Sunday, August 28, 2005

The Road to Oblivion

Culture is the intellectual version of inbreeding. What happens when culture demands sexual inbreeding as well as intellectual inbreeding? We include articles on diabetes in Arabia, albinism in Egypt, FGM in the Gulf, and a survey of birth defects across the Arabian Islamic world. Our conclusion is that Arabia is facing, aside from military annihilation by the West, its worst scenario in itself, its own inability to adapt to the physical world due to its totalitarian fetish of Islamic and tribalist intellectual inbreeding.

As the Islamic populations continue to rise, as some Islamic states continue to rely on rentier incomes from unearned oil revenue, and as other Islamic nations survive on foreign aid while at the same time biting the hands that feed them, the Islamic world faces a crisis of implosion: The populations rise while the content of their economies is a vacuum; they strive for further indulgences in phantasy ideologies at the expense of rational economies; and they risk provoking the militarily, economically, and intellectually superior Western world into self-defensive war.

Because of the irrationality of the Islamic cultural world-view, based as it is on the tenets of fascism, regardless of how primitive, they cannot act in their own best interest. Without endless and increasing foreign aid, without foreign technology, without foreign compassion, the Islamic world will collapse of its own internal rot.

It is our clearly stated thesis that the Islamic world is beyond hope of self-recovery from its current condition, and that only massive foreign intervention by way of and means of colonialism and intermarriage with the indigenous population will save the world Islamic population from extinction. If the West does not invade, conquer, and rule the Islamic world, that same Islamic world will continue to commit its own genocide, turning itself into a sand diorama.

For those who would shrug, let us point out that the public health risk of such a massive depletion of the world's population within the space of a mater of some few months would lead inevitably to plagues the like of which the world has never witnessed. It's not merely immoral, therefore, to allow the continued disaster of Islam, it is imprudent. And if that isn't sufficient to motivate a change of thought on the subject of the world's relationship with Islam, let us point out further and more immediate self-interest: The Islamic world is underdeveloped in all ways, emotionally, socially, culturally, technologically, economically, and by any other civilized measure one cares to apply to it. That alone supports the idea of invasion by superior forces to fill the vacuum, opportunities to amass wealth and power while, perhaps as an unintended benefit, one might well save a large part of the Human race.

Below we have some pieces on medical conditions that arise from culture and tradition. Physical sickness is a mental conditon that often arises from lack of thought itself. In some cases, one must assume that without a change of mental direction in culture, the road to the future leads to oblivion.

Diabetes 'a ticking timebomb' in Gulf

Dubai |By Mona Ahmed, Staff Reporter | 20-01-2004

Diabetes in the Gulf is a timebomb ticking down to a massive explosion, unless policy makers take a grip of the disease.

This was the stark warning issued here yesterday by a doctor who said as much as 50 per cent of the local Arab population in the Gulf states is at risk of suffering diabetes-related diseases.

In the UAE, Kuwait and Bahrain, up to one third of the population is obese, and at current levels half of them will get diabetes type two, according to Dr Oussama Khatib, regional advisor on non-communicable diseases for the World Health Organisation in Egypt.

Speaking during the Arab Health Congress, he said diabetes is the fourth largest cause of death in the region, and action from policy makers is needed now to stop deaths from this manageable disease.

He added that there are few health professionals qualified to deal with the disease in the region, and there is a great and urgent need for not only 'diabetologists', but also diabetic educators, nutritionists and even chiropodists, one who treats feet and their ailments.

He presented a paper at Arab Health 2004, the Middle East's leading exhibition and conference on hospital services and medical equipment being held at Dubai International Exhibition Centre (DIEC) until January 21.

"This region has more than 3.5 million diabetes type two sufferers and children as young as ten are being diagnosed with the disease due to obesity, coupled with physical inactivity, an unhealthy diet and hypertension," Dr Khatib pointed out.

"This problem is now at pandemic proportions, and is a great burden in terms of cost. This is no longer a problem for the individual sufferer, it is a problem for society, for government, it's a huge social challenge," he added.

He called on policy makers to introduce immediate public health programmes to increase awareness of the disease, "which is both preventable and manageable".

But in extreme cases, diabetes type two can result in blindness, kidney failure, amputations and death.

"Effective preventative solutions exist, but these are not being rationally or widely used in the region. While special treatment centres exist, most of them are beyond the reach of ordinary people, and there are still people in the wider region dying of the disease for want of insulin.

"If not addressed now, this will become the most expensive health problem ever faced by regional health care services," he added.



