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Re:In Amish village, a rural doctor sees the rarest diseases... by cstross on Saturday November 30, 2019 @05:55AM (#21669458)
... Or the doctor in question could just have moved to Dewsbury, in West Yorkshire.

(n the mid-1980s I made an early career mistake and qualified as a pharmacist. I did my pre-registration work at the -- now closed -- district hospital in Dewsbury, a Yorkshire town of roughly 60,000 people. Dewsbury is in a steep valley and the working-class population tended not to travel: according to an older relative who worked there all his life, he knew co-workers who had been born, worked, lived, and retired in Dewsbury without ever travelling more than ten miles away from their birthplace. (Automobiles didn't really become a mass-cultural phenomenon there until the 1950s-1960s.) Cue lots of first-cousin marriages. During the 1970s, a Pakistani immigrant community arrived ... also from an isolated mountain valley town that didn't have much time for exogamy.

The hospital serving a city of 60,000 people shouldn't have a 30-bed cystic fibrosis ward (CF is an inborn error of metabolism) ... but Dewsbury needed one. (CF has a frequency of roughly 1 in 3000 in Northern Europe, so you'd expect 20 living cases in a town the size of Dewsbury: but they wouldn't need hospital beds simultaneously! The local frequency was much higher.) Nor should it have exotic conditions like familial hypobetalipoproteinaemia showing up in the population. Again, Dewsbury had that. In fact, Dewsbury was so notorious for genetic disorders that house officers and registrars training in the relevant fields got rotated there from the big teaching hospitals in Leeds (the nearest big city).

Upshot: if you get geographically isolated communities with religious cultures that discourage exogamy, you get really weird genetic disorders cropping up within surprisingly few generations.

Re:In Amish village, a rural doctor sees the rarest diseases... by growlist on Saturday November 30, 2019 @07:26AM (#21669669)
Also in Surrey. A relative worked with visually impaired children, one of them of Pakistani heritage and having albinism, and this kid said one day "it's because we marry our cousins". This is one of those situations where the authorities etc. being all cringey and PC about things harms the very people they are trying to protect.
Re:In Amish village, a rural doctor sees the rarest diseases... by cstross on Saturday November 30, 2019 @07:46AM (#21669722)
It's not specific to Pakistan: the same problem tends to be seen in many if not all cultures with a strong dowry tradition. If substantial wealth is transferred with a bride, there's a powerful incentive to marry within the family.

(This used to happen in Europe, but during the middle ages the church banned cousin marriages for political reasons: it stopped the nobility consolidating too much power.)

Re:In Amish village, a rural doctor sees the rarest diseases... by iguy on Saturday November 30, 2019 @08:01AM (#21669775)
It was certainly common for a long time in many places, and still is across what's now the muslim world (although I think it long predates Islam). But I'm not sure dowry tradition is quite the right marker, IIRC it's much less common in Hindu tradition (where the pattern was larger caste groups instead).

But it's certainly a way of concentrating power in the family. And presumably, for a very long time, having lots of grandsons of undivided loyalty was important in conflicts with the neighbouring family/tribe... worth the individual fitness cost (and the extra miscarriages etc -- many of these strange illnesses would of course have killed the child).

Re:In Amish village, a rural doctor sees the rarest diseases... by masklinn on Saturday November 30, 2019 @08:38AM (#21669900)
> still is across what's now the muslim world (although I think it long predates Islam).

It can trivially be seen to have little to do with islam in examples like the House of Habsburg, and the famously ignominous end of the Spanish line. Or orthodox jews (the endogamous set is wider than just a family, but you still see lots of rare genetic conditions crop up, and some jewish communities don't even stray outside of it e.g. Mashhadi jews).

Though it does look related to Arabization.

While first-degree cousin marriage has gotten quite a bit rarer used to be extremely common across the globe, and aside from the middle-east it also remains legal throughout eurasia (except for a few eastern european countries and notably china where it's entirely banned and india where it's dependent on culture and religion) and south america

> IIRC it's much less common in Hindu tradition

It's less common but hardly non-existent: according to Shrikant Kuntla, Srinivas Goli, T.V. Sekher, Riddhi Doshi via wikipedia[0] rate of consanguinous marriage is 25% of indian muslims, 15% for indian hindu, and under 10% for other indians. State / culture presents a much wider spread, from 1.2% in Himachal Pradesh to 38% in Tamil Nadu.

