Unnamed children of Uppada coast in Andhra Pradesh

Koyya Durga (35) has yet to give a name to her eight-year-old son. “I’m afraid that something bad might happen to him if we name him,” she says.

In Sriramapuram village of Uppada-Kottapalli mandal, on the Uppada coast in the Kakinada district of Andhra Pradesh, Ms. Durga is among the many mothers who dread naming their children. They say that the grief and pain that their consanguineous marriages brought to their families are so deep and intense that they do not dare hold any more celebrations of their personal achievements, including naming their children.

The nearly 600 families in the village under the Pithapuram Assembly segment from which Deputy Chief Minister K. Pawan Kalyan is elected, the majority of whom belong to the Yadava community, irrespective of their economic and educational standards, share a common suffering—the burden of consanguinity and inbreeding.

A majority of the families here were traditionally shepherds who have taken to agriculture and aqua farming which thrive on the Uppada coast.

At 13, Ms. Durga married her 15-year-old maternal uncle Koyya Appala Raju. Their marriage was solemnised in 2002. “Our families fixed our wedding in six months after I attained puberty,” says Ms. Durga.

Within two years of marriage, she gave birth to a baby boy, who died due to health complications at the age of five. The couple did not have children for 14 years after the death of their first boy.

“We were blessed with another baby boy in 2016. Even though it was a caesarean delivery, my joy was boundless. But my son didn’t cry like healthy babies do. We had to keep him in an ICU at a private hospital for 25 days in Pithapuram,” she recollects.

When my son was nine months old, we got him tested, and he was diagnosed with cerebral palsy. The boy even suffers from seizures occasionally.

“The doctors concluded that some deformities might surface as he grows up, but there are possibilities for their cure in the future. They said consanguinity was the prime cause for these health disorders,” says Ms. Durga.

The calming sound of the waves or the soothing sea breeze seems to provide little relief to these villagers who are overwhelmed with the many children suffering from severe health problems as a result of their strict adherence to the culture of consanguinity.

Burden of unhealthy customs

“Today, at least 25 children in our village, born to couples who had consanguineous marriages suffer from various mental and physical disorders. There must be at least 30 consanguineous marriages that happened over the past few years here,” says farmer Perla Venkata Babji who also married within the family. Within two years, three consanguineous marriages were held in our village, the 40-year-old man says, adding that two of his three sisters have had consanguineous marriages.

Elaborating on the high prevalence of consanguinity in the villages on the Uppada coast, Kosuru Ravi Kumar, Medical Officer at Primary Health Centre at Perumallapuram of Thondangi mandal in Kakinada district, says: “Many consanguinous marriages are happening in our area. This practice is more prevalent among the Yadava and fisherfolk communities.”

Nearly 70% of children born to couples whose marriage is ‘First Grade’ consanguinity may develop health disorders. Given their genome history, a marriage between a girl and her maternal uncle can be termed ‘First-Grade consanguinity, he says.

Mr. Babji says the imposition of the practice of inbreeding begins with the ‘Voni’ promise, which is made right at the birth of the girl child in the community. That is when the family members choose a boy and make an oral agreement with the girl’s family that when she attains marriageable age, she will be married to the boy. 

It is also customary that when the girl attains puberty, her parents remind the boy’s family of the ‘Voni’ promise. The villagers explain that it is also considered a grave offence if any family violates the promise.

A. Vara Lakshmi of Perumallapuram in Thondangi mandal married her maternal uncle, a geologist at a Central government institute, as per the ‘Voni’ promise made by her parents on the day she was born. The Master’s degree in Commerce she holds hardly helped her shape her fate.

The eldest of her two children is her four-year-old girl Akanksha who cannot speak, respond, or balance her movements and constantly needs a guardian.  

“We never imagined that our Akanksha’s destiny would be so bad. The doctors at the National Institute of Mental Health and Neuro-Sciences (NIMHANS-Bengaluru) confirmed that she suffers from Dandy-Walker Malformation (DWM) and that it is a result of consanguinity,” says Ms. Vara Lakhsmi, who, like Ms. Durga, doesn’t want to give a name to her younger child, a four-month-old boy, fearing something bad can happen to him if she celebrates his birth with a naming ceremony. 

The grim reality of the unhealthy custom reflected in Ms. Akanksha’s inconceivable suffering has, however, not stopped her grandfather from making arrangements for another consanguineous marriage in the family. 

