Alarm Over Intermarriage Health Risks in Tajikistan

When Parviz Afzalshoev married his cousin, no one in his village in the mountainous northeast of Tajikistan thought anything of it.



Weddings between close relatives are common in Tajikistan and for Afzalshoev, a tall and handsome man, starting a family was the next logical thing to do.



At first all seemed well. The couple had six children in seven years, all of whom at first seemed perfectly healthy. Sadly, that was soon to change.



“When he was two, our first son was playing in the yard and fell down and didn’t get up. He was dead,” said Afzalshoev. “It was very hard for us, and we transferred all our cares to the younger child, the newborn girl. But she too died at about the same age and just as suddenly.”



One after the other, Afzalshoev’s remaining four children died in the same way. Doctors told the grieving couple that their tragedy was the result of genetic problems brought on by centuries of intermarriage among relatives in their region.



“My wife and I are in a hopeless situation – we don’t want to separate, but we can’t reconcile ourselves to the fact that we will be left childless,” said Afzalshoev.



A study conducted by Professor Abdulmajid Pulatov found that in areas where intermarriage is widespread, the number of ill people is five times greater than in areas where it is not. His six-year research was fairly representative since it involved examining 2.2 million people, about one third of the country’s population.



Pulatov and other doctors have long been trying to raise the alarm about the number of babies born with congenital defects, incurable hearing and vision problems, mental illnesses and deformities – all of which they believe result from marriages between close relatives, particularly cousins. Pulatov also recorded higher than normal rates of infertility, stillborn babies, albinism and epilepsy.



“We found many people with myopathy and muscle weakness in almost every village and every family,” he said of an area north of Dushanbe.



“We conducted observations on seven childless marriages between relatives. They were dissolved and 12 of the divorced men and women remarried and a year later they all had children.”



Pulatov saw children with abnormally small eyes, or none at all, in the village of Pasob, 80 kilometres north of Dushanbe. In the nearby Anzob area, he noted occasional cases of unusually small heads, or the complete absence of a brain.



Firuza Nasirova, a doctor of biology, says her research has shown that about 25 per cent of children in some Tajik villages are born with defects, something she puts down to gene pools depleted by generations of intermarriage.



In the south, where the population is more mixed, these types of health problems occur less frequently, the experts say.



Historically, marriage between relatives, known as consanguinity, has been common in remote and mountainous regions of Tajikistan where the difficulty of travel and hostility to neighbouring regions limited marital opportunities.



The bloody civil war of the early Nineties tended to exacerbate such feelings, with many families unwilling to forge marital ties with people from elsewhere.



“How can I ever have family ties with them?” said a woman angrily when asked by IWPR if she would consider marrying her daughter to a man from a distant region. “Eleven men in our family died at the hands of people who are hostile to us.”



Surayo Komilova agreed, “I will never take a bride from another region into my home. They cook, dress and talk differently and conduct celebrations and funerals differently. I'd never be able to get used to this, and there would be constant fights in the family. It is better to take a girl from among our relatives, or at least from our village.”



Mamlakat Kadirova, who comes from the south and is a mother of seven, said she would marry off her daughters to relatives for their own benefit.



“I will never give my daughter to a mother-in-law who will torment her and force her to work for a huge family,” said Kadyrova. “Only relatives – my sister or aunt – can take the bride into their house as a person who is close to them and not an unpaid housekeeper.”



Akmal Sharipov, a father of 11 children, said he favours marriage between relatives as a way of keeping wedding costs down. Sharipov has been saving for years to pay for the weddings of his seven sons, which could cost anywhere from 3,000 to 5,000 US dollars. The major expenses include the "bride-price" payment to the future wife's family, presents for her relatives, and food including rice, sugar and flour for her parents. The bride also expects a chest full of clothes and new shoes, he said



“If you don’t fulfil all these conditions, the wedding doesn’t take place,” said Sharipov. “I have seven sons. How can I earn so much money?



“Only relatives or close friends in the same village can treat our situation with understanding and not demand large expenditures.”



Although finances aren’t a problem in the Mutalibov family who live in a prestigious district of Dushanbe, Khaelbi Mutalibova is also looking for spouses for her children among relatives.



“Many people will wish to come into our prosperous home as members of the family, but we need to be especially careful when our children marry and start families. There are a lot of drug addicts and sick people among the young, including AIDS patients,” said Mutalibova. “Why should we take a risk and take a person we don’t know well into our home?”



The head of the medical and genetics department at the Institute of Gynaecology and Obstetrics, Olga Romanova, warns that unless Tajiks change their attitude towards consanguinity, health problems caused by the practice will continue to rise, which in turn could lead to social problems.



“The problems of financially providing for invalids, medical aid and employment are an intolerable burden for our country. And what a misery it is for parents to look after an incurably ill child all their lives.”



The concerns of Romanova and other doctors are falling on deaf ears, however, with the Tajik health ministry insisting that little can be done to solve the problem, as marriages between cousins are perfectly legal.



Ordinary Tajiks also appear unconcerned.



“Why do the doctors scare us?” asked 70-year-old Holbibi Nazarova. “As long as I can remember, all our family always married their cousins or more distant relatives. And everyone in our family is normal. They work and study. And we do not intend to change the traditions of our fathers.”



Valentina Kasymbekova is an IWPR contributor in Tajikistan.