September 2018

The Imazighen of Morocco: consequences of preferential marriage

In the picture, Radha, with her daughter, attends a rehabilitation session with a volunteer from the NouSol charity at the Handicapped Centre at Aghbala, an Amazigh town in the Middle Atlas region in the province of Beni Melal, Central Morocco. Radha receives rehabilitation because she is in a wheelchair, has reduced mobility in her lower limbs and atrophy and paralysis in her left hand.

The wrongly-named Berbers (a rude name -with no connection to their ethnic group- which the Romans and Greeks used: “barbarians”) are an indigenous people from North Africa with a specific identity and culture who call themselves the Imazighen (plural of Amazigh), which means “free people”. Their language, Tamazigh, has branched off into almost thirty languages and hundreds of dialects. For example, in the settlement of Imilchil, only 74 kilometres from Aghbala and famous for “The Weddings Festival” which is held there, they speak a version of Tamazigh which is different to that spoken in Aghbala.

Due to the traditional culture, one of the commonest kinds of wedding among the Imazighen is preferential marriage among relatives, mainly between first cousins. Given the high incidence of endogamy because of such marriages, the percentage of babies with genetic diseases considered “rare” (physical and mental handicaps) is very high in the Middle Atlas Mountains Region. For example, glutaric aciduria type I is a congenital disease which affects the metabolism and which, compared with other mountainous regions in the world, has an extremely high prevalence in this region.

The situation of these patients —as is the case with Radha— is really worrying, and needs addressing urgently. Many of these people live in remote and inaccessible areas and have not the means to get to medical attention. For example, it takes Radha and her daughter between 2 and 3 hours to get to Aghbala, and there is no fixed timetable for buses but there is endless waiting. The nearest hospital is in KashbaTadla, three hours away from Aghbala. The low educational level of the adult population aggravates the situation, as it determines their ignoring of the negative consequences of preferential marriages for health, apart from the fact that it is a deep-rooted practice in their cultural identity.

But the difficulties for accessing healthcare do not end here. As well as the distance, the tortuous paths, and the deficient means of transport, another barrier between the patient and healthcare workers is language. The specialist doctors in the hospitals do not speak Tamazigh, but rather classical Arabic (fushja). The younger population communicate in English, French, Tamazigh and Arabic with ease, as can be seen, but the middle-aged and elderly rural population cannot, even less those who live in isolated mountain villages. Due to this, during the development of the NouSol cooperation programme in Aghbala, we had local translators who helped us to communicate in the surgery.

For all these reasons, awareness and health education projects are essential, together with socio-sanitary intervention to prevent congenital diseases deriving from consanguinity, and, for now, to face their negative consequences.

Tamara Vaquero is a Doctoral Candidate in her third year of Biology at the Universidad Autónoma de Madrid. In the summer of 2016 she took part in the voluntary NouSol programme in Aghbala, in Morocco, where she was able to see for herself the socio-health consequences of consanguinity on the population. The asociación catalana NouSol, founded in 2008, carries out international aid programmes for healthcare education and attention in Morocco and other countries thanks to the help of volunteers from around the world.