I invite you all to experience the magical world that is the Siwa Oasis. We wish to share our rich tradition and culture with you.
We originate from the North African Berber tribes known as Amazigh. We are the Siwan Berbers. Because of our geographical isolation we have remained relatively unchanged. (To learn more about individual families please click on the family tree)

We live in a tribal system. This is broken up into two main groups, the East tribe and the West tribe. There are ten tribes within these two groups and one group lives in El Gara.

The leader of each group is the the chief we know as Amazigh Agleed, or as the Sheikh, the head of the family. He leads the family council of ten members, all respected elders of the tribe. He personally settles problems within the family group and also gives advice to other tribes. In this way, harmony, respect and close relationships are maintained both within the family tribe and co-existing tribes.

In the case of disputes between members of different tribes, the respective sheikhs arbitrate using the Siwan law and the Koran. Admonishments may be beatings, the giving of alms, fines or banishment from the tribe. If the problem is connected with the land, a special committee will gather and decide the land rights using old papers relating to the land. Some of these important papers are more than one hundred years old.

The Egyptian police also work in cooperation with the Sheikh when appropriate. The young are brought up to respect their elders and the Sheikh is respected by all. A child pretending to be an adult by doing what grown-ups do is chastised by being called 'Agleed'. It is a society where everyone has a place.

The Siwan people have a different perspective on life from other Egyptians. It is a mentality based on the tribal family. We marry within our own tribe as this is our preferred way. In this way we preserve the integrity of our community. However there are drawbacks to this as it can lead to genetic problems such as albinos.

We live a healthy life in the oasis. We help each other. There is nothing that we will not do for each other. In times of hardship we will give help and money. If one of us is punished then we help each other pay the fine or it may well be that the fine is not required as long as an apology has been given. We forgive each other.

Wealthier individuals will assist those who are less fortunate and will do this unobtrusively by setting up covenants. At Ramadan and after the Eid el Fitr and the Eid el Adha alms are given. These are also occasions of great celebrations. For more details click on the menu.
FGM in Arabia:

In many countries in Africa, in Oman, Yemen and in the United Arab Emirates, clitoridectomies (the surgical removal of the clitoris) are quite commonly performed on girls. There are several different procedures, but all of them are exceedingly painful and mutilating. The risk of infection is often very high, and girls do die from complications. These operations are generally performed between infanthood and adolescence. There are many intricately ensnarled reasons for female circumcision, including traditional customs, religious beliefs, curbing sexual desire, protecting virginity and preventing immorality. Female circumcision, as anyone can imagine, seriously impedes or totally extinguishes any potential enjoyment of sex for the woman (4).
A study of possible deleterious effects of consanguinity.

Abdulrazzaq YM , Bener A, al-Gazali LI, al-Khayat AI, Micallef R, Gaber T.

Department of Paediatrics, Faculty of Medicine and Health Sciences, UAE University, United Arab Emirates.

The aim of the study was to determine whether consanguineous marriages result in reproductive wastage and an increased incidence of illness in the offspring in a community with a long history of inbreeding and an expected high rate of consanguineous marriage. A representative sample of 2200 women aged > or = 15 years from Dubai and Al Ain, two cities in the United Arab Emirates, representing on the one hand a modern metropolis and on the other a traditional society, were studied. A questionnaire, which included questions on age, parity, gravidity, number of stillbirths, number of abortions, number of children alive, neonatal deaths and specific illnesses in children, was administered by nurses in antenatal and gynaecological clinics in the two cities. The rate of consanguineous marriage was 50.5% and parity, gravidity, ages and number of children were similar in consanguineous and non-consanguineous groups. There was no significant difference in rates of abortion, stillbirth and neonatal death between the two groups. Overall, there was statistically significant higher reproductive wastage in consanguineous couples, but when the category of less than second cousins was excluded from the consanguineous group no difference was found in reproductive wastage between consanguineous and non-consanguineous marriages. Children born to consanguineous unions also had significantly higher incidences of illnesses (37.1%) than those of non-consanguineous unions (29%). The occurrence of malignancies, congenital abnormalities, mental retardation and physical handicap was significantly higher in offspring of consanguineous than non-consanguineous marriages. In conclusion, consanguinity did not result in reproductive wastage, but was found to be an important factor in the causation of specific illnesses in offspring.

Inbreeding and genetic disorder among Arab population

The custom of inbreeding is as ancient as the history of the human life. In fact, it was not an exception among hunter homo sapiens; it was the rule. However, humans learned from experience of its devastating affect upon the offspring. For example, none of the male children of pharaoh Akhenaton that were born out of consanguineous marriages survived. Later, Moses prohibited the marriages between siblings, mother ≠son and father ≠daughter (Thornill, 1993), a very courageous step in a population that had long embraced inbreeding.

