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Middle East

First-cousin marriages come under scrutiny

Family unions are common in the Middle East, but it carries genetic risks. At a public debate in Qatar, science and culture collided

Noor was not the first in her Qatari family to marry a close relative, but she may be one of the last. "I wouldn't say that my parents pressured me, but I felt that society expected it," said Noor, who married her first cousin when she was 19.

They had a son together but the marriage ended after a year and a half. "We broke up because of the family dynamics, all the interference. It's not just the couple that's involved, it's the whole family," she said. "This society has invisible constraints. They're never mentioned, but you have to follow them."

Throughout the Middle East, Africa and parts of South Asia, marriage between family members has been widely practised for thousands of years, largely as a means of securing relationships between tribes and preserving family wealth. At least half of all Gulf Arab marriages are between cousins, with at least 35 per cent of Qatari marriages between first cousins, according to research by the Centre for Arab Genomic Studies based in Dubai.

In Saudi Arabia, the number ranges from 25 to 42 per cent while in the United Arab Emirates, it is between 21 and 28 per cent. In parts of Britain's Pakistani communities, it is in excess of 50 per cent.

At a recent public debate on intermarriage in Doha, much of the discussion focused on the tensions between cultural practices and the science cautioning against consanguineous marriage – defined as marriage between second cousins or closer. The discussion was part of the "Doha Debates", a series sponsored by the Qatar Foundation in which four speakers argue for and against a controversial motion, in this case the idea that intermarriage should be discouraged.

"I'm living evidence that cousin marriage doesn't work," said Salma, a Sudanese woman living in Qatar who was in the audience and spoke during the question and answer period. "My parents are first cousins. My aunt married a first cousin and had two children, both of whom died young. I'm afraid I'll get diabetes, because everyone in my family has it."

In recent years Gulf countries have introduced mandatory premarital testing for genetic diseases including sickle cell anaemia, as well as infectious diseases such as hepatitis and HIV. In Qatar, counselling is required if a potential genetic problem is detected, though the couple are free to marry.

Public awareness campaigns – particularly one started in Bahrain two decades ago targeting university students – have been successful in reducing rates of genetic diseases such as sickle cell anaemia, said Ghazi Tadmouri, assistant director of the Arab Centre for Genomic Studies in Dubai.

Yet even Mr Tadmouri, a geneticist, acknowledges that the social advantages of marrying a family member might outweigh the potential genetic disadvantages. "It's expensive to marry in the Gulf. Premarital financial negotiations are much easier when done among family members," he said. "And it provides a sense of security for the woman. She's not entering into a new world, she's entering a family she knows very well."

Others have expressed concern that testing could lead to social stigmatisation. "Gulf society is a very fragile society. These tests might suggest, 'This girl has a problem, don't touch her'," said Omar, an Omani in his twenties who was in the audience.

Though not prohibited by Islam, Christianity or Judaism, some cite the hadith, or saying, of the Prophet Muhammad, as an injunction against marrying family: "Marry those who are unrelated to you, so your children do not become weak." Others point out that the Prophet married his own daughter to a first cousin. With their tiny population of nationals – Qataris comprise only about 250,000 of the country's 1.7 million people – choices of potential spouses, even those who are not relatives, are limited.

For Gulf Arab nationals, if you don't marry your first cousin, you still are highly likely to marry within your clan or tribe. And if you're marrying within your clan or tribe, it's almost certain that you're marrying a relative, which also carries a certain degree of risk," said Alan Bittles, a geneticist at the Centre for Comparative Genomics at Australia's Murdoch University.