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Matchmaking within community or in cyberspace?

MARRIAGES IN the Indian subcontinent have several special features. Unique among these is the matrimonial advertisement in newspapers. No other part of the world, no other society and no other newspapers can boast such ads to find marriage partners. (Sure, The New York Times or Washington Post have ads that seek love partners or live-ins, but they do not say "Match for lovely convent-educated girl, wheat complexion, 22/150/48/B.Com., DCA, Bharadwaja, Vadama, Ayilyam, Mars in 3rd". The matrimonials in India Abroad do not count, they are simply another NRI carry-over and the matrimonial websites on the Internet are a no-cost or low-cost Indian extension of the idea). A foreigner with no knowledge of Indian society would conclude that marriages in India are made not in heaven, but in newspaper inserts.

Yet, such ads are not the usual manner of fixing marriages in much of India. They are but recent introduction, hardly 50 years old, used in case there is need for a greater choice; they are used if and only if the long-practised tradition of arranging marriages within the extended family or the sub-community is not to be followed. Even today, in many communities in India (and Pakistan and Sri Lanka), the first preference is to look within the family. Intra-community and consanguineous marriages are still more common and it has been so for centuries. Much of India, particularly South India, has practised endogamy or marriages within the community for centuries. In many communities, preference has been given to uncle-niece marriages, and between cousins (mother's brother's child, father's sister's child). The Tamil wife calls her husband "Athan" (father's sister's son) regardless; and the very word for mother-in-law is "Mamiyar" (respectful way of addressing mother's brother's wife). A recent study had shown that of the 100,000 children studied, 34 per cent were born to consanguineously related parents, and 18 per cent of these were uncle-niece marriages. In Pondicherry, the number of consanguineous marriages was as high as 55 per cent, 25 years ago.

Consanguinity (literally meaning of the same blood), defined as marriage between close biological relatives, is still very prevalent in South India. It is not restricted to South India, but prevalent in the Middle East and North Africa. (where the prevalence is between 20-50 per cent of the marriages). In China, Latin America and a few other countries, it is prevalent in between 1-10 per cent of the marriages; so it is in North India.

Consanguinity is thus colour-blind, region-blind and religion-blind. Some Christian elders forbid it. But Judaism and Islam sanction marriages up to and including first cousins (though not between uncle-niece in the Koran). Buddhism allows first cousin marriages, Sikhism, which follows the Aryan Hindu tradition, looks down on it. The North Indian Hindus prohibit marriage between kin that extends back to seven generations on the male side and five on the female side. But the South Indian Hindu tradition sanctions consanguinity. Yet there is a lot of unease and worry that has been expressed about the health outcome of consanguineous marriages, both in scientific circles and the societal mind.

Given this background, one wonders about the emergence and popularity of the matrimonial ads. Why advertise, when you have a ready bride or groom within the family or community itself? Why cast the net wider? In a manner, the ads represent the worry that consanguinity may have bad genetic consequences. Indeed, legislation in several states of the U.S. ban it. The Hindu Marriage act of 1955 bans uncle-niece marriage (though it has been relaxed saying "unless where custom allows it"). What are the scientific bases against inbreeding and consanguinity?

Dr. Alan Bittles of the Edith Cowan University in Perth Australia and Dr. N. Appaji Rao of the Indian Institute of Science at Bangalore are two of the world's experts in this field, and have worked together studying the biology of consanguinity over the last 25 years. They have written a comprehensive review (along with Drs. H.S Savithri, HSV Murthy, G Baskaran, Wei Wang and Janet Cahill) called "Human inbreeding - A familiar story full of surprises" in the book Ethnicity and Health (eds. H. Macbeth and P. Shetty, Taylor & Francis, London, 2001), which provides a comprehensive analysis of the subject. In addition, Bittles has a readily accessible and easily readable background summary of consanguineous marriages on the Internet; go to the web site www.consang.net.

There is a strong belief in Western societies that marriages between close relatives would lead to children with physical and/ or mental health problems. This is based on the belief that defective or detrimental recessive genes accumulate in the community because of inbreeding over generations. But the evidence produced in support of this contention has, as the above review points out, been vague and anecdotal in nature. In fact, quite the opposite point has been made by Dr. L. D. Sanghvi in his 1966 review called "Inbreeding in India" in the journal Eugenics Quarterly. He has argued that in communities that have practised endogamy over generations, there would have been a gradual but significant elimination of these detrimental recessive genes from the "gene pool".

Which is right — will endogamy and consanguinity lead to gene-based health problems, or to the cleansing of bad genes? Bittles, Rao and coworkers point out that the situation is confounded by the fact that most communities that practise consanguinity are socio-economically not so well off. Do any of the health problems seen in children here arise due to genes or due to the poor nutrition, and sanitation and environment-based ill effects?

In other words — nature or nurture? Factors such as maternal illiteracy, younger maternal age, short birth interval, nutrition and infection adversely influence child health and survival; to count these as due to genetic difficulties would be inappropriate.

In order to separate the nature factor from the nurture factors, Bittles got together with some Pakistani colleagues and examined the data collected in the 1990/91 Pakistan Demographic and Health Survey. The analysis confirmed that non-genetic variables have a significant negative effect on child health, morbidity and mortality, but Bittles concludes that even after controlling for these variables, consanguinity demonstrably exerted a negative effect on child health and survival. This appears to be a combination of nurture and nature in the Pakistani groups studied.

What about the studies conducted in India? Research by J John and P Jayabal (1971) and by PSS Rao and SCT Inbaraj (1977) has supported the Sanghvi thesis that deleterious genes have been purged from the gene pool, thanks to many generations of inbreeding. Later studies by Dr. Radha Rama Devi (now at CDFD, Hyderabad), Appaji Rao, Savithri, Venkat Rao and Bittles on over 1,00,000 children in Karnataka did indicate a range of genetic disorders (amino acid deficiencies in particular). On the other hand, the gene pool size here is comparatively large (Indeed huge in South India, it is rather the Caspian Sea than a pool) that many of these effects are effectively diluted out.

Quite unlike some communities that are dwindling with time (the Gypsies, the Parsis, the Ashkenazim) where the gene pool is small and gene effects (both positive-musical abilities, physiognomy, and negative) can dominate, the South Indian or Middle Eastern Arabs have a larger population and demographic base. Indeed, Professor Appaji Rao points out to me that the prevalence of these amino acid deficiencies in the Karnataka infants is quite similar to that observed in Western countries, which do not practise consanguinity.

Having said this is not to support or certify consanguinity.

More studies have to be conducted not only on hospital patients and general populations but also in specific communities, before the last word is said. The buzzword in human genetics today is community genetics, and our country is not behind in this area.

Given the worldwide trend, we need to think of ways of how to accommodate the ongoing preference for consanguinity from a clinical genetics point of view. Even as we do so, let the matrimonial ads flourish. After all variety is the spice of life!

D. Balasubramanian

dbala@lvpeye.stph.net

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