The practice of interfamily mariage is still relatively common among Arabs because of the structure of the Arabic society. Nomadic people (Bedouins) do not really have the chance to mix with others. They are organized in tribes based on common ancestry, and when it comes to marriage, the only opportunity is to inbreed (Teebi, 1993). This social structure is common in the Arabic desert in countries like Kuwait. On the other hand, among the agricultural communities, inbreeding also commonly takes place but for different reasons. There it is favored because it ensures the unity of lands. Inheritance of land by males and females is kept within the same family, and this is of great importance for peasants because small pieces of land are inefficient in agricultural economies. This pattern is common among Lebanese, Egyptians, Palestinians, and Jordanians (Klat et al., 1984).

The consequence of consanguinity in the Arabic population is worse than typical. Although Arabs are usually identified as Caucasians, modern Arabic populations especially in Egypt, Palestine, Jordan and Lebanon, are the result of a long history of blending with different human races (Der Kalustian et al., 1980). Arabs, Africans, Europeans, and other Asian people intermarried during wars, mass migrations, trade and religious practices (pilgrimage). All in all, this kind of "out breeding" rendered Arabic populations more susceptible to genetic disorders when comes to consanguinity; because out breeding introduced different deleterious recessive alleles common among other populations beside those alleles already common among Arabs.

The impact of consanguinity is that it increases the inbreeding coefficient (Thornill et al., 1993). Thus, the chance that an individual will inherit two alleles identical by descent increases. In other words, the frequency of homozygosity increases, while the frequency of heterozygosity decreases. Because recessive disorders phenotypes are only manifested in the homozygous state, their incidence increases in inbreeding populations. In the following section, Iπll discuss the degree of consanguinity and inbreeding coefficient in different Arabic populations.


In a study by Khoury et al., 1992, the frequency of consanguinity in Jordan was determined to be 50.33%. The average inbreeding coefficient was 0.0225. Interestingly, the study showed that male education didnπt have much effect on consanguinity. Fourty percent of university graduate males had consanguineous marriages. However, female education seems to be mare important. Only 20% of university graduate females were married to relatives. This study also demonstrated a regressive pattern of inbreeding.A 30% consanguinity rate early in the 20th century increased at the end of the century to 50%. The pattern was also independent of religious beliefs as both Christians and Muslims showed similar results. The types of genetic diseases will be illustrated for later but basically they are very common.


The Kuwaiti population is made up of Kuwaiti natives and Bedouins (40%), and immigrants from other Arabic countries and southeastern Asia (60%) (Al- Awadi et al., 1985). The incidence of consanguinity was 54.3% among Kuwaiti natives and higher among Bedouins. The average inbreeding coefficient was at least 0.0219.

Table I: The frequency of some genetic diseases in Kuwait compared to other countries. (Al-awadi et al, 1985) (OMIM) (Farag et al, 1983) (Teebi et al, 1994) (Zatz et al, 1989)

Disease Kuwait Others

Bardet-Beidel Syndrome +

Laurence Moon Syndrome 1/50000 Switzerland: 1/150000

Meckelπs Syndrome 1/3530 Finland (na)

Duchene Muscular Dystrophy 1/ 3 of Muscular Dystrophy USA: 5% of M D

PKU 1/6479 USA+Europe:1/11000

Table I. shows the relatively common recessive disorders among the Kuwaiti population. These cases were diagnosed among Palestinians, Jordanians, Egyptians, Lebanese; as well as Kuwaitis. Thus, they might be considered representatives of these communities. Noticeable here is the higher incidence of genetics diseases even when compared to high-frequency groups. Other genetic diseases especially high in Kuwait include Cystinuria, Spinal Muscular Atrophy, Werdnig-Hoffmann G M1 Gangliosidosis and Gaucher disease type 1.Besides, there are disorders that are endemic to the Mediterranean and gulf area like Familial Mediterranean Fever (FMF) and Thalessaemia.


The average consanguinity rate is 28.96% with an average inbreeding coefficient of 0.010.A higher incidence of consanguinity is found in rural areas (Abdel-Gafar et al., 1983). This consanguinity rate, though lower than other Arabic countries, is still very high.

The Egyptian population has a high frequency of several genetic disorders such as Adrenal Hyperplasia, FMF, PKU, etc (Barakat et al., 1986). All of these are recessive traits. Thus, again, high rates of consanguinity lead to a higher incidence of recessive disorders.


