Pre-marital medical testing on hold for now [Archives:2008/1152/Health]

May 5 2008
Pre-marital medical testing helps families ensure that their children will be free of infectious diseases and hereditary diseases.
Pre-marital medical testing helps families ensure that their children will be free of infectious diseases and hereditary diseases.
Jamal Al-Najjar
For the Yemen Times

Doctors confirm that pre-marital medical tests help prevent both infectious and hereditary diseases that threaten the lives of Yemeni children, but parliamentarians think it's too soon to implement a law forcing engaged couples to take such tests.

Pre-marital medical testing was part of the Safe Motherhood Law, which the Yemeni Parliament vetoed a few weeks ago. According to Member of Parliament Zaid Al-Shami, the veto was due to lack of proper health care services, particularly in rural areas, in addition to low levels of education.

“Because Yemen has a lack of doctors, labs and medical facilities, it's nonsense to approve a law preventing a couple from marrying unless they are certified as disease-free,” Al-Shami said, noting that young people can be encouraged to have these check-ups as an option to secure both their and their future children's well-being.

Dr. Najeeb Ghanim, head of Parliament's population and public health committee, says pre-marital testing is vitally important because it helps families ensure that their children will be free of disease.

“It's better for families to do these medical check-ups before marriage. If the tests show that one or both of them has a curable disease, they must get treated before marriage,” Ghanim explained.

“However, if they are found to have hereditary diseases, they must stop the marriage and marry into a different family, thereby protecting their future offspring from any potential hereditary diseases.”

Ghanim worries that partners will regret their marriage if they see their children suffering chronic or fatal diseases. Pre-marital medical testing can search out both infectious diseases, such as hepatitis and HIV, as well as hereditary diseases like sickle cell anemia and thalassemia, both of which are blood diseases resulting from hemoglobin abnormalities.

He further asserted that Parliament vetoed the Safe Motherhood Law's pre-marital testing component due to lack of awareness by its members, saying, “MPs don't realize the importance of such medical issues and as a result, they are unjustifiably apprehensive that the law will stall, particularly in rural areas.”

Ghanim added that the proposed law stipulated that pre-marital testing would only apply 10 years after the law's approval because “This period is enough to launch extensive awareness campaigns on the importance of pre-marital testing on one hand and improve health care services on the other,” he noted.

Lawmakers aren't the only skeptics, with marriage contractors also opposing such enforced pre-marital testing at this time. “Medical centers in rural areas lack most health services, including medical check-ups, so it would be extremely difficult to force citizens there to do these tests before marriage,” observed Ali Ismail Al-Hirdi, a marriage contractor and property document manager in Ibb governorate's Wadi Hilal region.

Al-Hirdi also warned of the results of such testing. “If a girl does a medical test, such as for hepatitis A, and the result is positive, the engagement may end and the girl may remain single forever because people think hepatitis A is a fatal and incurable disease, although this isn't true,” he said, noting, “Such a disease can be treated easily, but people aren't aware of this.”

Pediatrician and Sana'a University pediatrics professor Lutf Al-Zubairi points out that many Yemeni children suffer hereditary diseases, particularly thalassemia and sickle cell anemia, which often can be staved off by avoiding intermarriage among family members.

“Some families are infected with a particular hereditary disease. We advise these families not to intermarry with each other because with these hereditary diseases, if the mother or father is a carrier of the disease, [there is] at least a 25 percent chance their children will be infected with it,” Al-Zubairi explained.

He went on to say that pre-marital testing can help prevent these diseases – if families respond to doctors' advice – noting that hereditary diseases have a higher rate of transmission if both parents are carriers of the disease. Marrying outside of the same family means children have a better chance of being in good health.

Still, Al-Zubairi acknowledged that the availability of premarital testing remains limited and that enacting a law about it now would be premature. “Before pre-marital testing becomes obligatory by law, there should be studies to consider Yemen's health situation, increase public awareness about the importance of these tests and provide qualified working staff at medical facilities,” he said.

“Once hospitals and medical centers are sufficiently qualified to conduct these tests and citizens are aware and ready to take them, then a law can be made requiring pre-marital testing,” Al-Zubairi said, adding that he thinks the government should pay for such testing so that all citizens may access it.

Dr. Fatima Al-Shaibani, head of Al-Saba'een Hospital's pediatric emergency unit, says most families are aware that they have the potential to pass on health problems to their children, but still insist on marrying inside the family anyway. “We see many cases involving hereditary diseases, such as thalassemia and sickle cell anemia,” she commented.

“We warn against marrying from within the same family because their offspring will be subjected to many serious hereditary diseases, but unfortunately, most daughters are engaged to their cousins from the same family.”

Like Al-Zubairi and others, Al-Shaibani recommends launching a large and comprehensive educational outreach to inform Yemenis about the risks of intermarriage.