His young mother would stroke his head and whisper to him, trying to comfort him in the dark as she lay with him in the same hospital bed as the 3 year old cradled his aching hand and ceaselessly moaned the same complaint the entire night. To the right of the whimpering boy was a frail-looking little girl hooked up to an IV bag of a vile-looking reddish-brown liquid who remained silent and motionless our entire two week stay except for occasional, labored walks to the bathroom which sapped the little strength she had. In the bed to the left of the moaning boy and his mother, was a pair of sisters. The oldest girl, a very sober 13 year-old, was looking after her younger sister during her stay in the hospital. Their mother had to stay home to care for her other children. In the morning, after that first sleepless night in the hospital with a sick 6 month-old EttaMae, I asked that young mother about her son.
“What’s wrong with his hand?” I hadn’t noticed any cast or bandages to indicate that the little boy had been injured in any way.
“Nothing’s wrong with his hand, thank God”, she replied to my surprise.
“Oh, I was just wondering since I heard him complaining (the entire night) that his hand hurt him.”
“It’s not in his hand, it’s Takesser (Sickle-Cell)”, the young mother admitted in a hushed tone.
The frail looking little girl to the right was in for complications from Takesser too. A Nigerian doctor would ask her several simple medical questions in his remedial, broken Arabic phrases only to converse with his coworker using contrastingly complicated English words like “transfusion” and “organ failure”. The younger of the two sisters to the left was hospitalized for Takesser as well. Out of the 6 children in that particular family, only the oldest one, the 13 year old, did not have the disease and both the mother and the father had it as well. In fact, out of the 6 patients in that room, 3 were there for sickle-cell. And they weren’t alone.
In the United States people are often surprised when they learn that a person who is not African American has sickle cell disease. The disease originated in at least 4 places in Africa and in the Indian/Saudi Arabian subcontinent. It exists in all countries of Africa and in areas where Africans have migrated. The transatlantic slave trade was largely responsible for introducing the sickle cell gene into the Americas and the Caribbean. However, sickle cell disease had already spread from Africa to Southern Europe by the time of the slave trade, so it is present in Portuguese, Spaniards, French Corsicans, Sardinians, Sicilians, mainland Italians, Greeks, Turks and Cypriots. Sickle cell disease appears in most of the Near and Middle East countries including Lebanon, Israel, Saudi Arabia, Kuwait and Yemen. Sickle-cell in the western part of Saudia is similar to the type that shows up in Africa however, the type of sickle-cell in Eastern Province in Saudi Arabia is called the “Indian” sickle-cell mutation and is thought to have been introduced from/to the sub-continent via ancient maritime trade routes hundreds of years ago. Ironically, another study claims the reason sickle-cell has spread across so many diverse populations has everything to do with MALARIA. They propose that because people with sickle-cell are protected from malaria, they lived longer than their sickle-cell-free brethren in areas with high incidences of malaria enabling them to reproduce more thus, passing on their malaria-free though, sickle-cell tainted blood to their children. Judging by pictures like this of old Al-Hassa and how my house is filled with mosquitoes every winter during the “wet” season, I can go along with this theory as I imagine malaria used to be a big problem here. 
Al-Hassa has been hit particularly hard by Takesser and I’ve heard that we have more cases of Takesser here that in the entire rest of the kingdom combined. One study indicated that approximately 20-30% of Saudi newborns in the EP are carriers of the sickle cell trait. Can you imagine 30% of your population carrying a trait which could afflict their children with pain and misery most of the days of their shortened lives!
Although I’d been around Arabs a significant part of my life, I’d never been aware of how prevalent the disease was. No one wanted to talk about it or admit to having it in their family until recently. A government awareness campaign was launched a few years ago as well as mandatory pre-marital blood testing which put the topic of the disease on the table. Although I’d asked about the takesser-status of several individuals in the family before, up until 3 years ago no one knew nor would admit to who had sickle-cell or who was a carrier in the family. This all changed when a young man, known to have sickle cell because of the painful attacks he’d had in front of my husband’s brother, came to propose to one of the young women in the family.
“Has she been tested to see if she’s a carrier or not?” I asked my husband.
“I don’t know”, he replied with a type of indifference.
This was before the wide-spread governmental education program about the disease and the blood tests were not yet mandatory. Even if someone knew they were a carrier, many parents might not want to admit to their daughter being a carrier of the trait let alone having the disease because this may reduce her marriage prospects.
