WATANI International
4 April 2010
The subject of pre-marital health care has become a hot topic in Egyptian families. The efforts of the National Council for Childhood and Motherhood have succeeded in making it mandatory for couples engaged to get married to undergo pre-marital medical check-ups before legalising their marriage contracts. In Coptic circles, several church congregations have convened seminars to educate couples before marriage and convince them of the usefulness of pre-marriage medical examinations to avoid health problems and lessen the possibility of bearing children with genetic diseases.
In reality, however, health examinations are mere ink on paper. In not a few cases, medical certificates are made up. Owing to the reluctance of some couples to undergo examination, advocates of the checks say it is important to conduct awareness campaigns to convince couples of the importance of the checks. It is also essential to conduct training programmes for doctors, especially in rural areas, to survey young couples and counsel them before marriage, and to perform consultations and genetic analyses.
Inadequate
As Watani set out to investigate the matter, it became obvious that young women and their families are more enthusiastic than men about the pre-marriage check-up. In most cases, the girl’s father convinces her fiancé to have a check-up to allay his own fears about his daughter’s future.
One young woman, whom we shall call Mary, told us her father insisted they should undergo the required medical examination. She said she underwent an ultrasound scan on her pelvis and her fiancé had a sperm count, but they were told that because of psychological stress his count, which was too low, might not be accurate. Mary was sorry her father insisted on breaking off the engagement.
Some doctors insist the medical examinations required in the check-up are not adequate. Marcelle underwent abdominal ultrasonic and blood tests at the Anba Barsoum Hospital in Helwan. Her husband did some tests in the venereology clinic. Even though their tests were encouraging and they got married, they were later told by doctor friends that—ideally—more examinations should have been conducted.
Abeer told Watani that she and her fiancé went to the Sahel Hospital in Shubra, where the medical checks cost EGP220. Abeer was a little surprised to see that no physical examination took place, and she was only asked in the abdominal clinic if she had previously undergone any surgery. The doctor then simply filled in the application form and wrote that she was fit for marriage. Her husband had the sperm count, but he was told that these tests were only valid for three weeks.
Embarassment
For some families in Upper Egypt, the suitor is the one who does the pre-marital medical check; his fiancée does not. On the other hand, some suitors remain sceptical about the usefulness of seeing a doctor. One young man, convinced of his virility and sound health, proclaimed the health of his brothers and sisters as a guarantee for his worthiness as a companion. It was obviously a real potential embarrassment for him to be seen at a pre-marital health clinic.
Under the table
In the Bakri public hospital, Samira says that when she arrived with her fiancé a doorkeeper told them that he would take EGP50 to save them the hassle of a medical examination. After several minutes he handed them two sealed certificates listing no physical impediments to marriage. Their names were on the forms, and they were issued by the hospital. Owing to the lapse of procedures in public hospitals, many couples prefer to have pre-marital medical examinations done privately.
Maryam, who has been engaged for three months, says she does not mind going to a public hospital and paying a bribe to the nurse to get the medical certificate without being examined. Public hospitals, she says, do not guarantee privacy to the patients, and a person could be having an X-ray when a doctor’s friend would boldly enter the room to have a chat with the doctor. Another young woman, Gihan, says that when she went to the health centre near her home and asked for a pre-marital check, the nurse reprimanded her with the words: “Go home. Aren’t you ashamed of yourself?”
Cultural sensitivity
Obstetrician Rima Hosni points out that some couples are reluctant because of their cultural upbringing. She says it is important to spread awareness before marriage, and that pre-marital check-ups for couples could help discover genetic and contagious diseases such as hemophilia, congenital heart disease, sexually-transmitted diseases and mental illness, helping curb the spread of these diseases.
Medhat Thabet, a consultant gynecologist, says that ever since pre-marital medical checks became compulsory by law, medical certificates have been fabricated because they are issued from public hospitals with minimal fees, no more than EGP50. Dr Thabet advises couples to undergo a number of tests including the blood group type and Rhesus factor, syphilis and HIV antibodies, a complete blood count (haemoglobin, red and white blood cells and platelets), hepatitis B surface antigen and antibody, and sperm count.
Reported by Nadia Barsoum, Angele Reda, Lillian Nabil, and Madeleine Nader