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Somalia – The Truth of Unclaimed Nation

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Horn of Africa an old jewel left exploited and stripped has faced the non destined fortune which people have been facing since the last two decades. Somalia once used to be a great trading and immigration center for Asian and Arab merchants had lived its era of prosperity.

The greedy natures of the self discriminatory politics have crushed all hopes of this dying nation where people have been fighting for their survival every day.
The central transitional government recognized by the international community as the official representative for Somalia affairs hardly controls an area of more than few sq kms confined to the state capital Mogadishu.
Somalia saw its destruction due to four factors which intervened in its affairs since 1960s. These factors have always ruled the political environment of this once great nation. The Conference which was held in London in last month February 2012 under the leadership of David Cameroon – Prime Minister of UK and Hilary Clinton – US State Secretary has been a late but much needed attempt to draw the global attention towards Somalia.
But due to the negligence by the global community and rigid nature of terms set up by them for dialogue with various territory holders of Somalia resulted in the destruction of the lives and families of the people of Somalia and the nation at large.
Somalia and its people are fighting the war from within and with their neighbors’ who have never supported the cause of Somalia and are one of the major forces behind the destruction of the Somalia’s society and its country especially Ethiopia whose constant interference in the internal matters and policies of Somalia have damaged the entire political and national set up hence; dividing the country from all spheres of existence.
It is a surprising fact that a nation which has remained without a government and legal constitutional system from more than twenty years has existed with complete territorial integrity with no advances made by any African country with exception of Ethiopia which control a small part of Somalia’s territory however with no claim as such on it.
The second most disastrous factor which contributed in the start of Somalia Civil War and the national divide is due to the un-coordinated nature exists in the caste based system of Somalia. It is this factor which has done major destruction of Somalia’s national integrity and unacceptability of the national political system created after the independence in 1960 which ended up in the political disaster during 1991 when the President Siad Barre government was overthrown, resulted in the one of the most destructive civil wars took place in the recent history.
Millions since then have been affected by the ongoing conflict while entire Somali population suffers from pro-longed drought and famine existing conditions which they are experiencing from last 15 years which has taken toll to thousands of lives irrespective of any caste or creed of their domain.
Where people were forced to leave their homelands in search of safer abode where they can at least have one meal a day and can also live safe away from the hands of extremists who have not only ruined their country by taking large swathes of territory but has also put their livelihood on the cross-roads where they have no choice but to take up the work left for them to earn their fortune.
Billions of Dollars of international assistance have already been given and being provided by UN through various governments agencies and organizations but the matter of the fact lies the same old situation with no progress visibly telling the development story of once prosperous nation. Even though the London Conference was organized to bring out the solution to the two decades long conflict and provide a stable government with unified voices from various factions and controllers of the Somalia’s territory. The theme of addressing the causes of the Somali conflict and the need for new approach mentioned in the speech of UK PM, David Cameron seems abandoned or unarticulated while the publicly rejected Roadmap of the United Nations Political Office for Somalia (UNPOS) took the center stage.
The following seven themes hold different meanings to the Somali people as illustrated below:
1. Security: Means no professional responsible Somali national Security forces under the exclusive control of a legitimate national government and instead more foreign forces in Somalia. A local authority protected and empowered by foreign forces cannot be accountable to the Somali people.
2. Political Process: Means continuation of vassal Transitional Federal Government (TFG)’s model of IGAD, clan based regional states, letters to the Diaspora from the Special Representative of the Secretary General, and abusive threats and accusations as spoilers of peace to the critics of the inept TFG, Kenya and Ethiopian intervention in Somalia or opponents to Kampala Accord, the deceitful Roadmap or UNPOS’s wrongheaded policies.
Even the representatives of the people of Somalia (Members of Parliament) are not immune from the foreign threats for punishment in fulfilling their constitutional rights and responsibilities. IGAD’s angry letter (IGAD threatens sanctions over Somali parliament) to the MPs who ousted the ex Speaker Sharif Hassan is a frightening and appalling example of infringement of Somalia’s sovereignty and proves the falsity of the international legitimacy conferred to TFG. In clear terms, Somalia is presently under the direct control of Addis Ababa.
3. Local stability: Means expansion of the Dual Track Policy which expedites Somalia’s fragmentation and conflict for resource and power competition.
4. Counter-Terrorism: Means insecurity, loss of dignity, freedom, death of innocent people in the hunt of terrorists, and deprivation of vulnerable Somalis from foreign remittances incomes and denial of humanitarian assistance in addition to Al Shabab’s cruel bans. Banks have been pressured to stop transfers of money to Somalia for counter-terrorism reasons.
5. Piracy: Means restriction of the Somali territorial water and utilization of marine resources, imposition of Exclusive Economic Zone (EEZ), continuation of illegal fishing and dumping toxic waste.
6. Humanitarian: Means intensification of the current Somalia’s depopulation by increasing the refugees, the displaced and impoverished population due to the massive military interventions and actions in Somalia.
7. International Coordination: Means increased support for the disintegration, polarization and division of Somalia rather than increased support for Somali driven peace, reconciliation and nation building.
The UK led London Conference on Somalia, which has started with the hope of state building in Somalia but now it recycles the roadmap themes. The plan introduces a new element which is called a Joint Financial Management Board. The High Level Political Committee and the Joint Security Committee established in Djibouti, and the Joint Financial Management Board expected to be established in London will constitute the instruments (institutions) of illegal International Trusteeship Administration on Somalia.
In the context of London Conference, it has been circulated an Italian proposal which advocates a 16 months of UN/AU Trusteeship or what it is called Transitional Administration on Somalia. The Italian proposal has formally documented the total failure of the TFG and international efforts. Theoretically, the proposal is far better than the current situation of TFG’s vassal model or what Prof Afyare Elmi called “stealth trusteeship” on Somalia under disparate actors.
President Mwai Kibaki of Kenya is asking PM Meles Zenawi of Ethiopia to leave the areas liberated by Kenyan forces after massacring Al Shabab and civilians. But PM Meles Zenawi refused and responded by saying, “you don’t know anything. I have been manipulating this country in the past 20 years.” Therefore, PM Meles relaxes on the bleeding Somalia.
The entire situation on Somalia is alarming where on one hand the UK backed Transitional Government seated in Mogadishu is exploiting and misusing the funds collected for Somalia’s welfare where leaders have been found involved in corrupt practices where out of $54 million only one million dollars were spent for welfare while neighbours of Somalia making every possible effort to crush the growing hope of stable and united Somalia where Ethiopia lies at the centre of Somalia’s politics.
While its own people have now been involved into illegal and anti social activities of extremism and have now become the major threat to global shipping by indulging into piracy. With people have no choice to earn their livelihood, with no government to rule and with no serious initiative by international community has left Somalia lying with uncertainties and at the mercy of terrorist which has transformed Somalia into a hub for global terrorism where organizations are finding secure shelters and grounds to work up on their projects of disasters making poor and innocents their target and even their recruits. Its now high time that world should take a note of the situation and invite all the representatives from Somalia irrespective of their agenda, their activities and control including Al Shabab and other organizations and communities not only from Somaliland but also from Puntland in order to come to a common terms and settle on a point of peace and stability for making Somalia and better and prosperous nation ruled by great leaders with accountable system of governance. Ethiopia and other who are creating nuisance along with Transitional government and its leaders must be made accountable and should be dragged in the ICJ.

Organ harvesting

Organs are not useful when they are dead. They drug them first and remove the organs. Then they leave them to die. Human rights campaigner Hamdy Al-Azazy

International organ trafficking has become a huge multibillion $ business and it continues to grow. The traffickers have become more and more ruthless and have absolutely no boundaries. An example is Antonio Medina, 23 year old migrant from Central America on his way to USA with his wife were captured by a criminal gang. After being locked in separate rooms, Medina heard his wife screaming. Later on, he entered the room and saw his wife on a table with her chest wide open and without her heart and kidney. Medina was lucky; he and some others were saved by Mexican soldiers. This is the small part of global trafficking as for most of the part, organ trafficking occurs in hospitals where medical practitioners are corrupt and cooperate with traffickers because of the profit.

Poor and desperate people can earn between 3,000 to $15,000 for selling their organs, especially kidneys, to middlemen who re-sell them to wealthy buyers for as much as $200,000.

