, despite the research into the genetic impact. Standard cultural ones include keeping property within the family, familiarity with one’s intended spouse and strengthening bonds between different branches. Younger British Pakistanis confessed to pressure and emotional blackmail when it came to cousin marriage, with the izzat (‘honour’) of the family being stressed.
Yet the interviews also revealed a high level of denial and ignorance. First cousins who married (somewhat understandably) refused to accept that this could have been the reason for their children’s disability, blaming instead fate or Western medicine. Others pointed to non-disabled children as the result of cousin marriages as evidence that there was no link, and kept insisting that there was no information available on the subject. One religious ‘scholar’ refused point blank to consider any medical evidence, then repeatedly claimed he was not aware of any evidence. One man said simply: “why wouldn’t you want to marry your cousin?”
Ms Ahmad asked (as did others), why this issue wasn’t discussed enough, and why there isn’t a public campaign for it, especially as the last campaign was in the 1990s. The main reasons were a fear of offence and an ad hoc approach. The person who led the campaign in 1997 spoke of people tearing up the leaflets or writing counter messages on them. No MP whose constituency is significantly affected by this would speak out, with former MP Ann Cryer, one of the few politicians to make a stand on the matter, pointing out that those MPs did not wish to alienate a powerful voting block.
What then can be done, and is being done, about the problem? In many areas the health focus has shifted to advising individual families. A GPs’ surgery in Birmingham (where the doctors are British Pakistanis) is actively discouraging cousin marriages, and working with religious leaders to amplify the message. Other religious figures (such as an imam in Forest Gate) preach to their congregations on the dangers. What other barriers are there though?
Salma Yaqoob condemned the practice and warned that the fight against cousin marriages has become politicised. Others picked up on this, saying that campaigning against things like terrorism and forced marriage in the British Pakistani community has led to a siege mentality, with criticism of first cousin marriage being seen as an attack on the community. This seemed a somewhat weak argument, given the hostility to the last campaign, which occurred before the focus on terrorism or forced marriage (in 1997).
Where should the focus be now? Doctors and health professionals should talk about the risks more, but as the programme showed, medical evidence is not enough, as plenty of people will just ignore the evidence even when it is presented to them. Religious leaders should be co-opted in, and politicians need to be more willing to speak out on it, even if they risk upsetting some voters.
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Filed in: 'Honour'-based violence,Disability,Science