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#health In Nigeria Society

Love, Or Medicine?

Today’s blog is not going to be one of those where I share my opinions on a topic, because to be honest, I have not exactly decided where I stand on this issue yet because I don’t know if there is a “one size fits all” answer. Rather I’m going to highlight the opinions I have heard concerning it.

It is likely that in your journey through this life you have heard or been asked this question: “should a person with a genotype of AS marry someone with the same genotype?”. If you’ve heard this before you’ll know where I’m headed by now. If you’re a newbie and you have not heard of this before now, welcome. I’ll introduce you around.

Basically, all living things have genes in them which are DNA or RNA molecules determine the various traits that they are going to have. Humans are no exception, obviously. Your genes determine literally everything, from the colour of your hair to the size of your toenail to your genotype, which is what I’m narrowing on today. Genes are transferred from parents to their biological children, that’s why we end up having similar looks as our parents and all. Now to the genotype issue, it simply refers to our haemoglobin (which is an important protein in the red blood cell) gene constituents. We inherit these genotypes in pairs, and will contribute a member of this pair when transferring them to our biological offspring. The genotypes are generally AA, AS, AC, SC and lastly SS which manifests as sickle cell anaemia. This disease changes the structure of the red blood cell (to a shape of a sickle, hence the name) reducing its efficiency in transporting adequate oxygen throughout the body, this leads to an unsavoury variety of complications in almost every body system, including severe pain, severe infections, organ damage, stroke, heart problems and so many others. It’s quite intense.

Now here’s the deal about the AS genotype. Although it doesn’t usually manifest as a disease or anything, it carries the trait for it. So if two people who have the AS genotype decide to have children, there is 25% chance that their child will have the SS genotype. There are diagrams below to help you understand better.

Note that this risk is equal for EACH pregnancy, therefore the risk is 25% for every unborn child. So it’s possible for a couple in which both the man and woman are AS to have four children who don’t even have the trait at all or have all four children with the disease. It’s literally a pot of luck.

In spite of all this knowledge on the risk of it all, people still decide to take the chance and hope and pray that the odds are in their favour. Couples have this issue and know the risk, yet decide to move forward with their relationship against all medical logic. There’s a school of thought that believes that it is quite a selfish thing to do. Their points? ” Why take the risk of bringing an unhealthy child into the world due to something that could have been avoided? Suppose a child with sickle cell anaemia is now born, that kid is going to have a tough time and suffer just because two people were “in love”. There are so many other things that can be inherited, as least we know to avoid this one, yet people still go into it with their eyes open? Why take the risk?” These are very logical argument based on facts and I cannot render them invalid.
The other side to this however are those who view it from more of a faith-based angle. “If you really have a go-ahead from God to marry this person irrespective of his/her genotype, why worry? God will make a way. There are worse things in life to happen to a child than sickle cell anaemia. You can marry someone with compatible genotype but if the person has incompatible character, who you epp/what’s the point?” As a young person growing in relationship with God, I cannot ignore the place of faith. I know of couples who are both AS, knew before marriage, decided to trust God, have no children with the disease and boy, the way they are fulfilling purpose as a team! I don’t know if it would have been so if they didn’t marry each other. However this is not to validate everyone who takes this risk, as not everyone who goes under the umbrella of “God told me too” actually was told anything. Only God knows who He really told. It’s not my place to judge.

June 19th has been internationally recognised since 2008 as World Sickle Cell day, meant to raise awareness about this disease, of which Nigeria has the highest burden in the world and is also the top sickle cell anaemia endemic country in Africa, with an annual infant death of about 150,000, which represents more than 8%of infant mortality in the country. Over 150,000 babies are born each year with sickle cell anaemia. According to 2014 statistics by the World Health Organization, the disorder killed at least 100,000 babies. These statistics are alarming, this is why there is medical advice against men and women who both possess the traits having biological children. Although unawareness is one of the major reasons why it’s this way, children born to educated carriers still contribute to the staggering number. Hmmmm. With the way we are so ‘religious’ in this country, I’m not sure if the situation will get better or worse.

So which side are you on? Are on the side of adhering to medical advice or do you believe that true love will conquer all? Are you on the fence about it? Please share your views in the comment section below. More importantly, please try to respect and/or kindly educate those with opposing views, we all learn every day.

Thank you for reading through.

TITLE PICTURE BY: Sope Sogunle

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7 replies on “Love, Or Medicine?”

True Love conquers all. This is what I believe.
True love among the couple and true love among the couple and God.

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Prevention is better than cure. Love is good but love should not be put to test. Medically, it is proven there is a greater risk of having a child with “AS”. Why bring in child that will come into the world to suffer. Faith is good, what if things work against you…everything suffers including your money, emotion, time etc.

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There’s really no side to be on exactly. There are so many options to consider, however the children are the victims and we shouldn’t have more cases.

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Huuuuum,Excercising faith is good., gambling is dangerous to both the player & service provider.To me ,We should not play God.Practically,I have seen lot of women suffered abandonment both from their husbands /extended family just because of the frustration/financial implications of keeping a sickler.Why go through all these For love that might become bitter or sour later?A stitch in time saves nine.

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I think it depends on what is most Paramount for the couple, love or procreation?when measured if love is superior then they can go ahead and perhaps go for adoption later in the marriage.

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Hmmm. Not an easy subject. But as someone who manages sickle cell disease patients for a living i can assure that love is not enough reason to subject oneself and kids to a life of misery.
However with advances in science it is now possible to determine Hb phenotype in utero. That however throws up other dilemmas….religious and ethical….as to what follows: Does one terminate it or carry on with it
Never an easy subject., this. Thanks for sharing

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