I continued to talk in his ear for several days, “you have to talk her into getting tested. You have to be the one as the most educated one in the family. This is very important. You wouldn’t wish for her to watch her children writhing in pain, constantly hospitalized during pain attacks. Since you know, you have to insist so at least they can make informed decisions regarding whether or not they’d want to go through with the marriage if it would may in all their children being born with this horrible affliction.”
My husband succeeded in convincing the perspective bride to go and get herself tested. However, after the results came back and the wedding plans began to roll forward, she was a bit odd whenever I’d bring up the topic of the blood tests.
“So, you aren’t a carrier then”, I asked the bride a few days after she’d had the blood tests done then immediately accepted the young man’s proposal.
“Al-Humdulilah (thank God)”, she replied and quickly shuffled away to engage in another wedding planning activity.
Hmmmm…that was ambiguous! I didn’t want to be pushy; as long as she knew what the consequences of her decision would be and she was well informed it wasn’t my place to impose my opinions on delicate matters of the heart. And it was apparent, she already had her heart set on marrying this frail, pain-racked young man and nothing was going to deter her.
After the wedding contract was signed and sealed, the ladies of the family all lounged around at the “engagement” party (khortuba) amongst the palm trees at one of Al-Hassa’s many farms and chatted about the bride’s decision to marry the sickly young man.
“You do realize the blood tests confirmed she is a carrier, don’t you? She was just afraid to tell you and your husband for fear you may do something to try and stop the wedding”, one of her cousin’s intimated to me.
I smiled, “I figured as much, but we wouldn’t have done anything like that. We just wanted her to know so she was fully aware what she was getting herself into. It broke my heart watching those kids in the hospital and I’d never wish that on anyone.”
“I know, I’ve seen so-and-so with their kids as well as so-and-so…” and this cousin began naming off individuals in my husbands family who are all afflicted with sickle-cell as well as their kids. I was gob smacked! I didn’t have any idea. I made this cousin spill the beans and tell me EVERYONE who has the disease in his family.
As it turns out, none of my husbands siblings have the disease although a few of them do carry the trait. However, there are many, MANY members of his extended family who have the disease and who are in and out of the hospital with their ailing children. I was around these relatives all the time, but any problems they had from takesser were explained off by other causes such as “achiness” caused by changes in the weather or “bad periods” for young women.
Time rolled on and the young bride became a mother. I held my breathe during her pregnancy until we received the happy news that her beautiful boy with shining eyes and gorgeous dimples was takesser-free and would never suffer the pain his father endures.
All I can say is, Al-Humdulillah (thank God).
31 comments:
I remember my doctor a few years ago insisted I get tested. She repeated that although it was mostly found in African Americans, she wanted to make sure.
Alhumdulilah, nothing.
Bravo Daisy for this informative post. I applaud the way that you have written this post which illustrates your understanding of the culture and customs and explains some Saudis reactions to even broaching the topic of testing.
Perhaps if those of us do more at this grass roots level on spreading awareness of sickle cell; need for mammograms and other routine checkups; need for immunizations; in our own ways we can make a difference and have this be one of our contributions towards CSR as well.
I eagerly look forward to your next post!!!
Regards,
American_Bedu
Very interesting. I wasnt aware it was in Saudi Arabia. I thought it was purely an African thing.
I'll have to ask my wife about this.
Thanks.
i wonder if all of the marrying of cousins has anything to do with it? i understand the genetics and it can happen when any two parents are carriers, but if there is a family with a high number of carriers/incidence of sickle-cell wouldn't that make people think twice about marrying such close relations.
hmmmm.......for me i find the cousin thing hard to take. i accept it, but since my only male cousin is a meth addicted toothless redneck with a mullet living in a trailer there wasn't a chance of me looking at him. I have read that the muslim world(arabs specifically) has the highest number of genetic issues with children.
i also had no clue it was outside the african americans, thanks for this information daisy.
Organic- Upon going with my Egyptian friend to register her son in kindergarten in the States, they requested a sickle-cell test be performed. At that time I questioned the administrator's racial knowledge but know I realize she was right to assume it could be a possibility.
Carol- I'm confident that if the there were an educational campaign launched like the one done for sickle-cell, attitudes would change drastically. You can't walk into a doctors office without seeing one of those charts like the one on my post which illustrates how sickle cell is transmitted, it could be done with cultural and religious sensitivity for women's health as well.