The data about Lebanon is especially interesting. It shows a consanguinity of 18% (Der Kalustian). Another study shows a higher consanguinity incidence of 26% (Teebi, 1994). But the second one was done on Lebanese workers in Kuwait. Both studies, however, demonstrated a lower incidence among Christians than among Muslims. In general, the Lebanese community is almost completely divided into subpopulations of Druze, Sunnites, Shiites (Muslim denominations) and Maronites, Greek Orthodox, Armenians (Christian denominations). Christians (about 50% of Lebanese) have a consanguinity incidence of 10% of the general population, the rest are among Muslims 90%. Despite the lower percentage of consanguinity, Lebanese still show higher incidence of genetic diseases including FMF, familial Hyperplasia, Glucose-6-Phosphate dehydrogenase deficiency, sickle cell anemia and Thalessaemia ( Der Kalustian et al., 1980). This is consistent with a high frequency of recessive disorders in the general population.

Types and Reasons Behind Consanguinity:

Among Muslims and Christians, the most common type of consanguinity is between first cousins especially from the paternal side (Teebi, 1994) (Al-Nassar et al., 1989). In fact, a common Lebanese way of complimenting the spouse is to call her/him "cousin"(Der Kalustian et al., 1980). In addition, marriages within the extended family are also common especially in villages and among Bedouins. However, aunt-nephew and uncle-nice marriages as practiced by Jews from Arabic origin, are prohibited by Islam and by state laws (Teebi et al., 1988). Genetically speaking, aunt-nephew and uncle-niece marriages result in the same inbreeding coefficient of double first cousin marriages (F=1/8) (Abdel-Gafar et al., 1983).

The question is why does the practice of consanguinity persist among Arabs in face of severe genetic consequences. Several factors might be involved here including religion, education, socioeconomic status and culture.

To begin with, most Arabs are Muslims. Many researchers tend to conclude from religious studies that Islam discourages consanguineous marriages (Teebi, 1994). I think Islam is in theory equivocal about this issue. There is a very clear teaching from Prophet Mohammed encouraging people to outbreed. On the other hand, he was very proud of his tribe. One might deduce here that oneπs tribe is favored especially when it comes to marriage.

The data from Lebanon show a significant difference in the incidence of consanguinity between Christians and Muslims (Der Kalustian et al., 1980). However, most Lebanese Christians (Maronites and Armenians) do not identify themselves as Arabs. Clearly, they have different origins and cultural practices. In Jordan, however, consanguinity rates among Christians and Muslims are very similar (Khoury et al., 1992). Besides, the practice is also common among Jews of Arabic origin (Stark et al., 1984). Thus, religion is at least not the single determinant of consanguinity rate.

Another consideration is educational level. I initially thought lack of education was the reason behind consanguinity. However, the data, especially from Jordan, demonstrated that the phenomenon is independent of the degree of education. For instance, university graduates showed a consanguinity rate of 40%, which is close to that of illiterates 44%. Nevertheless, in urban populations, that traditionally have higher degree of education, there is a lower occurrence of consanguinity than among suburban and rural populations. All in all, the relationship between consanguinity rate and educational level remains indirect and thus inconclusive.

I think the consanguinity problem is culturally based. Arabs previously lived as either nomads or as peasants in agricultural villages. Both styles of living, as I mentioned before, have their reasons to inbreed. As people moved toward urban cities in the 20th century, the pattern in cultural practices and inherent mentality remained untouched. Urbanization didnπt challenge the mentality of the old out-dated system, and it didnπt offer any alternative. In fact, it even strengthened the practice with the development of modern statehood in the Arabic countries (in Jordan for example). Political leaders didnπt legitimize their rule based on public consent, elections or economic development, but rather based on the power of their tribes or tribal allies. This tradition has had a great negative impact on the general population.


The high rate of consanguinity increases the inbreeding coefficient, and the frequency of genetic disorders in Arabic populations. This effects health, psychological state and economic status of many unfortunate families, and it has implications on the whole population. I thought level of education was a key causative element. But to my disappointment, It is not. Clearly, The roots of this problem go deeper. And regardless of the reasons behind it, there has to be an effort at least in the medical field and population genetics to evaluate the situation. There is a lack of research and information concerning the problem. I wasn't able to find the frequencies of endemic genetic disease in the area like thalassemia. Besides, genetic screening has to become both available and mandatory for effected families. Finally, premarital genetic counseling could be of great importance in helping young couples understand the high risk associated with consanguineous marriages.

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