There are an unusually high number of male pseudohermaphrodite births in the Gaza neighborhood of Jabalya, where Nadir and Ahmed live.
Dr. Jehad Abudaia, a Canadian-Palestinian pediatrician and urologist practicing in Gaza, says he has diagnosed nearly 80 cases like Nadir’s and Ahmed’s in the last seven years.
”It is astonishing that we have [so] many cases with this defect, which is very rare all over the world,” Abudaia says. He attributes the high frequency of this birth defect to ”consanguinity,” or in-breeding.
”If you want to go to the root of the problem, this problem runs in families in the genes.” Abudaia says. ”They want to get married to cousins… they don’t go to another family. This is a problem.”
Spinal muscular atrophy and the gene that causes it, along with several other serious genetic disorders, are common in Saudi Arabia, where women have an average of six children and where in some regions more than half of the marriages are between close relatives.
Across the Arab world today an average of 45 percent of married couples are related, according to Dr. Nadia Sakati, a pediatrician and senior consultant for the genetics research center at King Faisal Specialist Hospital in Riyadh.
In some parts of Saudi Arabia, particularly in the south, where Mrs. Hefthi was raised, the rate of marriage among blood relatives ranges from 55 to 70 percent, among the highest rates in the world, according to the Saudi government.
Widespread inbreeding in Saudi Arabia has produced several genetic disorders, Saudi public health officials said, including the blood diseases of thalassemia, a potentially fatal hemoglobin deficiency, and sickle cell anemia. Spinal muscular atrophy and diabetes are also common, especially in the regions with the longest traditions of marriage between relatives. Dr. Sakati said she had also found links between inbreeding and deafness and muteness.
Inbreeding among immigrants is causing a dramatic rise in birth defects, a government minister has warned.
Referring to the culture of Muslim arranged marriages between cousins, environment minister Phil Woolas said: ”If you have a child with your cousin the likelihood is there’ll be a genetic problem.”
Mr Woolas, whose views were supported today by medical experts, said the practice did not extend to all Muslim communities and that most cases occur in families from rural Pakistan, where up to half of all marriages are thought to involve first cousins.