“Looking at my granddaughter Akanksha, I do hesitate to ask my son to take the same risks. But the entire family has given its consent for his marriage to a girl in the same family during the ‘Voni’, and I cannot go back on my word. The engagement is likely to be held during the coming Pongal festival”Kadari ArjunuduVillager, Perumallapuram

“Looking at my granddaughter Akanksha, I do hesitate to ask my son to take the same risks. But the entire family has given its consent for his marriage to a girl in the same family during the ‘Voni’, and I cannot go back on my word. The engagement is likely to be held during the coming Pongal festival”, says Kadari Arjunudu.

Evil of dowry

Meanwhile, in the Perumallapuram gram panchayat, every family has a history of consanguinity, says Buddiga Ramana, a farmer and a local politician. “By 2019, not less than 25% of marriages performed in our village were consanguineous marriages. Now, it has reduced to 10%. Everybody is aware of the health consequences of consanguinity, but socio-economic factors such as land for dowry and familiarity of the alliance are some things that our Yadava community cannot discount while making a marriage alliance,” claims Mr. Ramana, who married his niece.

Despite the high prevalence of birth deformities caused by consanguinity in the area, no specific surveys were conducted or targeted campaigns were run to curb the practice, say officials. 

“There is no specific campaign targeted at the prevalence and prevention of the practice of consanguinity. However, our field-level staff are campaigning against consanguineous marriages during the door-to-door campaigns of various programmes and surveys”J.N. Narasimha NaikKakinada District Medical and Health Officer

Kakinada District Medical and Health Officer J.N. Narasimha Naik has said, “There is no specific campaign targeted at the prevalence and prevention of the practice of consanguinity. However, our field-level staff are campaigning against consanguineous marriages during the door-to-door campaigns of various programmes and surveys.”

Dr. Naik notes that the local communities are fully aware of the health consequences of consanguinity and still choose to continue for various reasons, including cultural and economic.

Prenatal counselling

Meanwhile, Government General Hospital (GGH-Kakinada) Superintendent Dr. Vittal says that they are making efforts to bring awareness among the consanguineous couple who visit the hospital for prenatal health check-ups. “We collect the marriage history during the prenatal tests. We also inquire about consanguinity, particularly when some defect is traced. Families of both couples are called for a counselling session where we explain possible disorders the baby could be born with, their causes and treatments. We also have been performing minor surgeries on the children to remove some defective parts or prescribe treatment in the GGH-Kakinada,” he says.

Father of a boy suffering from albinism, at Srirampuram village in Uppada Kothapalli Mandal Kakinada District.
| Photo Credit:
T. APPALA NAIDU

“In our area, particularly among the Yadavas, it is a must to give land in dowry if the bride’s family has any and 90% of the dowry agreed upon is given in the form of land but not cash,” observes Nagalla Srinu, an elder of Sriramapuram village even as he watches his neighbour, an albino boy, Krishna, born to a consanguineous marriage leaving for school.

The sudden spur of economic activity, with the development of the Kakinada Special Economic Zone (KSEZ) for multi-sector industries in the area and the development of the Kakinada port, has brought an unprecedented demand for land here in recent times. With land prices soaring, the people here say the demand for land in dowry is also increasing, forcing more families to prefer consanguineous marriages to other alliances for their children.

A decisive move

Meanwhile, Perla Nookalamma of Kodada gram panchayat of Thondangi mandal takes a decisive step to end the misery of consanguinity in her family. While two of her three children were born with visual impairment, she resolves to end the practice with her and not let it pass on to the next generation.

All the children were born out of a consanguinous marriage which was forced upon her as a child, she recounts

 Perla Nookalamma and her visually impaired son Sattibabu.
| Photo Credit:
T. APPALA NAIDU

Ms. Nookalamma, a daily wager, decides to marry her son to a girl outside their family. “People began to think of adversaries of the consanguinity. However, the lives of some people such as ours are irreversible”, says her son Mr. Sattibabu, 30, who aspires to become a government school teacher. His wife, Ms. Kameswari, is also visually challenged, but she does not belong to the same family.

“My husband passed away in 2011 due to prolonged illness. I had to sell 30 cents of family land for the medical treatment of Mr. Sattibabu, who began to suffer from seizures. My entire life is riddled with challenges as if I was born to face them, all thanks to my marriage,” she rues. I will not have any nameless grandchildren in my family, she resolves.

At Srirampuram, Ms. Durga, however, is heartbroken. “I have made up my mind not to try for another child. I cannot undergo family planning surgery because I can’t afford to take post-surgery rest for weeks and let my child suffer. There is not one to look after my ailing boy,” she says as tears welled up in her eyes.

“My ailing boy, who will remain unnamed,” she adds as she wipes her tears.

(Names of children changed to protect identity)