أبو سنان - If she's hijazia she may not have been aware of it. According to the information provided the sickle cell on the west coast is of the African variety and only affects a portion of the population as compared with Al-Hassa where it's practically epidemic.
UmmAbdurRahman- I'm glad I'm not the only condescending westerner:P Consanguineous marriage being a major contributor was the first thought that had gone through my head actually. It can't be bred out of the population because they're all "kissin cousins". ALL of my friends who are all married to their first cousins have told me they don't want their own children to do the same and prefer they marry from outside of the family (but perhaps still within the "tribe"). I think that Saudi livestock owners diversify their breeding stock to keep herds healthy more than they do within their own families!
I'm a carrier, not of sickle cell but of Thalassemia, which is related to sickle cell and I have heard of the same theory in relation to it, about the malaria.
Most doctors look at me weird when I first mention it, it's basically a mediterranean disease but also prevalent in Africa and Asia. None of which I look, being mostly of Western European genetics but I had a relative a few generations back who was from Spain.
They test for it here when you get married too, the major form (I have minor, being a carrier) means a lifetime of blood transfusions and dialysis and often a young death.
Reading up on it again for the first time in awhile, I guess it's getting worse there too. :(
Arsie- Thalassemia is another nasty one that I had originally considered putting in this post. Perhaps it's due to those same "ancient maritime trade routes" to Asia, there's a lot of individuals with it here too.
I have a maternal uncle who is a thalassemia carrier. The advice given since then is that his children and their prospective husbands / wives must undergo genetic testing before proceeding further.
For those of us who were related by blood, the testing issue was also raised, particularly for those of us with known case histories of anaemia or unusual paleness (which runs in the family, myself being a prime example).
However, nobody has admitted to going for the tests todate. You are right in that they would probably have chosen to get married. But what gives? So far, there are no family members with known and serious cases of thalassemia, but what if the foetus is found to have inherited something totally debilitating? Would abortion be an option, or would personal values, culture and religion preclude that option? What about genetic preselection of the egg/sperm/embryo?
I ask this because while I am not a thalassemia patient, I do have a couple of serious medical conditions that were most likely to have been inherited ie diabetes and a form of sarcoma that originated from chromosomnal irregularities.
It is not well-known within the extended family that I had been hospitalised for extended periods since I was treated overseas, but I also found it interesting that my mother accepted that my diabetic condition was inherited, but she just refuse to believe that my cancer is also most likely to be hereditary as well.
While I am glad to be alive, I do wonder whether I will go for genetic screening of my eggs if I should one day choose to have children. And while I accept that every child deserves the right to life, I am not sure that they should be made to suffer unnecessarily.
This was an extremely interesting post with equally interesting responses. I too was unaware of the prevalence of sickle cell in the Middle East. My parents came from entirely different continents, so it's possible that genetics and the law of averages were on my side. I have a student with sickle cell this year and one last year, and it breaks my heart to know of their suffering.
Asalam Alaikum
Wow I didn't know this. This is so sad.
I wondered if the whole idea of admitting to having it in the family goes back to race issues within Middle East. Perhaps it was viewed as an "African/Indian disease" and admitting to having it would be admitting to having had these ethnicities somewhere in ones heritage. Very interesting stuff Daisy. I remember studying about sickle cell/malaria connection in one of my anthropology classes in college.
I live in the UAE and it was here that I heard about thallasemia for the first time. It seems to be a real epidemic here. My husband is medittereanian and never heard about this disease either. It is terrible and I believe that marrying within the family has everything to do with spreading genetic diseases like this one :(
kite- I agree with you when you say "And while I accept that every child deserves the right to life, I am not sure that they should be made to suffer unnecessarily"
I've never gone to get an amniocentesis during pregnancy to ascertain whether my fetus has birth defects or not, perhaps because at the stage in pregnancy that they are offered I already feel the little life-force inside me and I wouldn't abort it anyway. But, if screening were offered before they were even implanted, I could go for that because I agree with you completely.
teacherlady- I'm confident that none of my children will ever get the disease due to the fact I don't carry the trait although to this day, we don't know if my husband carries the trait or not. I want my hubby to get tested just so we'll know if we'd need to get all our kids tested for the trait as it may affect marital choices in the future. After reading how wide-spread the disease is (the prevalence in Italy stunned me!) I would recommend anyone at least test if they're a carrier or not.
