Who is carrying the thalassaemia bomb?

Jamal Uddin Tanin
Published : 10 Oct 2019, 10:13 PM
Updated : 10 Oct 2019, 10:13 PM

A little patient of mine came to me on her father's lap. The two years old was a case of thalassaemia, a genetic disease of blood. She needs regular blood transfusion and also some costly oral medications and injections. Lifelong regular follow up with a haematologist (specialist in blood disease and blood cancer) is mandatory. Before marriage, her parents had no clue that they were carriers of thalassaemia. As a result of the marriage between two apparently healthy individuals who were actually carrying the gene of thalassaemia, the offspring is now a sufferer of thalassaemia. How unlucky she is!!!

Another patient of mine knew that she was a carrier of thalassaemia. But her family decided to conceal it and married her off. Now the couple is planning to have a baby. But there is possibility of the father of being a carrier as carriers have no external signs at all. It is making the expected carrier mother extremely tense and is ruining the peace of her life. Because if the father is also a carrier, their child can be a sufferer. But is it possible to inform the husband now? She wanted me to find a way to test her husband for thalassaemia without informing him!!! How unlucky!!!

An elderly female was diagnosed as a carrier of thalassaemia in her fifties. I asked her about her family. She informed me that her elder daughter just got engaged. I hurriedly informed her that her daughter has the possibility to be a carrier of thalassaemia and if she is, her fiancé must check his thalassaemic status too. Otherwise the offspring may become a sufferer. She was really worried. It's tough to go back for a recheck after engagement. She also said that the wedding is already creating tensions due to various social reasons. But it is a must to test for thalassaemia, I insisted. Because it is tougher to carry a child with thalassaemia. However, she did not return for a checkup with her daughter so far. Really unlucky!!!

A pretty girl was having some problems getting married. A good proposal came later. But before engagement, the suitor informed the girl that he was a carrier of thalassaemia and the girl should check it too. She came to me and after proper methodical medical checkup, she was diagnosed to be a carrier too. The girl and her guardians were really depressed as I informed them that it must be a no. Really ironic and unlucky!!!

But, it is definitely better than bringing a child with thalassaemia and carrying all the burdens for the rest of the life.

Whenever I examine the blood reports of various patients as a haematologist, I find that a lot of these reports carry indications of thalassaemia. It's a fact that South East Asia is an endemic zone for thalassaemia and related blood disorders. And so, Bangladesh is a hotspot for thalassaemia too. But thank Allah that a good number of thalassaemics are just carriers but not sufferers. These carriers mostly do not have any external problems at all. But they have high potential of getting married to another carrier and give birth to a sufferer of thalassaemia. So, the fact is that millions of people in our country are actually living like a hidden time bomb. The bomb is going to explode whenever it meets another bomb. And this meeting is occurring by marriage between one thalassaemia carrier to another. And more ironically, this bomb detonates on the baby by making it a lifelong sufferer. But the carriers never understand the problem as their problem is hidden from external eyes. The only way to detect the carrier is undergoing some tests under supervision of a specialist (as tests may be false negative). And it must be done before marriage so that a carrier can avoid marrying another carrier.

Now the final question is who do you think the most unlucky among those patients? The child or the engaged girl? The carrier who concealed her status of thalassaemia or the girl who had to deny a good proposal for both being carriers? Well, readers may have various opinions. But to me the most unlucky is the person who is reluctant to know his or her thalassaemic status even after reading this article. Because every reader can be the carrier of the time bomb… tick tock… tick tock… tick tock… boooooom!!!