In a lot of African countries where sickle cell is endemic, you will find that people who are carriers of sickle cell have love relationships with other carriers and these relationships generally do lead to marriage. A few decades ago, this was attested to scientific ignorance, meaning people didnt understand the scientific basis and devastating outcome of their choices. So couples who fell in love and got married ended up having children with sickle cell trait. Today, with so much scientific knowledge out there, should these issues still exist? I’d say no…but they actually still do.
I heard about a couple who are both AS and are still forging on to get married. Whilst love is a beautiful thing, i dont think people should play russian roullette with their kids lives. Scientifically, If two sickle cell carriers get married (AS and AS), the genotype of their children will be (AA, AS, AS, SS). So, there is a one in four chance of getting an SS child. But if the couple getting married is AS and SS, then 2 out of every 4 kids would have the sickle cell (SS) trait and the gentoypes will be (AS, AS, SS, SS). All this is based on chance and frankly it doesn’t happen in this order. its possible to even have more sickle cell kids than what the scientific crosses suggest.
You will find that in Nigeria, people that get married with this genetic trait fall into two categories. 1) people that have absolutely no clue what sickle cell is and 2) people that base their decisions on having faith and being a christian and believing that God will not let them have an SS child. The former can be excused especially in rural areas of the country where health information rarely reaches communities, but the latter is inexcusable. This is similar to someone knowing they are HIV positive but decides not to take anti-retroviral drugs based on faith. One thing happens with these patients ..Death!. Whilst having faith is great, we need to be more informed and realistic about certain decisions.
I feel we need to be more responsible in making health decisions especially when it affects out future. Its unfair bringing in children into the world that will end up suffering. In a country where the health system isnt up to par and the economy is so terrible, the cost of taking care of a sickle cell child will be high especially for lower income families. The emotional and mental burden on both the child and members of the family will be very daunting.
So when next you meet someone new, dont forget to ask ”hey, whats your genotype?”.