[0] https://en.wikipedia.org/wiki/Cousin_marriage#India

Re:In Amish village, a rural doctor sees the rarest diseases... by Aaron_Putnam on Saturday November 30, 2019 @02:12PM (#21671635)
https://www.telegraph.co.uk/news/health/children/11723308/Fi...

While British Pakistanis are responsible for 3% of all births, they account for 30% of British children born with a genetic illness.

Cousin marriages in the UK are 1/200 for White couples, but 2/3 for Pakistani couples.

The solution is to ban cousin marriages. It is unfair on the rest of society to have to shoulder the burden of excess healthcare costs, caused by the outdated and harmful cultural practices of immigrants.

Re:In Amish village, a rural doctor sees the rarest diseases... by iguy on Saturday November 30, 2019 @08:57AM (#21669967)
Well, royalty are special and weird, and a drop in the bucket, and prove little. My point was that it was a widespread pre-islamic custom, not one which arrived with the book; the geographical correlation with islam is because (as cstross says) it was largely stamped out in Europe a thousand years ago.

It's my understanding that cousin-marriage was rare among european Jews, but a bit more common elsewhere. (Not sure if as high as the surrounding peoples, not sure.) There are indeed rare and interesting genetic conditions in some Jewish groups, but that's another story.

(Am surprised by Tamil Nadu's 38%, thanks. But certainly north-indians take dowry pretty seriously, while avoiding cousins.)

Re:In Amish village, a rural doctor sees the rarest diseases... by masklinn on Sunday December 01, 2019 @06:33AM (#21674988)
> (Am surprised by Tamil Nadu's 38%, thanks. But certainly north-indians take dowry pretty seriously, while avoiding cousins.)

Yes, India seems extremely split between the north and the south, northern cultures have disapproved of it or forbidden it forever while southern states much less so.

Re:In Amish village, a rural doctor sees the rarest diseases... by iguy on Sunday December 01, 2019 @11:30AM (#21676189)
I wonder how this happened... do you know if it's known? Could it be one of the relics of Buddhism adopted by the ~ Gupta revival, and never made it down south?
Re:In Amish village, a rural doctor sees the rarest diseases... by sateesh on Saturday November 30, 2019 @09:12AM (#21670022)
* IIRC it's much less common in Hindu tradition (where the pattern was larger caste groups instead).

In Hindu families too it was not that uncommon at all, though this trend has declined in the current generation marriages.

Re:In Amish village, a rural doctor sees the rarest diseases... by iguy on Saturday November 30, 2019 @09:19AM (#21670046)
Can you say where this is from? TIL that there's a strong N/S pattern, wikipedia says 0.1 in Delhi in 1980, but an astonishing 38% in TN.
Re:In Amish village, a rural doctor sees the rarest diseases... by sateesh on Saturday November 30, 2019 @09:47AM (#21670177)
My observation is from southern part of India (more specifically of Karnataka) which also ranks higher in the same cousin marriage (as per wikipedia).
Re:In Amish village, a rural doctor sees the rarest diseases... by dghf on Saturday November 30, 2019 @03:35PM (#21672005)
> (This used to happen in Europe, but during the middle ages the church banned cousin marriages for political reasons: it stopped the nobility consolidating too much power.)

Not so much banned it, as restricted it: dispensations were fairly common among the nobility and royalty, who could afford the fees charged by the Church for the privilege.

And not just cousin marriage, either: marriages between uncle and niece were hardly unknown. For an example somewhat after the Middle Ages, have a look at the family tree of Charles II of Spain [0]: his father and mother were uncle and niece, as were his paternal great-grandparents and his maternal great-great-grandparents. He was descended in 14 different ways from Philip I and Joanna of Castile, at a remove of five, six or seven generations. Of his 16 great-great-great-grandmothers, Anna of Bohemia and Hungary was four of them (and also four of his 32 great-great-great-great-grandmothers). And so on.

[0] https://en.wikipedia.org/wiki/Charles_II_of_Spain#Ancestry

Re:In Amish village, a rural doctor sees the rarest diseases... by iguy on Saturday November 30, 2019 @06:34PM (#21672756)
Royalty are special and weird, and a drop in the bucket. Overall the ban was pretty successful, it created a world where a few Hapsburgs behaved this way, instead of every guy in a village with three cows to his name.