ummali- wa alaikum salam, unfortunately sad but too true.
lianne- I don't think until recently most would have made the connection between ethnicity and the disease in order to be ashamed by it. I think it mainly had to do with being viewed as "damaged" to potential suitors as well as a cultural tendency to downplay/hide illnesses. People will openly admit to diabetes, another disease that runs rampant here, but not to sickle cell although both are inherited- I don't understand why yet. Perhaps because diabetes is an "old folk" ailment here.
sabah- "epidemic" is truly accurate. Although intermarriage is definitely a major contributor, the disease is so prevalent that even those who marry outside the family but with another EP family risk transmitting the disease. Like the stats said, up to 30% are carriers!!
My wife is Hijazia on her mother's side, and her father's side is originally from Yemen, back some 90 years ago.
I dont know that much about it. Can children get it from just one parent or do both parents have either have it or be carriers?
As I am a "white as snow" blond haired blue eyed guy born in Germany, I dont think I have a background for it.
Genetics is a weird thing.
What do you know about the rates of Autism in the Kingdom? I dont think it is diagnosed like it is here.
Also, I know you have a child with special needs, so do we. In the past the Kingdom has had little or nothing for children with special needs, although I heard this is changing and I also heard something about a center in UAE. Are you aware of this?
I really think someone needs to start a group for Muslims with special needs. There is a lot of education needed out there and TONNES more resources needed.
We'd love to move to the Gulf. My wife has family there of course and I could make a load of money considering my career field, but we wont make the move because there are little to no resources for children with special needs. If that changed, we'd move in a heartbeat.
I was just talking to someone about the same issues affecting many middle eastern families,especially Thalassemia. I know they are closely related to sickle cell anemia. My cousin(she is older about my mom's age) has a step-son who had a child with Thalassemia,she never lived that long poor child. He is married to his cousin, so I just figured/assumed that they could be carriers or they had it in the family. Many families in emirat marry amongst themselves which I think has caused an epidemic of such genetic *pass me down*. I heard that they are now encouraging families to marry outside their own *compounds* if they can as the numbers of children born showing traits or are carriers or have it is so high. Many pple as you mentioned would try to avoid testing their children or requesting the other interested *party* during the time of marriage to have these tests done. You are right, I would rather know than go through heartache to see a child suffering. I think there should be information provided to families and a blood test should be made manditory whenever there is going to be a marriage. sf
assalamu aleikum wa rahmatulahi wa barakatuhu,
My husband is also a carrier of Thalessimia. He is Arab. My family roots are from Spain (mom and grandparents both sides). So I naturally freaked when my kids got anemia. When my daughter was little, it passed rather quickly, and the same with my son (i also get anemia even though we are meat-eaters-lol). I had them tested for Thalessimia just in case, and nothing as well-Alhamdulillah. But just in case, my husband and I agree - no marrying into the family, cousins, OR extended family. (too much diabetes on his side-no cousins from my side).
What's the overall population of the region in KSA where this is most common? There was a study done in the UAE a few years ago in which doctors listed off the most significant afflictions among the Emirati population and almost all of these ailments could be attributed to a small gene pool in which cousins married one another, increasing the likelihood of passing on genetically-based illnesses.
أبو سنان - None of your kids could have the disease but if your wife is a carrier, they could be as well and maybe pass the trait/disease (depending on if they marry a carrier) onto their children. Children of parents who BOTH carry the trait have a 1 in 4 chance of developing the disease.
As far as Spec Ed in Saudia, that's my Master's degree actually! Let me inform you...it's pathetic. This is what the government claims is available but as a mother of a child with special needs, I can confirm there is a huge gap between the claim and reality. It's almost impossible to find government resources and the private ones can be very costly. Also they are run by Egyptians who were educated eons ago in obsolete methods and when I try to advise them on newer research, they become all defensive and aren't willing to hear me out although I'm an "expert" for all intensive purposes. This was a far cry from my daughters spec ed school in England where I was an integral part of deciding on treatments and methods every step of the way. School administrators here are trying but unfortunately, its so far behind that our children will the one's to suffer from inferior education.