Although it happens in most of the countries, however it is more prevalent in Israel, India, China, Pakistan, Turkey, Brazil, Nepal, the Philippines, Kosovo, Iran and the former Soviet states in Eastern Europe. Most of the countries here have weak authorities and poverty makes people desperate to sell their organs to the wealthy. The customers are from the US, Western Europe, the Arab Gulf states, Israel and other wealthy countries.

Everybody has 2 kidneys that filter the toxins out of the bloodstream. If a patient with failure in both kidneys will die quickly unless he/she is treated with a dialysis machine or get a transplant. The transplants prolongs the lives of the patients but patients who receive organs from living donors have better survival rates rather than those receiving from deceased donors.

Online Business

China has done it well by attracting sellers and buyers by using the web. The communist country has the world’s highest execution rate and the dead convicts supply healthy young organs at all time. The Chinese justice system works effective and quick for those who are sentenced to death and corrupt government workers take advantage of the situation to earn extra money.

Once patients arrive to China, the organizers will force them to bid more than the others so that a single organ will go for the highest price. They are forced to sit at the hospital and wait and watch who will get the organ from the executed prisoner.

Israel and shortage of donors

This globally black market is deceptive and dirty. The traffickers use deception, violence and coercion to buy and sell organs from desperate people and sell them for much higher price to more developed countries. These middlemen form partnership with doctors in different hospitals who perform these transplants for an arranged fee and no questions. The numbers from World Health Organization (WHO) reveals that 5000 people sell their organs on the black market each year. Many of the black marketed kidneys harvested by the rootless gangs are destined to patients in Israel.

With a population of 7,4 million and a very modern medical system, Israel has a alarming shortage of donors because of the religious belief. Only 12% of Israelis are registered as donors according to the Israeli National Transplant center. What’s positive is that the Israeli police has been very aggressive against organ traffickers and managed to break up 3 international gangs since 2008.

The criminals profits from the poor and the sick, both parts that try to survive. They will pay a seller $10,000 and collect $150,000 from the patient.  The buyers are flown to cities and hospitals to wait for the procedure until they find a recipient.

Unfortunately, there are corrupt doctors everywhere and it is impossible for them not to know about the transplants because of the money that is involved. How can they not know about whether the donor is a blood relative or not?  Not only the middlemen, but the doctors must also be held accountable together with everyone that is involved.

Levy Izhak Rosenbaum, from New York, admitted in a Trenton federal court to brokering three illegal kidney transplants for desperate New Jersey-based customers in exchange for payments of $120,000 or more. He also pleaded guilty to a conspiracy count for brokering an illegal kidney sale.

The religious debate

Rabbi Yosef Shalom Elyashiv, a prominent and leading arbiter of Jewish law in Israel advises that donating body parts violates the religious faith, which states that “upon death, a body should be buried intact.” This has lead to a huge shortage of donors and the list of patients is growing. The result is that money hungry gangs prey on these desperate people.

Shmuel Eliyahu, chief Rabbi of Safed, Israel has started a project to get 100 colleagues to sign a document advocating organ donation. “The Torah tells people to help others when they can, especially if it means saving a life. Donating an organ is a mitzvah, or good deed, “he said.

Egypt

In this area, there is a network of Bedouin smugglers who steal organs from refugees who travel in the harsh desert in search for a better life in Israel. If they can’t pay for the large amount of money to their smugglers, they have to pay with their organs. Many African refugees have been found in the desert with their organs missing.

The most dangerous and cruel traffickers are the Sawarka Bedouin tribe who steal organs from refugees coming from Ethiopia, Eritrea or Sudan. If they can’t pay, the men lose their organs and the women are raped.

Al-Azazy, a human rights activist stated that the victims are drugged before the traffickers remove the organs as the organs aren’t useful when the victim is dead. After the surgery, the victim is dumped in a dry well where hundreds of other bodies rest. They all have one thing in common, and that is the deep scar they all carry. This heinous act is a shame and the corrupt Egyptian doctors are working together with the Bedouins and perform the surgery in mobile hospitals.

Countries involved

According to information from WHO, kidney transplants are carried out in 91 countries. Approximately, 66,000 kidney transplants, 21,000 liver transplants and 6000 heart transplants were performed globally in 2005.

Organ harvesting is going on at full speed in Philippines, Turkey, Iran, central Europe, mainly in the Czech Republic, Caucasus, mainly in Georgia, Pakistan, India, Africa; such as Mozambique and South Africa as one of the main countries.

The surgeons removes kidneys, lungs, pieces of liver, even corneas, bones, tendons, heart valves, skin and other sellable human bits. The organs are kept in cold storage and air lifted to illegal distribution centers in the United States, Germany, Scandinavia, the United Kingdom, Israel, South Africa, and other rich, industrialized locales. This barbaric business makes more money than human trafficking and drug trafficking.

The Middle East residents of the Gulf States (Kuwait, Saudi Arabia and Oman) have travelled to India, Philippines and to Eastern Europe for many years to purchase organs because of some Islamic teachings that allow organ transplantation to save life but prohibit organ harvesting from brain-dead bodies.

The Gurgaon kidney scandal

Police arrested several people for running a kidney transplant clinic in Gurgaon, Delhi. The kidneys came mostly from poor people from Uttar Pradesh and transplanted to clients in USA, UK, Canada, Saudi Arabia and Greece. Dr. Amit Kumar, who ran the clinic and the guesthouse, was arrested in Nepal on 7 February 2008 but not surprisingly, he denied having anything to do with the trafficking. Officials seized a bank draft worth Rs. 936,000 together with €145,000 and $18,900 in cash. He tried to bribe the Nepali police but was not successful.

The donors were lured to the clinic for job opportunities and then asked if they were willing to donate their kidney for the amount of Rs. 30,000. If they resisted, they would forcedly be dragged into the operation room.

I personally stand for saving lives but this type of harvesting should not happen in the 21st century. The way the eastern Europeans and Chinese perform the surgery reminds me of the death camps in Nazi Germany. There are many pictures on the internet showing dead naked bodies dumped over each other on the floors. All of them are opened up and emptied for organs. It’s disgusting and inhuman how a human life can be taken away so easily. As long as there is a shortage of donors, the business will continue flourishing. It is sad to think about all those who are chained to the bed waiting for a kidney, liver or heart but no one has the right to murder another human being for the sake of money.

“When I look in the mirror and see that scar, it’s a daily reminder of what I went through,” he says. “I feel this raw grievance inside.” Abdullin, 28 from Azerbaijan.

Mirror mirror on the wall, who is the fairest of them all?

Skin bleaching originated from Asia all the way to ancient China and Japan where the proverb says; “one white covers up three ugliness.” Then in 1960, skin lightening products were imported from Asia and launched in USA mainly for African-American women then it spread to Africa and Latin America where societies considers far skin as beautiful and as a higher social standing.

In Britain, obsession with fair skin can be traced all the way back to the 16th century and was called Venetian Ceruse, also known as Spirits of Saturn. The ceruse would be used as a skin whitener and the best they could find in that time. The product consisted of a pigment made by a white lead that caused lead poisoning and damage the skin as well as significant hair loss. If used over a long period of time, it would cause death. A famous user was Elizabeth I of England.

Skin whitening is considered to be a multi product as the consumers in the West use it for its lightning and anti age benefits while Asian consumers prefer it for lightening the overall color and tone of the skin. An important fact is that Asian women does not use these products to look like Caucasians but simply because fair skin has a social status in the society.

Poor people,villagers and those in India who are considered as low cast works outside and their skin will become dark. Rich people and those who can afford to stay indoors will remain pale and fair so this is connected to social status. Japanese, Chinese, Vietnamese etc have a yellow undertone in their skin and the whitening products do target this as well.

Dangerous effects

There are 2 dangerous and extreme methods of whitening the skin. The first one employs cortisone which destroys the epidermis (the outer layer of the skin). It passes into the bloodstream and the person develops a strong addiction towards it. Many women who have used this method have reported that they have developed depression. The other method is to use products with an ingredient called hydroquinone which was banned in the entire European Union in 2001 but still sold in the black market. Hydroquinone lightens the skin color by killing the cells that produce melanin (the melanolyte). From historical background, hydroquinone was first used in the 1930s when some African-Americans employees noticed that there were some discolorations appearing on their skin caused by Monobenzyl Ether of Hydroquinone (Monobonzone).

