heltha

|| DR ZAFAR IQBAL & MUBASHIR GULL

Abstract          

          Consanguineous marriage is widely preferred among Muslims in any part of the world. Studies have shown that consanguineous marriage significantly increased the number of births of exceptional children. The aim of the study was to see the role of consanguineous marriage in the disability and clinical profile of differently- abled in Kashmir. A total of 120 differently-abled case histories were taken from CRC (Department of Rehabilitation Psychology). Out of 120, 59.2 percent (71) were male and 40.8 percent (49) were female differently-abled children. The mean age of the patient was 8 years.

        The results show’s that out of 120 patients only 45 patients (37.5 percent) were of parents having consanguineous marriage whereas most of the patients (75) (62.5 percent) were of parents having non-consanguineous marriage. This indicates that besides consanguineous, non- consanguineous marriages are equally responsible for the birth of a disabled-child. The result further shows that the chief complaints of the differently-abled in general are that most of them are dependent in ADL’s (Activity Daily Living’s) and have physical and cognitive problem.

Differentl-Abled

     The term differently-abled was first coined by US democratic national committee in 1980s as an alternative term used to refer disabled and handicapped conditions. It was introduced with the belief that it would give a positive message and may help to avoid discrimination with disabled ones. Person with Disability Act, (1995), defines disability as persons suffering from not less than 40 percent of any kind of disability certified by a medical authority. There are several kinds of disabilities such as mental retardation, cerebral palsy, learning disability, hearing impairment, visual impairment, multiple disability and locomotor disability. The cause of disabilities may be congenital/ hereditary or acquired/ environmental. Congenital causes are spinal cord injuries like spinal bifida, cerebral palsy and muscular dystrophies. Acquired causes of disabilities include road traffic accidents, war, sports injuries etc.

Consanguineous marriage:

        Consanguineous marriage is the marriage between two people who share an ancestor. In this marriage couples must at least have one ancestor in common. These types of marriages are common in many families especially among Muslims and Dravidian Hindus of Southern India. In these societies, marriages are often between a man and his parent’s sibling’s daughter. Korotayev (2000) found a universal feature of societies where consanguineous marriage, specifically Father Brother’s Daughter marriage, is prevalent – Islamization and inclusion in the eighth century Arab-Islamic Khalifate with the latter being a stronger predictor of consanguineous marriage within a given society. Othman, Hasan and Sadat (2009) found that 30.3 percent of marriages in urban areas of Syria were consanguineous in nature whereas, 39.8 percent of marriages in rural areas were consanguineous.

         First cousin marriages were the most popular form of consanguineous marriage representing 20.9 percent of consanguineous marriages. Patrilateral parallel cousin marriage (FBD marriage) was most popular followed by matrilateral parallel cousin marriage and finally cross-cousin marriage. Khoury & Massad (1992) found that religion plays an important role in the first cousin marriages occurring among Muslims. They also found that these marriages were typically prearranged. Al-Abdullulkareem, Abdulkareem & Ballal (1998) Conducted a cross-sectional study in Saudi and found 52.0 percent of marriages were found to be consanguineous with 20.4 percent being first cousin marriages and 12.5 percent being double first cousin marriages.

         The rates of consanguineous marriage were relatively constant from 1950 to the present. Mohammadi, Hooman, Afrooz and Daramadi (2012) aimed to identify the role of consanguineous marriage in increasing the fetal and infant deaths. They found that consanguineous marriage significantly increased the number of births of exceptional children. Further the rate of fetal/infant death in exceptional births of consanguineous marriages was higher than that of non-consanguineous marriages. The above studies revealed a strong association between consanguineous marriage and disability. It becomes important to study whether this association in also present in the present sample (Kashmir).

  Objectives of the Study:

    To study the clinical profile of differently abled children in Kashmir (CRC Srinagar). To study the chief complaints of differently abled children in general. To identify the role of consanguineous marriage/non-consanguineous marriage in the birth of a disabled child.

Materials & Methods 

  Study setting:

     The study was conducted in the Composite Regional Centre, Srinagar (J&K). It is a teaching, learning & rehabilitating differently abled institute run by Central government. Besides Srinagar, its catchment areas include the district Budgam, Baramullah, Pulwama, Shopian, Anantnag, Ganderbal and Bandipora. Patients attending the clinical services are accompanied by their parents, relatives and/or family members.

 Sample selection:

  Patients of any age, diagnosed as differently-abled children according to DSM-IV-TR were included in the study. A total of 120 patients were included into the study. Objective data regarding the demographic details and clinical profile of illness was collected from the mothers/fathers in a specialized case history form prepared for the study. The data collected was subjected to statistical analysis.