We have Emirati friends in AbuDhabi who's daughter goes to an excellent, purpose built school with great resources and they're quite pleased with it. I have friends in Jeddah and Riyadh who sing the same song as I so I know it's not so much better there than in the EP where I am. We're even considering a move to Dammam only because there is more, although not excellent, therapies and schooling available. If I were you, as far as Spec Ed goes, I'd either stay put or go to the Emirates! Feel free to email me for any more info on this topic.
sf- I'm so happy that it is now MANDATORY to do bloodtests with full disclosure before any marriage is allowed to take place in Saudia and I wouldn't be surprised if Emirates follows suit. However, I just read an article which stated some 90% of marriage applicants in which the couple has tested as incompatible because of inherited diseases, still go through with the weddings!!!
musulmana- I'm curious, is the disease as well-known or prevalent in Spain as it is in Italy where there are huge treatment centers and special interest groups or is it as hushed as in Saudia?
Cairogal- I'm trying to instill a subconscious aversion to consanguineous marriage into my kids without being too overt since it is such a part of the culture.
Btw, I'll like to add that given the state of today's medical technology, the link between an inherited gene and my medical conditions ie diabetes and sarcoma, are not as clear-cut as that for thalassemia and sickle-cell anaemia. So regarding musulmana's comments about diabetes in the family -- it's not something that can be prevented by NOT marrying close cousins. Diabetes is what is known as a complex multi-factor disease ie genetics only increase the likelihood, but there is rarely a 100% certainty.
If you would like to find out more about genetic diseases, the following Wikipedia entry is quite interesting
http://en.wikipedia.org/wiki/Genetic_disorder
NYTimes also had an article in 2003 on the elimination of the Tay-Sachs disease from the Ashkenazi Jews, who had a 10X likelihood of being a Tay-Sachs gene carrier versus the general population. Their method of choice was via marriage counselling and abortion. Pre-implantation screening was not yet an option in the 70s.
http://query.nytimes.com/gst/fullpage.html?res=9F05E0D81E3AF93BA25751C0A9659C8B63
And as for why Tay-Sachs was much more prevalent amongst the Ashkenazi Jews, and Thalassemia and Sickle Cell being unusually common in the Middle East, I've read a lot about the spread of genes due to intermarriage over multiple generations within small insular groups, but a quick Google search did not really turn up any article that is succint and yet explain things clearly. Perhaps someone else can supply relevant articles?
kite- I knew about Tay-Sachs amongst Ashkenazi Jews (and French Canadians and Cajuns for some reason) but I didn't know the campaign was going on since the '70's nor was I aware that it included abortion.
I would love to get my hands on some statistics regarding the number of marriages which are/are not consaguinous in Saudi Arabia. Many times it seems that people look within their families FIRST. Anyone with a remedial understanding of Mendelian genetics (which I learnt in 8th grade) and/or animal husbandry will know that this much intermarriage is unhealthy.
During the time of the Prophet (PBUH) it was the opposite situation, people would NOT marry from within their family which is one reason why his marriage to Zaynab bint Jahsh (his aunt's daughter) was significant since it allowed for consanguineous marriage as well as formalizing that an adopted son is NOT the same as a biological son. (Zaynab had been married to the Prophet's (PBUH) adopted son Zaid and marrying a woman after a biological son is forbidden).
well, i primarily meant, I don't Thalessemia to be inherited. I had never met anyone with Diabetes even though some in my family are very overweight until I moved to New Orleans. Then I discovered that many of my husband's aunts and uncles have it even though they are thin!
Cubans diets are bad, but noone in my family has Diabetes. As for ethnicity, we are mostly from Spain, also, noone with Diabetes, Alhamdulillah.
I am seeing inherited traits here...
I think it's strange how in my whole life I have only met 2 African Americans with sickle cell. BTW I am African American and do not have sickle cell nor trait. A doctor once tested my daughter for it. I found this out yrs later when I took her back to her regular doctor and they asked me did she have sickle cell. I was shocked, concerned and answered "No I don't think so." The crazy doctor that tested her never put the test results on the paper nor in her chart. But if there was a problem I hope he would have told me. So we came to the conclusion that she doesn't have it even though her dad is Arab and I am African American. Maybe when she gets older we will have her tested again just as a safety precaution.
musulmana- Inshallah with as much mixing and matching going on in the west (such as within our marriages), many inherited traits will be "bred" out eventually and our kids won't have to worry about it.
S.H. Mommy- You're right, I'd haven't met ANY African Americans with sickle cell but recognized it as an ethnically "African" disease through educational programs. Inshallah it won't be an issue for your daughter until it comes time for her to marry now that you know Arabs carry the trait too.