A fair business

The strongest and fastest growth remains in Asia-Pacific with Japan dominating the market followed by India and China. According to a report done by Global Industry Analysts (GIA), the Asian market will cross $2 billion by 2012. By 2015, it will reach $10 billion as new markets in the West emerge together with the growth in Asia-Pacific. Western markets have shown growth largely because Asian and African consumers demanded lightening products. The same report also revealed that lately there has been an increase in the market for men’s whitening products.

Fair & Lovely was first launched in India in 1975 and has become the largest selling skin whitening cream in the world. It is created by Unilever’s research laboratories and claims to give drastic results in 6 weeks. On their website, the product is called “the miracle worker* and is proven to give 3 shades of change. It held a commanding 50-70% share of the skin whitening market in India in 2006, a market that is valued at over $200 million. The target market for Fair & Lovely is mainly young women aged 18-35 but according to retail and market research reports, girls down to 12.14 years widely use fairness creams.

Despite being one of the leading products in this sector, are allegedly using photo touch-up to achieve desired results. The ad campaign was withdrawn when they got public criticism, especially from women’s groups from India, Malaysia and Egypt. Similar ads manufactured by FMCG giant Unilever showed a miraculous change in the complexion from dark to very fair using photo touch-ups was also withdrawn from the UK market in October 2008.

Many dermatologists have been debating on this subject and they claim that the fairness creams won’t be effective and show such results without the use of skin bleaching ingredients such as hydroquinone, steroids, mercury salts and other dangerous chemicals and Fair & Lovely does not contain this.

These products were once produced targeted only to women but the products are very popular among men. The sales have raised 100% in rural India and the products for male increased 20%.

Hindustan Unilever, one of the largest consumer products companies in India, producing Fair and Handsome, sent CNN an email saying: “Fair and Handsome is a market leader with almost 70% market share in India and doing extremely well in Gulf countries and the Middle East as well.”

Africa

Sale of whitening creams in Africa is worth millions of dollars each year. In Tanzania, where use and import of skin lighteners are banned, the sale is still high as dangerous creams are smuggled into the country and caused many women skin damages such as scratch marks and black dots after burning their skin. Others developed skin cancer. There is no doubt that bleaching harms the skin. The procedure destroys the black pigment in the top layer of the skin called epidermis, but exposure of the dermis layer under the epidermis to harsh weather will increase the chances of skin cancer. In Tanzania, women have been warned against using these chemicals after a woman had taken some tablets to bleach her skin and died after her flesh turned into liquid form and started dropping off. Despite the dangers, the women still use the products and the men continue desiring women with lighter skin.

Pakistan and India

Fair & Lovely is the most popular whitening product in Pakistan and recently this company has come up with a whitening product for men called Fair & Handsome. The commercial starts with a young darker skinned man sad because he can’t get a date. The Indian actor Shahrukh Khan advises him to use Fair & Handsome his skin tone gets lighter and he is suddenly surrounded by sexy supermodels. The same is shown in a television drama named Bidaai, featuring 2 sisters, one adopted and has dark skin while the other is pale. The pale gets prince charming. In another TV commercial that is very discriminating, two men, one with dark skin, and the other with light skin stands on a balcony overlooking a neighborhood. The darker skinned guy says “I am unlucky because of my face” to his friend. His light skinned friend replies, “Not because of your face, because of the color of your face” before handing over a whitening cream. The commercials are sending the message; get whiter skin, and you’ll get the girl, the job of your dreams etc.

 

Pakistanis and Indians are obsessed with the idea of becoming fair. The women who can afford it, stays away from the sun, get facial treatments with whitening products and use foundation and powders that are several numbers lighter than their own skin color making them look gray rather than white. So when parents look for a bride for their sons, they prefer a fair skinned girl and the men are more attracted to lighter skinned girls. A survey done for the biggest matrimonial site named Shaadi.com showed that almost 12,000 people said that skin tone was the most important criteria for choosing a life partner in 3 northern Indian states.

Even after the partition from India, Pakistanis held on the cast system and most families prefers to marry their children within the family and cast. Most of the upper class does have lighter skin and many of the lowest casts have the darkest skin. Darker skinned people do have a hard time in both countries since having lighter skinned people gets more respect. A choice of a partner with darker skin color will raise many questions from people (also in front of your partner) of why you married a dark skinned person. They don’t mean to offend but ask because it is strange to them.

The desire for fair skin has also isolated the women so that they are not able to function outside the home such as participating in sports. “Because of Indian men’s concept of beauty, so many talented players do not take up cricket because it is a grueling sport and you are out in the sun for at least seven to eight hours,” said a Cricket Captain to the news once. If the men also do the same then there will be no sports played in the country. On the other side, Fair & Lovely has an ad where a female cricket broadcaster gets a job after lightening her skin…

Snow white syndrome; Maybe not fair but still lovely
Unfortunately people can’t accept their skin color in countries where they are dark or brown skinned and go drastic steps to change the color of their skin. One of the major reasons for this is that the media and the society that forces on these ideas. A fair skinned female is more likely to get the job instead of a darker skinned girl, the handsome boy is more likely to choose the fair skinned girl to be his wife and the fair skinned girl will get the lead role in a movie or music video while the darker skinned once are pushed behind her.  The same goes for men. Let’s be honest, if you have fair skin, you will be successful. We all know that the ads aren’t truthful and that there is Photoshop work behind.

Just look at Aishwarya Rai. Her picture on the cover of Elle magazine India made headlines when she appeared miraculously fair. Instead of doing this, Elle India could go in front as an example by putting a dark, dusky, golden, brown girl on the cover to respect those who have a darker color, to show them that they are beautiful and to tell them that they too matter.

This obsession with fair skin and priority of the girls and men with lighter skin color is discriminating. Still in the 21th century, there is this ignorance that those with lighter skin is more superior and those would darker does not matter. Girls have the pressure of trying to find a suitable husband who will marry her because he loves her, not because of her skin color. I dont think that the older generations will change this way of thinking but the younger generations can stand against the stereotypes and make a statement.

 

Harmful practices to the female body; part 1 Female Genital Mutilation

“Mama tied a blindfold over my eyes. The next thing I felt my flesh was being cut away. I heard the blade sawing back and forth through my skin. The pain between my legs was so intense I wished I would die.” –Waris Dirie, UNFPA Goodwill Ambassador and spokesperson on FGM

1. What is FGM?

Female Genital Mutilation (FGM) has been defined by the World Health Organization (WHO) as “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons.” Most of the victims live in African countries, some in the Middle East and Asian countries and it is increasing in Europe, Australia, New Zealand, USA and Canada.

FGM is usually performed by an older experienced woman with no medical training. In primitive areas, anaesthetics and antiseptic treatment is not used and the tools consist of knives, scissors, scalpels, pieces of glass and razor blades. A mixture of herbs is placed on the wound to tighten the vagina and stop the bleeding. The age of the girls varies from infants to girls to the age of 10 depending on the community and family.

It is extreme form of discrimination against women and performed on innocent children that are not able to defend themselves. It is nearly always carried out on minors and is a violation of the rights of children. The practice violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

2. 4 types of FGM

According to WHO;

a)     Excision (removal) of the clitoral hood with or without removal of part or all of the clitoris. Occurs in 85% of the FGM.

b)     Removal of the clitoris together with part or all of the labia minora. Occurs in 85% of the FGM.

c)      Removal of part or all of the external genitalia (clitoris, labia minora, and labia majora) and stitching and/or narrowing of the vaginal opening leaving a small hole for urine and menstrual flow. Occurs in Djibouti, Somalia, Sudan, parts of Egypt, Ethiopia, Kenya, Mali, Niger, Nigeria and Senegal.

d)     All other operations of the female genitalia.

3. History of Female Circumcision

Female circumcision, also known as Female Genital Mutilation (FGM) is not a recent phenomenon as it has been dated back as far as to 2nd century BC when a geographer, Agatharchides of Cridus wrote about the subject that occurred among tribes residing on the western coast of the Red Sea (today’s Egypt). Based on the current areas practicing FGM, it seems as the tradition has originated from Egypt and spread. Others believe that the custom was rooted in the kingdom of the Pharaohs.