Their family trees are weird and alien to us because we live in this new world. Whereas I don't think many of his subjects thought that Saddam Hussein's family tree was freak-show material.

Re:In Amish village, a rural doctor sees the rarest diseases... by Gibbon1 on Saturday November 30, 2019 @04:10PM (#21672159)
I remember reading that the Church in the middle ages was pitted against tribalism. So they tried to make rules to weaken it. One of those was recognizing free consent to marry over betrothals arranged by their families.
Re:In Amish village, a rural doctor sees the rarest diseases... by barry-cotter on Saturday November 30, 2019 @06:54PM (#21672839)
Cousin marriage isn’t a specifically Pakistani thing. At the levels it occurs at in the Pakistani community it is basically a Muslim thing though. The only non-Muslim country that falls in the Muslim range is India which has about the same population prevalence as Turkey. Given the much higher prevalence in Pakistan I’d guess that’s almost entirely due to India’s large Muslim population.

See the image on page 3 of this pdf.

https://www.researchgate.net/profile/Ghazi_Tadmouri/publicat...

Consanguinity and reproductive health among Arabs

Re:In Amish village, a rural doctor sees the rarest diseases... by jasonmp85 on Saturday November 30, 2019 @11:22AM (#21670568)
How did being PC harm anyone in this case? It appears they knew exactly what was doing it and clearly said so?
Re:In Amish village, a rural doctor sees the rarest diseases... by FireBeyond on Saturday November 30, 2019 @12:39PM (#21671100)
I think the implication is that while, even as younger members of that society are figuring out what the root of the problem is, that the departments supposed to be helping with this are too fearful of saying so, for fear (real or otherwise) of being labeled racist/prejudiced.
Re:In Amish village, a rural doctor sees the rarest diseases... by growlist on Saturday November 30, 2019 @12:29PM (#21671038)
I'm slightly surprised it's not obvious to you but giving you the benefit of the doubt: if we had had more open discussion/education about the horrible effects cousin marriage can have it might have helped change attitudes in the Pakistani community, but this was apparently resisted due to cringey PC fears about saying anything that might offend said community; the latter evidently a completely legitimate fear given the weaponising of offence by the left. If you still dispute what I'm saying, I'm far from the first to say it - below is from 2005:

'The Labour MP Ann Cryer has called for British Pakistanis to stop marrying their first cousins... Speaking to the Guardian, Ms Cryer said: "I'm not calling for a ban or a change in the law because that would mean changing the law for everyone. I'm simply calling for an enlightened debate. We've avoided discussions on this subject. People are being politically correct.'

Re:In Amish village, a rural doctor sees the rarest diseases... by lostlogin on Saturday November 30, 2019 @12:36PM (#21671073)
> given the weaponising of offence by the left.

Is this left versus right thing? I note that the quote you provide comes from a centre left source.

Re:In Amish village, a rural doctor sees the rarest diseases... by akiselev on Saturday November 30, 2019 @01:44PM (#21671487)
It really isn't. The "right" has been doing the exact same thing for ages. See the weaponization of anti-semitism allegations by the Republicans (against Ilhan Omar most recently) or Tories (against Corbyn and Labour in general).

It's not a new phenomenon. Before racial/ethnic issues came to the forefront, partisans used religion and other relevant ideologies.

Re:In Amish village, a rural doctor sees the rarest diseases... by growlist on Saturday November 30, 2019 @03:58PM (#21672104)
> weaponization of anti-semitism

Labour is the only party apart from the BNP to be investigated over allegations of racism by the Equality and Human Rights Commission.

Re:In Amish village, a rural doctor sees the rarest diseases... by akiselev on Saturday November 30, 2019 @06:41PM (#21672781)
A fact the Tory media, politicians, and supporters (case in point?) repeat incessantly, despite it being a Labour party matter. That's weaponization.
Re:In Amish village, a rural doctor sees the rarest diseases... by growlist on Saturday November 30, 2019 @08:01PM (#21673105)
> despite it being a Labour party matter

This is an internal matter and has no bearing on who might be leading the country in a few weeks and voters don't have a right to know and the Tories don't have a right to point it out? Ok then.

Re:In Amish village, a rural doctor sees the rarest diseases... by growlist on Saturday November 30, 2019 @03:54PM (#21672091)
And she was the exception that proves the rule.