1. RESULTS & DISCUSSION:
Table 4.1 shows the gender of the differently-abled
Gender      Frequency         Percent
Male               71                       59.2

Female           49                      40.8

Total              120                      100.0

Table 4.1 shows that out of 120 patients, 71 (59.2%) were male
and 49 (40.8%) were female. Below is the graphical representation
of the gender of the differently-abled.

heal1

Figure 1 Gender of the subject

Table 4.2 shows the chief complaints of the differently-abled children

Chief Complaints                    Frequency                     Percent
Valid ADL’s (Dependent)            15                                 12.5
Speech Disorder                           30                                 25.0
Slow learners, ADL’s                   42                                 35.0
Locomotion problem, ADL’s      18                                 15.0
Behavioural Problems                 15                                  12.5
Total                                             120                                  100.0

Table 4.2 shows that the chief complaints of differently-abled were; they are dependent in ADL’s (Activity Daily Livings), some have speech problems, locomotion problem, some are slow learners, and some have behavioral problems (Spitting, hyperactive, aggressive, unusual smile, abusive language, nail biting etc). Below is the graphical representation of the chief complaints of differently-abled children.

heal2

Figure 2 Chief complaints of Differently-abled children

Table 4.3 shows the type of marriage

Type of Marriage                  Frequency              Percent
Valid Consanguineous              45                          37.5
Non-Consanguineous               75                          62.5
Total                                           120                         100.0

Table 4.3 shows that out of 120 patients (differently- abled), 45 (37.5 percent) were from parents having consanguineous marriage and most of the disabilities were reported from parents having non-consanguineous marriages 75 (62.5 percent) The findings have been contracted by Mohammadi, Hooman, Afrooz and Daramadi (2012); Othman, Hasan & Sadat (2009). They found that consanguineous marriage significantly increased the number of births of exceptional children. Further the rate of fetal/ infant death in exceptional births of consanguineous marriages was higher than that of non-consanguineous marriages. Below is the graphical representation of the type of marriage.

hela3

Figure 3 Type of marriage

Table 4.4 shows the different types of disability

Type of Disability                  Frequency                       Percent
Valid MR                                        41                                    34.2
CP                                                     7                                        5.8
Speech Disorder                            13                                     10.8
Multiple Disability                       44                                     36.7
Locomotor Disability                     9                                        7.5
ADHD                                               3                                        2.5
Learning Disability                        3                                         2.5
Total                                              120                                     100.0

Table 4.4 shows the type of disabilities diagnosed by the rehabilitation psychologists during the clinical interview. It can be seen from the above table that out of 120, 44 (36.7 percent) were patients having multiple disability, 41 (34.2 percent) were having mentally retarted, 13 (10.8 percent) were having speech disorder, 9 (7.5 percent) were having locomotor disability, 7 (5.8 percent) were having Cerebral Palsy, 3 (2.5 percent) were having attention deficit hyperactive disorder and 3 (2.5 percent) were having learning disability. Below is the graphical representation of different types of disabilities.

helATH4

Figure 4 Types of disability

2. CONCLUSION

The result shows that the chief complaints of the differently-abled children were; most of them are dependent in ADL’s (Activity Daily Living’s), have speech problems, and have physical and cognitive problem. Earlier studies show an association between consanguineous marriage and birth of a disabled child. Our finding shows no difference between the associations of consanguineous/ non consanguineous marriage in the birth of a disabled child.

3. LIMITATIONS

The data was collected from Composite Regional Center only; depth understanding and better results requires that data should be collected from other rehabilitation centers of the Kashmir valley also.

4. REFERENCES

Al-Abdullulkareem, Abdulkareem, A. & Ballal. S.G. (1998). Consanguineous Marriage in an Urban Area of Saudi Arabia: Rates and Adverse Health Effects on the Offspring. Journal of Community Health, 23(1), 75-83.Khoury, S.A. & Massad. D. (1992). Consanguineous Marriage in Jordan. American Journal of Medicine, 43(5), 769-775. Korotayev, A. (2000). Parallel- Cousin (FBD) Marriage, Islamization, and Arabization. Ethnology 39(4), 395-407. Mohammadi, M. M., Hooman, H. A., Afrooz, H. A., & Daramadi, P. S. (2012). The relationship between consanguineous marriage and death in fetus and infants. Journal of research in medical sciences, 448-451.Othman, Hasan, & Saadat, M. (2009). Prevalence of Consanguineous Marriages in Syria. Journal of Biosocial Science, 41(5), 685-692.The Persons with Disabilities (Equal Opportunities, Protection Rights and full Participation) Act, 1995.