As Islam rose throughout the region, Egyptians raided territories in the south and exported Sudanic slaves. Female slaves were sold at a higher price if they were “sewn up” as they became unable to give birth. After many converting to Islam, this practice was abolished as Islam prohibits Muslims from harming their body and enslaving others.

Today this primitive tradition has reached the coasts of America, Europe, Australia and Canada. Numbers from Amnesty International estimates that 135 million women have experienced FGM and that between 2-3 million girls and infants undergoes this practice every year.  In Africa alone it is about 92 million girls who has undergone FGM.

4. Medical consequence of FGM

FGM have absolutely no health benefits for the girls except doing harm and causing extreme pain. As the healthy genital tissue is being removed, the body cannot function in a natural way. Since this procedure is being practiced by people who have no medical training and without using any necessary anesthetic or sterilization, the FGM can lead to death by shock from bleeding or infections by the unsterilized tools. The first sexual intercourse will be extremely painful who will be needed to be opened and this is being performed by the partner with a knife. Besides bleeding there are several short and long term complications that these girls have to deal with and I have listed them shortly.

Depending on the degree of mutilation, short term health problems caused by FGM;

  1. Severe pain and shock
  2. Bacterial infection
  3. Urine retention
  4. Open sores injury to adjacent tissues
  5. Immediate fatal haemorrhaging (bleeding)
  6. Extreme pain as girls are cut without being numbed and the worst pain occurs the next day when the girls have to urinate
  7. Trauma as girls are forced and held down by several women

Long-term implications;

  1. Extensive damage of the external reproductive system
  2. Uterus, vaginal and pelvic infections
  3. Cysts and neuromas
  4. Increased risk of Vesico Vaginal Fistula
  5. Complications in pregnancy and child birth
  6. Psychological damage
  7. Sexual dysfunction
  8. Difficulties in menstruation
  9. Recurrent bladder and urinary tract infections
  10. Infertility
  11. The need for later surgeries such as to be cut open to allow childbirth and sexual intercourse after marriage. Sometimes it is also stitched again several times after childbirth.
  12. Problems urinating as girls are left with a small opening. This can slow or strain the normal flow of urine and lead to infections
  13. Gynecological health problems as they are not able to pass all of their menstrual blood out and have infections over and over again.
  14. Increased risk of Sexually Transmitted Diseases/Infections (STD/STI) including HIV as the procedure is being performed in unclean conditions
  15. Psychological and emotional stress. A study by Pharos, a Dutch group that gathered health care information of refugees and migrants revealed in February 2010 that majority of these women suffered from stress, anxiety and was aggressive. They were also most likely to have relational problems or fear for relations. According to the study, it is believed that an estimate of 50 girls is being genitally mutilated every year in the Netherlands.

5. Where is FGM practiced?

Southeast Asia; Indonesia, Malaysia,

Central Asia; Tajikistan

Eastern Europe; Chechnya, Dagestan, Ingushetia

Middle East; Yemen, UAE, turkey, Syria, Saudi Arabia, Palestinian territories, Pakistan, Oman, Jordan, Iraq and Kurdistan, Iran,

Africa; Zimbabwe, Zaire, Uganda, Togo, Tanzania, South Africa, Somalia, Sierra Leone, Senegal, republic of Congo, Nigeria, Niger, Mozambique, Mauritania, Mali, Malawi, Libya, Liberia, Kenya, guinea-Bissau, guinea, Ghana, Gambia, Ethiopia, Eritrea, Egypt, Djibouti, democratic republic of the Congo, cote d’ivoire, Comoros, Chad, central African republic, Cameroon, Burkina Faso, Benin, Algeria

The majority of cases of FGM are carried out in 28 African countries. In some countries, (e.g. Egypt, Ethiopia, Somalia and Sudan), prevalence rates can be as high as 98 per cent. In other countries, such as Nigeria, Kenya, Togo and Senegal, the prevalence rates vary between 20 and 50 per cent. It is more accurate however, to view FGM as being practised by specific ethnic groups, rather than by a whole country, as communities practising FGM straddle national boundaries. FGM takes place in parts of the Middle East, i.e. in Yemen, Oman, Iraqi Kurdistan, amongst some Bedouin women in Israel, and was also practised by the Ethiopian Jews, and it is unclear whether they continue with the practice now that they are settled in Israel. FGM is also practised among Bohra Muslim populations in parts of India and Pakistan, and amongst Muslim populations in Malaysia and Indonesia.

6. Religion or culture?

Although FGM happens in countries with Muslim majority, and people think that it is associated with Islam, FGM is not supported by any religion and condemned by many religious leaders.

In fact FGM is a pre-Islamic tradition and since Islam prohibits humans from harming and mutilating their body, therefore FGM is forbidden in Islam. In Ethiopia, Cote d’Ivoire, Kenya, Senegal, Benin, and Ghana, Muslim population groups are more likely to practice FGC than Christian groups but in Nigeria, Tanzania, and Niger, the prevalence is greater among Christian groups.

Today FGM is a mixture of cultural, religious and social factors. For instance, the social pressure to perform FGM because others in the same community do it keeps the practice strong. As from the religious view, the parents thinks that FGM is necessary to raise the daughter properly and make sure that she is a virgin until she is married even though no religious scripture supports this. It is motivated by the thought of proper sexual behavior.

7. Reasons and justification

  1. custom and tradition
  2. religion; in the mistaken belief that it is a religious requirement
  3. preservation of virginity/chastity
  4. social acceptance, especially for marriage
  5. hygiene and cleanliness
  6. increasing sexual pleasure for the male
  7. family honour
  8. a sense of belonging to the group and conversely the fear of social exclusion
  9. enhancing fertility

8. What can be done to prevent and abolish FGM?

Each community should arrange meetings where they discuss, talk and consider opinions about FGM. Here it would be important to allow the elder generation to speak with the young. It is important to spread out and explain about the harsh health problems FGM causes.

Next important thing is education. Education is the key to everything. As we can see, this is happening in areas where most people is illiterate or doesn’t have the possibility to go to school. The generations repeat themselves and the circle is hard to break. Another important thing would be that Islamic scholars and other religious leaders should change the perception about FGM as people listen to them.

Every country and community should work towards changing the attitude as women feels they are being disloyal to their culture for not choosing FGM. This pressure can change if doctors and other health care workers would talk with women about the dangers of FGC and offer other options that don’t involve cutting. Some human rights advocates also suggest that men could help reduce the practice of FGC by openly marrying uncut women. Many human rights organizations are also calling on religious leaders to openly confirm that their religions do not require women to have FGC.

Last, if the countries establish strict laws and investigate cases regarding FGM, then it will have some effect but it will not be enough to abolish it as 18 African countries has laws or decrees against FGM. Even countries with the highest rates of FGM have recently openly noted the need for banning this practice. Fines and jail sentences are typically minor, but most view any sanctions against FGC as a good start.

It is important that everyone is aware of this heinous practice that mutilates the female body. It is hard to understand how parents can perform this on their infant babies who are not able to defend themselves. Every country should implement various strategies to eliminate FGM and it starts with education and communication.

Lesotho – A country of Women Upliftment

Independent from British colonial rule in 1966, the kingdom of Lesotho was used to be trouble state where just like rest of Africa the power struggle leads into the greed of politicians & affects innocent citizens. Gripped in the variety of law codes which decides the fate of the people of Lesotho who are by origin are from Buntu descent results of the early Buntu migrations who got settled down in this hilly country. Lesotho is the highest ground level in the world making it the only country who’s even the lowest point from the sea level is 1455mtrs above. It is sovereign state with constitutional Monarchy or parliamentary monarchy system where King has no public role with its capital at Maseru. Surrounded on all sides by South Africa; It has the healthiest sex ration in Africa where for 100 women there are 95 men. After the introduction of a proper constitution & democratic system in 1998 the condition of women has been lifted on a very wide scale. The involvement has reached at such a stage that now women shares equal number of ministries, public servants positions, Army ranks, in Lesotho political & public structure. The literacy rate of 95% among women & 75% literacy rate among men which is the highest in Africa & one of the highest in the world makes women more advantageous & opportunistic. This situation has now completely transformed the family per capita tally where in Lesotho there are more women earning members than men now.  Now women are serving in every field where in early years men used to dominate.

