12/03/2021
Mrs A, a 29-year-old trader, was married to Mr A, a 40-year-old farmer who was a member of a Yoruba rural community in southwest Nigeria.
When his wife remained childless till seven years after the marriage, Mr A’s extended family got him married to a second woman, Mrs B, who was a traditional birth attendant.
In the following year, Mrs B gave birth to male twins, X and Y.
When the twins were four years old, symptoms of autism were observed in Y, while X was without symptoms.
After persistent but unsuccessful attempts to treat the child with herbal medication, the family was advised to consult the priest for a traditional diagnosis.
The child’s neurological inactivity was diagnosed as a non-pathological result of the gods’ wishes, something which was considered incurable.
Since there was now no question of treatment, the only option left was that of care.
A few months after the family members had managed to convince themselves that Y’s neurological condition was the handiwork of the gods, the family’s traditional physician confirmed that Mrs A was pregnant.
This was after about 11 years of being unable to bear a child and facing stigmatisation for her barrenness.
Mrs A was looked after by the family’s traditional physician and the entire household.
Her husband’s younger brother, Mr C, felt that she should undergo prenatal genetic screening and have the delivery outside the village to be on the safe side.
Initially, Mr A was in favour of his wife receiving prenatal care in the house itself.
However, due to the family elders’ efforts to persuade him and the trust he had in his brother, Mr A agreed to Mr C’s request.
The screening revealed that the foetus had a high risk of autism.
The amniocentesis carried out later confirmed the chromosomal abnormality.
Mr A was not only unable to understand the results of the screening amniocentesis, but was also reluctant to accept the medical advice that the pregnancy be terminated .
Credit:Fayemi Ademola Kazeem
University of Lagos, department of philosophy
Lessons from the story above:
* There's need for genetic counseling if there was a history of genetic disorder in the family.
* The genetic counselor gives enough information on genetic risks based on the family history and advised on the screenings to undertake.
* Early detection of genetic disorder helps the family to take appropriate informed decision.