Thanks for the information Daisy. Where we live in the Metro DC area has probably one of the best Special Ed programs in the USA and they all use cutting edge programs.
I guess it depends on what issues your children face, but with issues like autism, I certainly wouldnt want to look at techniques and ideas from 20 years ago being used.
I guess we got a leg up on this one as well as Manal is doing the Special Ed route on her Masters as well.
Thanks again.
As someone who has gone through paper work for marriage recently, me and my fiancee were tested for sickle cell. While we are both of non Arab origin (I'm Indonesian, she's Malay/Thai) with very little chance of carrying the gene, we were still worried about the results. Did a unified sigh of relief when the result came out a-ok.
I know the reasoning behind the test and I support them 100%, but I gotta tell ya, during that week of waiting for results I cursed the need for them.
I guess I'm a fallible human after all :)
Thanks for the excellent writeup Daisy.
this is an excellent post daisy...i now how more people will spread this information so less children will have to suffer..
i do slightly disagree however...i am a black american who has had much experience in the Arabian Gulf...i do believe 100% many within the Arabian peninsula have recognized sickle cell as a "Black African disease"...
just as u stated earlier..as you were growing up you were told that only Africans carried this disease...
there is a very very VERY heavy stigma attached to having African lineage in Arabia..it is the worse thing imaginable..to have African blood...
hopefully one day things will change..but that truly is part of the reason why testing can become part of the problem...unless it is thalassemia or a non-african sickle cell (from the indian subcontinent)..then the stigma is not so severe...
god willing...people will begin to do this mroe for the sake of their children
أبو سنان - definitely...stay!
Saudi Jawa- awwww, how cute! But seeing as how there are so many Yemenis mixed in with Indonesians, one can never make assumptions.
jan- your right that there is a strong stigma attached to being of African decent. I think my perception of SickleCell being a "black" disease is because people of African descent would be the only minority numerous enough in America to warrant public attention to the disease, since Arab and Asian minorities are newer/less numerous additions to the "melting pot".
I was just surfing the TV and I landed on the topic of takseer and health check ups for marriage, it was in Almajid channel. I don't even remember who they were interviewing but the point is, that the guy was making was that Health check ups were mandatory for marriage although the result were not mandatory to follow. And that this is the first step in Saudi and in the future the results will be mandatory to follow to avoid such epidemic in genetic disease and a weak generation. Why aren't result mandatory now, one might ask? Its to avoid a clash in society. And statistics were made on the result of poor health result and the decision of marriage. In the first year the decision of marrige was about 97% despite poor compatiblity. And the government was worried if this was a waste of finances that could be put to better use. Yet in the 2nd and 3rd year the percentage has been decreasing approxiately 10% yearly which is tells us the people are starting to be aware of this and are starting to make better choices. So baby steps...
Hi. I found your blog linked on Nzinga's - the title you picked caught my attention & I'm glad it did. I'm enjoying your writing style lol.
I know this is awhile after you posted this blog but have to comment for a few reasons.
I'm of mixed heritage (have almost everything but mostly Irish & Native American) living in US.. and one of my cousins has sickle cell.. they keep quiet because that part of my family doesn't want to admit one of our ancestors was African. Noone else has been tested because of this. I've thought about it more than once, but you get funny looks if you look white & mention it.
Also, I went to Tanzania while I was in college... I too had heard that you can't get malaria if you have sickle cell. One of my friends has it & was with us one summer... He didn't take the drugs because of that... and he did catch malaria! He asked the dr & found out that people with sickle cell can get it, it's the carriers that are immune!
Your comment about it being found in Lebanon caught my attention too becuase my husband is of Lebanese descent. I don't think there is any in his family though... I'm curious now.
Fascinating! I am of African descent, and my mother has several cousins with sickle cell. When my husband and I first began talking about having children, my mother called to suggest we both be tested for the trait (which my brother may possess). We agreed to do that, but then I found out that I was already pregnant. I was surprised because my husband is of Amer. Indian, Spanish and Japanese descent, but my mother said Asians can carry the sickle cell trait, too.
Education is key!
Thanks for the information, we just found my 14 years old step son has Thalessemia. Both of his parents somalis and the were cousin . This was a shock we thought it only affected the Greeks, Italian and arabs.
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