Concerns: As per UNAID 2009 report Lesotho has the world’s highest number of HIV/AIDS infected people where in every 4 women are infected out of 5 & the same of men as well. With the non availability of hygienic & proper medical facilities in the kingdom & poor sanitation & high poverty levels make Lesotho more vulnerable to the highest infant mortality rate in the world & the lowest life expectancy due to highest number of HIV/AIDS infected people which counts for Men 45 years & same for Women 45years too. The ration of doctors / physicians is 5: 10000

It is among the poorest countries in the world & majority of population lives below poverty line. 75% of the population is rural & 25% is Urban. Population growth rate is 0.13% with a total GDP of 2.13billion USD.

Inbreeding – Cousin marriages and health disorders

It is estimated that at least 55% of British Pakistanis are married to first cousins and the tradition is also common among some other South Asian communities and in some Middle Eastern countries. But there is a problem: marrying someone who is themselves a close family member carries a risk for children, a risk that lies within the code of life, inside our genes. Communities that practice cousin marriage experience higher levels of some very rare but very serious illnesses known as recessive genetic disorders.

Such unions are seen as strong because they build on tight family networks and family events gets better because the in-laws are already related to each other and have the same family history. But the statistics for recessive genetic illness in cousin marriages is serious as British Pakistanis are 13 times more likely to have children with genetic disorders than the general population.

Cousin marriages

Cousin marriage is marriage between two cousins. This kind of marriage is highly stigmatized today in the West, but it does account for over 10% of marriages worldwide as it is common in the Middle East, where in some nations they account for over half of all marriages.

According to Professor Robin Fox of Rutgers University, it is likely that 80% of all marriages in history have been between second cousins or closer. It is generally accepted that the founding population of Homo sapiens was small, anywhere from 700 to 10,000 individuals. Rates of first-cousin marriage in the United States, Europe, and other Western countries like Brazil have declined since the 19th century, though even during that period they were not more than 3.63% of all unions in Europe. But in many other world regions cousin marriage is still strongly favoured: in the Middle East some countries have seen the rate rise over previous generations, and one study finds quite stable rates among Indian Muslims over the past four decades.

Cousin marriage has often been chosen to keep cultural values and ensure the compatibility of spouses, preserve familial wealth, sometimes via advantages relating to dowry or bride price. Other reasons may include geographic proximity, tradition, strengthening of family ties, maintenance of family structure, a closer relationship between the wife and her in-laws, greater marital stability and durability, ease of prenuptial negotiations, enhanced female autonomy, the desire to avoid hidden health problems and other undesirable traits in a lesser-known spouse, and romantic love.

United States

The United States has the only bans on cousin marriage in the Western world. As of February 2010[update], 30 U.S. states prohibit most or all marriage between first cousins together with other 6 states.

Cousin marriage was legal in all US states in the Union prior to the Civil War. However, according to Kansas sociology professor Martin Ottenheimer, after the Civil War the main purpose of marriage prohibitions was increasingly seen as less maintaining the social order and upholding religious morality and more as safeguarding the creation of fit offspring. By the 1870s, Lewis Henry Morgan was writing about “the advantages of marriages between unrelated persons” and the necessity of avoiding “the evils of consanguine marriage.” Cousin marriage to Morgan, and more specifically parallel-cousin marriage, was a remnant of a more primitive stage of human social organization. Morgan himself had married his mother’s brother’s daughter in 1851.

In 1846 the Governor of Massachusetts appointed a commission to study “idiots” in the state which implicated cousin marriage as being responsible for idiocy. Within the next two decades numerous reports appeared coming to similar conclusions, including for example by the Kentucky Deaf and Dumb Asylum, which concluded that cousin marriage resulted in deafness, blindness, and idiocy. Perhaps most important was the report of physician S.M. Bemiss for the American Medical Association, which concluded “that multiplication of the same blood by in-and-in marrying does incontestably lead in the aggregate to the physical and mental depravation of the offspring.”

These developments led to thirteen states and territories passing cousin marriage prohibitions by the 1880s. Though contemporaneous, the eugenics movement did not play much direct role in the bans, and indeed George Louis Arner in 1908 considered them a clumsy and ineffective method of eugenics, which he thought would eventually be replaced by more refined techniques. Ottenheimer considers both the bans and eugenics to be “one of several reactions to the fear that American society might degenerate.” In any case, by the period up until the mid-1920s the number of bans had more than doubled. Since that time, the only three states to successfully add this prohibition are Kentucky in 1943, Maine in 1985, and Texas in 2005. The NCCUSL unanimously recommended in 1970 that all such laws should be repealed, but no state has dropped its prohibition since the mid-1920s.

Europe

Only Austria, Hungary, and Spain banned cousin marriage throughout the 19th century, with dispensations being available from the government in the last two countries. Protestant, the Church of Sweden didn’t ban first-cousin marriage until 1680 and required dispensation until 1844. England maintained a small but stable proportion of cousin marriages for centuries, with proportions in 1875 estimated by George Darwin at 3.5% for the middle classes and 4.5 % for the nobility, though this has declined to under 1 % in the 20th century. Queen Victoria and Prince Albert were a preeminent example.

The 19th century academic debate on cousin marriage evolved differently in Europe than it did in America. The first-cousin marriage was legal in ancient Rome from at least the Second Punic War (218–201 BC) to its ban by the Christian emperor Theodosius I in 381 AD in the west and until after Justinian (d. 565 AD) in the east.

Early Catholic marriage rules forced a sharp change from earlier norms in order to deny heirs to the wealthy and therefore increase the chance they would will their property to the Church.

Middle East

The Middle East has uniquely high rates of cousin marriage among the world’s regions. Saudi Arabia, have rates of marriage to first or second cousins that may exceed 50%, Iraq was estimated in one study to have a rate of 33%, and figures for Iran and Afghanistan have been estimated in the range of 30–40%. Though on the lower end, Egypt and Turkey nevertheless have rates above 20%.

All states in the Persian Gulf currently require advance genetic screening for all prospective married couples. Qatar was the last Gulf nation to institute mandatory screening in 2009, mainly to warn related couples who are planning marriage about any genetic risks they may face. The current rate of cousin marriage there is 54%, an increase of 12–18% over the previous generation. A report by the Dubai-based Centre for Arab Genomic Studies (CAGS) in September 2009 found that Arabs have one of the world’s highest rates of genetic disorders, nearly two-thirds of which are linked to consanguinity. Research from CAGS and others suggests consanguinity is declining in Lebanon and Egypt and among Palestinians, but is increasing in Morocco, Mauritania and Sudan.

Dr. Ahmad Teebi, a genetics and pediatrics professor at Weill Cornell Medical College in Qatar, links the increase in cousin marriage in Qatar and other Gulf states to tribal tradition and the region’s expanding economies. “Rich families tend to marry rich families, and from their own – and the rich like to protect their wealth,” he said. “So it’s partly economic, and it’s also partly cultural.” In regard to the higher rates of genetic disease in these societies, he says: “It’s certainly a problem,” but also that “The issue here is not the cousin marriage, the issue here is to avoid the disease.”

Africa

Cousin marriage rates from most African nations outside the Middle East are unknown. It is however estimated that 35–50% of all sub-Saharan African populations either prefers or accept cousin marriages. In Nigeria, the most populous country of Africa, the three largest tribes in order of size are the Hausa, Yoruba, and Igbo. Muslim Hausa practice cousin marriage preferentially, and polygamy is allowed if the husband can support multiple wives. Divorce can be accomplished easily by either the male or the female, but females must then remarry. Even for a man, lacking a spouse is looked down upon. Baba of Karo’s first of four marriages was to her second cousin. She recounts in the book that her good friend married the friend’s first cross cousin.

The Yoruba people are split between Islam and Christianity. A 1974 study analyzed Yoruba marriages in the town Oka Akoko, finding that among a sample of marriages having an average of about three wives. These included not only cousin marriages but also uncle-niece unions. Reportedly it is a custom that in such marriages at least one spouse must be a relative, and generally such spouses were the preferred or favourite wives in the marriage and gave birth to more children. Finally, the Igbo people of southern Nigeria specifically prohibit both parallel- and cross-cousin marriage, though polygamy is common. Men are forbidden to marry within their own patrilineage or those of their mother or father’s mother and must marry outside their own village. Igbo are almost entirely Christian, having converted heavily under colonialism

In Ethiopia the ruling Christian Amhara people were historically rigidly opposed to cousin marriage, and could consider up to third cousins the equivalent of brother and sister, with marriage at least ostensibly prohibited out to sixth cousins. A man marrying a former wife’s “sister” was seen as incest, and conversely for a woman and her former husband’s “brother.” Though Muslims make up over a third of the Ethiopian population, and Islam has been present in the country since the time of Muhammad, cross-cousin marriage is very rare among most Ethiopian Muslims.

