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Failing Genetic Counselling Programs, Mediterranean Anemia, and Ethnic Stigmatization in Turkey
Abstract
From the 1980s onwards, the Republic of Turkey has launched a public campaign against the practice of consanguineous marriages, the alleged genetic risks of which are continuously propagated by the media, medical scientists, and state institutions including schools and hospitals. In the context of these campaigns, ideas of modernity and backwardness were clearly set along the lines that persons that are still engaging in consanguineous marriages are usually uneducated and anti-modern. Moreover, since the 1990s, particularly in the Mediterranean parts of Turkey, there have been warnings that children born to consanguineous marriages may have higher risks of inheriting the genetic disease of Akdeniz Anemisi (Mediterranean Anaemia or ß-thalassemia, and Sickle Cell Anaemia). It was at this time that the Turkish Ministry of Health implemented a premarital screening programme and built prenatal diagnostic centres in Mediterranean cities, such as Adana and Antakya, to manage the risks of these potential blood diseases. Among the diverse ethnic groups that live in these cities, the Arabic-speaking Alawites are depicted as being particularly at risk due to their ongoing practices of cousin marriage. After years of state financed education, genetic counselling and screening programs, biomedical publications stress that the rates of sickle cell disease and ß-thalassemia are still increasing in Adana and Hatay, explicitly blaming Alawites for their “unwillingness” to stop engaging in consanguineous marriage. This paper analyzes how health programs supported by scientific research in Turkey use ideas of “healthy and unhealthy blood” not only to create a healthier population, but also as a means of state governmentality and control of ethnic and religious minorities within the nation, stigmatizing those that do not perfom well. Secondly, the paper examines how Alawite communities in Southeastern Turkey are working towards dynamic ways of understanding “blood” and “genes” in order to adapt to the Turkish state’s vision of “modernity” while remaining committed to the preservation of their ethno-religious identity. In the aftermath of the public health campaigns, Alawite kinship ideas and conceptualizations about blood and genes are shifting, and Alawite families are embracing new marriage patterns between individuals they consider to be more distant “blood relations”. The concept of sharing “blood” among the Alawites remains intertwined with ideas of marriageability, kinship solidarity, and religious and ethnic identity, making it a complex field of thought that does not easily compare to bio-medical explanations.
Discipline
Anthropology
Geographic Area
Turkey
Sub Area
None