South Asia

Attitudes in India on cousin marriage vary by region and culture. For Muslims it is acceptable and legal to marry a first cousin but for Hindus it may be illegal under the 1955 Hindu Marriage Act, though the specific situation is more complex. The Hindu Marriage Act makes cousin marriage illegal for Hindus with the exception of marriages permitted by regional custom. Cousin marriage is proscribed and seen as incest for Hindus in north India. In fact it may even be unacceptable to marry within one’s village or for two siblings to marry partners from the same village but in south India it is common for Hindu’s to marry cross cousins, with matrilateral cross-cousin (mother’s brother’s daughter) marriages being especially favoured. In Mumbai, studies done in 1956 showed 7.7% of Hindus married to a second cousin or closer in contrast to the northern city of New Delhi where only 0.1% of Hindus were married to a first cousin during the 1980s.

India’s Muslim minority represents about 12% of its population (excluding Jammu and Kashmir) and has an overall rate of cousin marriage of 22% according to a 2000 report. Most Muslim cousin marriages were between first cousins with a rate of 20%.

United Kingdom

There has been a great deal of debate in the past few years in the United Kingdom about whether to discourage cousin marriages through government public relations campaigns or ban them entirely. The debate has been prompted by a Pakistani immigrant population making up 1.5% of the British population, of whom about 55% marry a first cousin. There is evidence that the rate of cousin marriage has increased among British Pakistanis from rates in their parents’ generation. Most British Pakistani marriages are arranged, but these can be of two types: conventionally arranged marriages where the bride and groom have little or no say, and what some British Pakistanis describe as “arranged love marriages” where the bride and groom play an important role.

Other regions

In the East, South Korea is especially restrictive with bans on marriage out to third cousins, with all couples having the same surname and region of origin having been prohibited from marrying until 1997. Taiwan, North Korea, and the Philippines also prohibit first-cousin marriage. It is allowed in Japan, though the incidence has declined in recent years. China has banned it since passing its 1981 Marriage Law, yet there is a conspicuous lack of data on actual cousin marriage rates there.

Recent 2001 data for Brazil indicates a rate of cousin marriage of 1.1%, down from 4.8% in 1957. For example, in São Paulo in the mid-19th century the rate of cousin marriage apparently was 16%, but a century later it was merely 1.9%.

Social aspects of cousin marriages

People may think that cousin marriages are more common among those of low socioeconomic status, among the illiterate and uneducated, and in rural areas due to the dowries and bridewealths that exist, but some societies also report a high prevalence among land-owning families and the ruling elite: here the relevant consideration is thought to be keeping the family estate intact over generations.

In South Asia, rising demands for dowry payments have caused economic hardship and have been linked to “dowry deaths” in a number of North Indian states. The increasing number of cousin marriages in the West may also occur as a result of immigration from Asia and Africa and some observers have concluded that the only new forces that could discourage such unions are government bans like the one China enacted in 1981.

Genetics

In April 2002, the Journal of Genetic Counseling released a report which estimated the average risk of birth defects in a child born of first cousins at 1.7–2.8% over an average base risk for non-cousin couples of 3%, or about the same as that of any woman over age 40. In terms of mortality, a 1994 study found a mean excess pre-reproductive mortality rate of 4.4%, while another study published in 2009 suggests the rate may be closer to 3.5%. Put differently, first-cousin marriage entails a similar increased risk of birth defects and mortality as a woman faces when she gives birth at age 41 rather than at 30. Critics argue that banning first-cousin marriages would make as much sense as trying to ban childbearing by older women.

In Pakistan, where there has been cousin marriage for generations and the current rate may exceed 50%, one study estimated infant mortality at 12.7 % for married double first cousins, 7.9 % for first cousins, 9.2 % for first cousins once removed/double second cousins, 6.9 % for second cousins, and 5.1 percent among nonconsanguineous progeny. Among double first cousin progeny, 41.2 % of prereproductive deaths were associated with the expression of detrimental recessive genes, with equivalent values of 26.0, 14.9, and 8.1 % for first cousins, first cousins once removed/double second cousins, and second cousins respectively.

For example because the entire Amish population is descended from only a few hundred 18th century German-Swiss settlers, the average coefficient of inbreeding between two random Amish is higher than between two non-Amish second cousins. First-cousin marriage is taboo among Amish but they still suffer from several rare genetic disorders. In Ohio’s Geagua County, Amish make up only about 10 % of the population but represent half the special needs cases. Similar disorders have been found in the highly polygamous FLDS, who do allow first-cousin marriage and of whom 75 to 80 % are related to two 1930s founders.

A BBC report reported about Pakistanis in Britain where 55% of whom had married a first cousin and many children come from repeat generations of first-cousin marriages. The report stated that these children were 13 times more likely than the general population to produce children with genetic disorders, and one in ten children of first-cousin marriages in Birmingham either died in infancy or would develop a serious disability. The BBC story contained an interview with Myra Ali, whose parents and grandparents were all first cousins. She has a very rare recessive genetic condition, known as Epidermolysis bullosa which will cause her to lead a life of extreme physical suffering, limited human contact and probably an early death from skin cancer. Knowing that cousin marriages increase the probability of recessive genetic conditions, she is against the practice. Finally, in 2010 the Telegraph reported that cousin marriage among the British Pakistani community resulted in 700 children being born every year with genetic disabilities.

The increased mortality and birth defects observed among British Pakistanis may, however, have another source besides current consanguinity. Genetic effects from cousin marriage in Britain are more obvious than in a developing country like Pakistan because the number of confounding environmental diseases is lower. Increased focus on genetic disease in developing countries may eventually result from progress in eliminating environmental diseases there as well.

Public Health in Norway published in March 2007 a research on intermarriage in Norway. The report identifies both the prevalence of intermarriage and the medical consequences for the children. The analysis was done on the basis of data from the Medical Birth Registry, Statistics Norway, Population Register and the Cause of Death Register of data for all persons born in Norway from 1967 to 2005 because Norway is the only country in the world that keeps the statistic numbers between the parents of all born babies. These were the key findings:

Prevalence of intermarriage:

  • In Norway, the most widespread intermarriage can be found among people of Pakistani origin. In first-generation immigrants from Pakistan intermarriage is 43.9% of all children born of parents who are cousins, and the total intermarriage ratio is 54.4%.
  • Among the descendants of first generation immigrants from Pakistan, the proportion of cousin pairs 35.1%, and the total intermarriage ratio 46.5%. Interbreeding units are therefore somewhat lower than in the parental generation.
  • Intermarriage-shares seem to be heading down in the Norwegian-Pakistani population, both first generation immigrants and descendants.
  • Intermarriage is relatively common also among people with origins from Turkey, Iraq, Iran, Sri Lanka, Morocco and Somalia.
  • For people of Norwegian origin, intermarriage is very rare, but it used to be more common a few decades back. This particularly applies to second cousin marriages. In those of Norwegian origin is 0.1% of parental pairs cousins ​​and second cousins ​​0.4% (in the period from 1967 to 2005).

Medical risks of intermarriage
Intermarriage leads to increased risk of stillbirth, infant death and congenital malformations. In addition, there is an increased risk of death right up to adulthood among children of intermarried parents.
For children of cousin marriage is the increase of risk in the following order:

  • Stillbirth: 60%
  • Deaths during the first year: 150%
  • Congenital malformations: 100%
  • Deaths from the age of one year and up to adulthood: 75%

These findings are statistically reliable, and not the result of random variation.

The significance of intermarriage for public health
Since intermarriage is rare in the population as a whole, intermarriage does little for public health in Norway, however, it is a major cause of illness and death among children in the country groups where intermarriage is common.
One must always bear in mind that most children of intermarriage, marriage is healthy and completely normal. Illness and death affects only a small minority of them.

Jewish communities affected by Tay-Sachs

Tay–Sachs disease (TSD, also known as GM2 gangliosidosis or Hexosaminidase A deficiency) is an autosomal recessive genetic disorder. In its most common variant, known as infantile Tay–Sachs disease, it causes a relentless deterioration of mental and physical abilities that commences around 6 months of age and usually results in death by the age of 4. Tay-Sachs is caused by a genetic defect in a single gene with one defective copy of that gene inherited from each parent. The disease occurs when harmful quantities of gangliosides accumulate in the nerve cells of the brain, eventually leading to the premature death of those cells. There is currently no cure or treatment but the Tay–Sachs disease is rare.

Tay-Sachs disease was named after British ophthalmologist Warren Tay, who first described the red spot on the retina of the eye in 1881, and the American neurologist Bernard Sachs of Mount Sinai Hospital, New York who described the cellular changes of Tay-Sachs and noted an increased prevalence in the Eastern European Jewish (Ashkenazi) population in 1887. Research in the late 20th century demonstrated that Tay–Sachs disease is caused by a genetic mutation on the HEXA gene on chromosome 15. These mutations reach significant frequencies in several populations. French Canadians of southeastern Quebec have a carrier frequency similar to Ashkenazi Jews, but they carry a different mutation. Many Cajuns of southern Louisiana carry the same mutation that is most common in Ashkenazi Jews. Most HEXA mutations are rare, and do not occur in genetically isolated populations. The disease can potentially occur from the inheritance of two unrelated mutations in the HEXA gene.

Millions of Ashkenazi Jews have been screened as Tay-Sachs carriers since carrier testing began in 1971. Jewish communities, both in and outside of Israel, embraced the cause of genetic screening from the 1970s on and the increasing number of Tay–Sachs disease led Israel to become the first country to offer free genetic screening and counseling for all couples making Israel a leading center for research on genetic disease. Both the Jewish and Arab/Palestinian populations in Israel contain many ethnic and religious minority groups, and Israel’s initial success with Tay–Sachs disease has led to the development of screening programs for other diseases.

Tay-Sachs has sometimes created an impression that Jews are more susceptible to genetic disease than other populations. Sheila Rothman and Sherry Brandt-Rauf, of Columbia University’s Center for the Study of Society and Medicine, have criticized this emphasis on ethnic identity in the study of disease. When several breast cancer mutations were discovered in the 1990s, the TSD model was applied, both consciously and inadvertently. Researchers had initially focused on breast cancer cluster families, not on ethnic groups. But because thousands of stored DNA samples were available from Tay-Sachs screening, researchers were quickly able to estimate the frequency of newly discovered mutations in Ashkenazi Jewish populations.

Inbreeding in the Royal and Nobel families

The family relationships of royalty are usually well known to be highly inbreeded. Royal intermarriage was mostly practised to protect property, wealth, and position.

  • In ancient Egypt, royal women carried the bloodlines and so it was advantageous for a pharaoh to marry his sister or half-sister. Normally the old ruler’s eldest son and daughter (who could be either siblings or half-siblings) became the new rulers. All rulers of the Ptolemaic dynasty from Ptolemy II were married to their brothers and sisters, to keep the Ptolemaic blood “pure” and to strengthen the line of succession. Cleopatra VII (also called Cleopatra VI) and Ptolemy XIII, who married and became co-rulers of ancient Egypt following their father’s death, are the most widely known example of brother and sister marriage.

The family-tree of Charles II of Spain shows an extraordinary number of uncle-niece and cousin unions of varying degrees that can be seen on the picture.

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  • Among European monarchies Jean V of Armagnac formed a rare brother-sister relationship. Also other royal houses, such as the Wittelsbachs had marriages among aunts, uncles, nieces, and nephews. The British royal family had several marriages as close as the first cousin, but none closer.
  • The most famous example of a genetic disorder aggravated by royal family intermarriage was the House of Habsburg, which inmarried particularly often. Famous in this case is the Habsburg jaw/Habsburg lip/Austrian lip typical for many Habsburg relatives over a period of 6 centuries. The condition progressed through the generations to the point that the last of the Spanish Habsburgs, Charles II of Spain, could not properly chew his food.
  • Besides the jaw deformity, Charles II also had a huge number of other genetic physical, intellectual, sexual, and emotional problems. It is speculated that the simultaneous occurrence in Charles II of two different genetic disorders: combined pituitary hormone deficiency and distal renal tubular acidosis could explain most of the complex clinical profile of this king, including his impotence/infertility which in the last instance led to the extinction of the dynasty.
  • The most famous genetic disease that circulated among European royalty was haemophilia. Because the progenitor, Queen Victoria, was in a first cousin marriage, it is often mistakenly believed that the cause was consanguinity, however, this disease is generally not aggravated by cousin marriages, although rare cases of haemophilia in girls (though not including Victoria) are thought to result from the union of haemophilic men and their cousins.
  • Intermarriage within European royal families has declined in relation to the past. Inter-nobility marriage was used as a method of forming political alliances among elite power-brokers and these ties were often sealed only upon the birth of progeny within the arranged marriage. Marriage was seen as a union of lines of nobility, not of a contract between individuals as it is seen today.
  • Some Peruvian Sapa Incas married their sisters. The Inca had an unwritten rule that the new ruler must be a son of the Inca and his wife and sister. He then had to marry his sister (not half-sister), which ultimately led to the catastrophic Huáscar’s reign, culminating in a civil war and then fall of the empire.

Queen Victoria

Royal dyslexia
When we look at the Norwegian history, marriage between cousins was rare and attempted to be prohibited in 1687 but the exception was the royals. They married relatives to build alliances, and ensure values ​​and positions. It is not different from the today’s cousin marriages except the only difference was that the royal house had a stronger fundamental superstructure that was at the family’s superiority. Monarchical thinking assumes that your place in society is God-given and that your family is predetermined.

King Olav V and Queen Maud of Norway
To keep the heritage in their own hands, the Spanish Habsburgs started to marry more and more within the family. The result was that the lethal inbreeding within a few generations brought the male succession to destruction with 11 royal marriages in 200 years. 9 of these were intermarriages including two marriages between uncles and nieces and four between cousins. As a consequence of this, the Habsburgs suffered stillbirths and deaths of babies. Between 1527 and 1661 there was born 34 children and of these, 10 died before the age of 1 year. Another 17 died before the age of 10.

The Habsburgs last king, Carlos II, was born in 1661 and the Spaniards called him El hechizado, the enchanted. He had a large head and was relatively weak as a baby. He did not learn to speak before he turned four, and learned to walk when he was eight years old and stayed weak and very thin. His first and second wife claimed he was impotent and he would vomit and suffer from diarrhea. As a 30-year-old, King Carlos looked like he was an old man. He also couldn’t manage to bring an heir so the Halsburg Dynasty died with him in 1700.
Scientists have calculated that 25.4% of his gene variants were inherited in double dose and they believe he was hit by two genetic diseases that today are known as CPHD and distal renal tubular acidos (dRTA).

The Danish royal house was struggling with similar problems. Early in the 1800s did not King. Several diseases spread in the European royal houses of the 1800s and the British Queen Victoria’s descendants were affected by haemophilia resulting in her son Leopold death of the disease as 30-year-old. Her daughters, Princess Beatrice and Princess Alice brought the disease to the European royal houses.

Porphyria is another “royal disease” and the British king George III (1760 to 1820) was known as “Mad George” for his madness. Two professors of molecular genetics, Martin Warren and David Hunt of the University of London, examined in the book Purple Secret (1998) a thesis that George III’s illness was porphyria. They followed “Mad George” s genes down to today’s royals, and estimated that the Queen’s cousin William, who died in 1972, suffered from the disease. Also porphyria was brought further into the European royal families.
Norwegian Princess Astrid has been open to and told how she has experienced it to be dyslexic, like King Olaf was and the Princess’ five children also struggling with this problem.
In contrast, Swedish King Carl Gustaf, the Crown Princess Victoria and her brother Prince Carl Philip has been open with the disorder.

Swedish royal family

Camilla Stoltenberg of Public Health in Norway explains:
“If you inherit the gene from one parent, you may get a slight degree of the condition. Inherit it from both mother and father, the stronger the disposition, and then you can get a more serious disorder.” What then is the relationship between intermarriage and dyslexia?
“The chance that you get two identical copies of a gene is higher. This is also true for genes that predispose to dyslexia. And since dyslexia is probably conditioned by many genes, it is also a greater chance that you may have received two copies of several of the dysleksidisponerende genes,” she says.

International World Tuberculosis Day, 24th March

24th March every year is the World Tuberculosis day designed to spread awareness about the global epidemic of tuberculosis and efforts to eliminate the disease. Today, this disease causes the deaths of about 1,6 million people each year, mostly in the third world.

The reason that it is on 24th March is because the day commemorates the day in 1882 when Dr. Robert Koch announced that he had discovered the cause of tuberculosis, the TB Bacillus. By the time of the announcement in Berlin, Europe and Americas was already being raged by the TB-virus causing the death of every one out of seven people.

In 1982, on the 100th anniversary of Robert Koch’s presentation, the International Union Against Tuberculosis and Lung Disease (IUATLD) proposed that March 24th would be proclaimed as an official World TB Day.

Signs and symptoms

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When the disease becomes active in the human body, 75% of the cases are pulmonary TB, that is, TB in the lungs. The symptoms include; chest pain, coughing up blood, and a productive, prolonged cough for more than three weeks. Systemic symptoms include fever, chills, night sweats, appetite loss, weight loss, pallor, and fatigue. Tuberculosis also has a specific odour attached to it; this has led to trained animals being used to vet samples as a method of early detection.

In the other 25% of active cases, the infection moves from the lungs, causing other kinds of TB, collectively denoted extra pulmonary tuberculosis. This occurs more commonly in immunosuppressed persons and young children. Extra pulmonary infection sites include the pleura in tuberculosis pleurisy, the central nervous system in meningitis, the lymphatic system in scrofula of the neck, the genitourinary system in urogenital tuberculosis, and bones and joints in Pott’s disease of the spine.

Causes

The cause of TB, Mycobacterium tuberculosis (MTB), is a small aerobic non-motile bacillus. High lipid content of this pathogen accounts for many of its unique clinical characteristics. It divides every 16 to 20 hours, an extremely slow rate compared with other bacteria, which usually divide in less than an hour.

Epidemiology

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A third of the world’s population has been infected with M. tuberculosis, and new infections occur at a rate of one per second. However, not all infections with M. tuberculosis cause TB disease and many infections are asymptomatic. In 2007, an estimated 13.7 million people had active TB disease, with 9.3 million new cases and 1.8 million deaths; the annual incidence rate varied from 363 per 100,000 in Africa to 32 per 100,000 in the Americas. Tuberculosis is the world’s greatest infectious killer of women of reproductive age and the leading cause of death among people with HIV/AIDS.

In 2007, the country with the highest estimated incidence rate of TB was Swaziland, with 1200 cases per 100,000 people. India had the largest total incidence, with an estimated 2.0 million new cases. The Philippines ranks fourth in the world for the number of cases of tuberculosis and has the highest number of cases per head in Southeast Asia. Almost two thirds of Filipinos have tuberculosis, and up to an additional five million people are infected yearly. In developed countries, tuberculosis is less common and is mainly an urban disease. In the United Kingdom, the national average was 15 per 100,000 in 2007, and the highest incidence rates in Western Europe were 30 per 100,000 in Portugal and Spain. These rates compared with 98 per 100,000 in China and 48 per 100,000 in Brazil. In the United States, the overall tuberculosis case rate was 4 per 100,000 persons in 2007. In Canada tuberculosis is still endemic in some rural areas. The incidence of TB varies with age. In Africa, TB primarily affects adolescents and young adults, however, in countries where TB has gone from high to low incidence, such as the United States, it is mainly a disease of elder people, or of the immunocopromised.

What are the main causes of TB?

There are a number of known factors that make people more susceptible to TB infection such as HIV. Co-infection with HIV is a particular problem in Sub-Saharan Africa, due to the high incidence of HIV in these countries. Smoking more than 20 cigarettes a day also increases the risk of TB by two to four times. Diabetes mellitus is also an important risk factor that is growing in importance in developing countries. Other disease states that increase the risk of developing tuberculosis are Hodgkin lymphoma, end-stage renal disease, chronic lung disease, malnutrition, and alcoholism.

Diet may also modulate risk. For example, among immigrants in London from the Indian subcontinent, vegetarian Hindu Asians were found to have an 8.5 fold increased risk of tuberculosis, compared to Muslims who ate meat and fish daily. Although a causal link is not proved by this data, this increased risk could be caused by micronutrient deficiencies: possibly iron, vitamin B12 or vitamin D. Further studies have provided more evidence of a link between vitamin D deficiency and an increased risk of contracting tuberculosis. Globally, the severe malnutrition common in parts of the developing world causes a large increase in the risk of developing active tuberculosis, due to its damaging effects on the immune system. Along with overcrowding, poor nutrition may contribute to the strong link observed between tuberculosis and poverty.

Prisoners, especially in poor countries, are particularly vulnerable to infectious diseases such as HIV/AIDS and TB. Prisons provide conditions that allow TB to spread rapidly, due to overcrowding, poor nutrition and a lack of health services. Since the early 1990s, TB outbreaks have been reported in prisons in many countries in Eastern Europe. The prevalence of TB in prisons is much higher than among the general population, in some countries as much as 40 times higher.

Robert Koch

Heinrich Hermann Robert Koch (11 December 1843 – 27 May 1910) was a Prussian physician. He became famous for isolating Bacillus anthracis (1877), the Tuberculosis bacillus (1882) and the Vibrio cholerae (1883) and for his development of Koch’s postulates. He was awarded the Nobel Prize in Physiology or Medicine for his tuberculosis findings in 1905 and considered one of the founders of microbiology,

Heinrich Hermann Robert Koch was born in Clausthal, Prussia one of the German states as the son of a mining official. He studied medicine under Friedrich Gustav Jakob Henle at the University of Göttingen and graduated in 1866. He then served in the Franco-Prussian War and later became district medical officer, Wollstein (Wolsztyn), Prussian Poland. Working with very limited resources, he became one of the founders of bacteriology, the other major figure being Louis Pasteur. After Casimir Davaine showed the direct transmission of the anthrax bacillus between cows, Koch studied anthrax more closely. He invented methods to purify the bacillus from blood samples and grow pure cultures. He found that, while it could not survive outside a host for long, anthrax built persisting endospores that could last a long time. These endospores, embedded in soil, were the cause of unexplained “spontaneous” outbreaks of anthrax. Koch published his findings in 1876, and was rewarded with a job at the Imperial Health Office in Berlin in 1880. In 1881, he urged the sterilization of surgical instruments using heat.

In Berlin, he improved the methods he used in Wollstein, including staining and purification techniques, and bacterial growth media, including agar plates (thanks to the advice of Angelina and Walther Hesse) and the Petri dish, named after its inventor, his assistant Julius Richard Petri and these devices are still used today. With these techniques, he was able to discover the bacterium causing tuberculosis (Mycobacterium tuberculosis) in 1882 (he announced the discovery on 24 March). Tuberculosis was the cause of one in seven deaths in the mid-19th century.

In 1885, he became professor of hygiene at the University of Berlin, then in 1891 he was made Honorary Professor of the medical faculty and Director of the new Prussian Institute for Infectious Diseases (eventually renamed as the Robert Koch Institute), a position from which he resigned in 1904. He started traveling around the world, studying diseases in South Africa, India, and Java. He visited what is now called the Indian Veterinary Research Institute (IVRI), Mukteshwar on request of the then Government of India to investigate on cattle plague. The microscope used by him during that period was kept in the museum maintained by IVRI. Probably as important as his work on tuberculosis, for which he was awarded a Nobel Prize (1905), are Koch’s postulates, which say that to establish that an organism is the cause of a disease, it must be:

  • found in all cases of the disease examined
  • prepared and maintained in a pure culture
  • capable of producing the original infection, even after several generations in culture
  • Retrievable from an inoculated animal and cultured again.

Koch’s pupils found the organisms responsible for diphtheria, typhoid, pneumonia, gonorrhoea, cerebrospinal meningitis, leprosy, bubonic plague, tetanus, and syphilis, among others, by using his methods.

Robert Koch died on 27 May 1910 from a heart-attack in Baden-Baden, aged 66.

Source info; Wikipedia

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