do not respond to advice
Dr. Zakaria Muhammad Hawsawi, Director of the Center for Hematology and Consultant of Genetic Hematology and Oncology at Children''s Hospital in Madinah, said that 90% of those we interview carry carriers of the disease before marriage, do not respond to advice, and complete the marriage due to social considerations, or pressure from parents not to break the engagement, and the result is Children with sickle cell disease or thalassemia.
He pointed out that these diseases cause major health problems for those who suffer from it, which are chronic diseases that suffer for life, indicating that we met in the center approximately 50 incompatible cases, and the response to non-pairing was only 4 cases, as they responded to advice and instructions, and broke off engagement, explaining that they reviewed them in the center 120 children To receive treatment, he said, treating thalassemia patient annually costs 100,000 riyals, and added our endeavor to establish the Madinah Charitable Society for Hereditary Hematology to support and help patients. “The City” had a lengthy dialogue with Dr. Zakaria Hawsawi, who talked about many things about genetic blood diseases, to the text of the dialogue:
At first we would like you to give us an overview of the center?
The center was established in 1412 AH, and its beginning was in the old building of the Obstetrics and Gynecology Hospital next to the Prophet’s Mosque in a small section, where it provides services to these patients with sickle cell disease and thalassemia, then the department gradually developed until it became a center in the new building, and we said that we accommodate 10 patients daily, The center has a capacity of 25 beds, and there is a section for hematomas, and now a new building is d in the vicinity of the hospital that will have a large department, and within two years it will be completed, and it will be a specialized and integrated center with a large capacity for hematology, in addition to other specialties through which we can provide more services For patients with hereditary blood diseases, Dr. Hawsawi added that the center located in the city is considered one of the best centers in the Kingdom, as it provides comprehensive services, where we provide the patient with all his needs, by requesting doctors of all specialties that the patient needs from the outpatient clinics to check it like an endocrinologist Sugar and gastroenterologist, and there is a nutritionist to educate them about the appropriate food for them, and with us the social worker is making a great effort to follow up the patient in schools, so that c All matters for him, and therefore are taken into account, and we have provided a special laboratory in the center and the analyzes that he needs and all services are provided to the patient in the center, and he does not need to see clinics at all, indicating that we are currently coordinating with the military hospital in Jeddah to provide an MRI machine to measure the level of iron in the heart and liver, and we hope that This device is coming to us in the city soon.
What are genetic blood diseases?
Hereditary blood diseases are diseases that are transmitted from parents to children through inheritance, and they are multiple and many diseases, but the most important ones that cause serious problems are (sickle cell anemia and thalassemia which is also called anemia of the Mediterranean basin), which are prevalent in most countries of the world, but are concentrated In some regions, the Kingdom is among these regions where this disease is spread, including the eastern and southern regions, and the Medina area where this disease is spread, especially sickle-cell.
What about sickle cell anemia? What are its complications?
Sickle cell anemia is a hereditary disease in which the parents are carriers of this disease, and therefore it is transmitted through intermarriage to the children and this disease has multiple complications, where the patient suffers from severe episodes of severe pain that require a hospital review to take analgesics, and usually are strong analgesics, including (the anesthetic) to relieve pain from it, Consequently, the patient becomes hospitalized for treatment. The patient also suffers from severe blood shortage, needs blood transfusion, and is exposed to strokes, and thus is subject to hemiplegia or quadriplegia as a result of this disease.
So the goal of adopting the prenuptial examination program is to protect the generation from these diseases?
The state - Dear God - approved this examination since 1425 AH because of the suffering incurred by children with hereditary blood diseases, where a royal decree was issued by the Council of Ministers, and this program was started, and the disclosure became mandatory, and the Ministry of Health adopted the establishment of centers for pre-marital examination in all The regions of the Kingdom, and the marriage is not concluded until after a report from the center has been prepared that the man and the woman have been examined, and the authorized person takes the report and the marriage is concluded.
Did the number of patients decline after the approval of the examination before marriage?
Unfortunately, the disease has not diminished or decreased! It is estimated that 90% of the interviewees are carriers of the disease, whether the young man or the girl before marriage, and the two types of this disease, and unfortunately the marriage continues, and they have children with the disease. And for us in the Madinah region, there are still inadequate awareness of society and the reason is due - according to his description - to the problem of customs and traditions from the side of marriage, and the lack of awareness of the seriousness of the disease, and many of them work the examination in the final stages before the marriage, and it is difficult for them socially to break the engagement, and many of them set an appointment The network, the invitation was distributed, and they decide to continue completing the marriage.
Are there instances they have been advised to continue marrying and have infected children?
Yes .. as it was advised cases of people with the disease before marriage, but they completed the marriage, and they had the first child with sickle cell anemia, and they came to review the center.
What about other disease (thalassemia anemia) and its complications?
Thalassemia anemia is also a hereditary disease similar to sickle cell anemia, where the father and mother are carriers of the disease, and therefore transmitted to the children, and he said that a patient with thalassemia cannot produce blood, and he has a deficiency in that, and he needs to donate blood repeatedly that transmits blood every 3 weeks for life, and there is for him A treatment with a bone marrow transplant, but it is difficult and rare, and it has complications, and its treatment is for life by reviewing a specialized blood transfusion center like we have in the city area.
And Dr. Hawsawi indicated that the continuous blood transfusion of a thalassemia patient results in a high level of iron, and this rise causes problems for the patient, as it is deposited in the body parts such as the heart, liver and pancreas What causes them diabetes, or heart failure that leads to death, or cirrhosis of the liver and treatment blood transfusion.
What is the solution to treat this deficiency and lack of social awareness of the seriousness of the disease?
Society in general, some of them have no knowledge of sickle cell anemia and thalassemia, and the solution must be paid attention to this matter, educating the community, and spreading health awareness of this disease.
How many injured children are attending the center?
The center reviews 120 children who receive treatment regularly, blood transfusions, the number of thalassemia patients is estimated to be 100 children, and the number of sickle-cell patients 20 children, and there are other numbers who review in outpatient clinics in the hospital without severe complications.
What are your ways to provide blood for thalassemia patients?
Blood is provided by the central blood bank, and this is a suffering for thalassemia patients, as their lives depend on the availability of blood on a regular basis, and we have a problem sometimes with the lack of a suitable family for the patient - praise be to God - the blood bank strives to provide blood for the patients, and we find it difficult in some The seasons, where the Medina is considered a pilgrimage and Umrah region, and requires large quantities of blood, and sometimes there is scarcity in providing blood for these patients.
How much is the value of the sums spent on a child with this disease?
The costs are very large, where we calculate the cost of blood transfusion and review, and for drugs given to reduce iron very expensive, where a thalassemia patient exceeds treatment per year 100,000, and sickle-cell patient is almost less expensive by between 50 and 60 thousand per year.
Mention the negatives that you face in the center?
He said the problem facing us for patients who are over the age of childhood (more than 13 years) has no place, and therefore we are continuing their treatment, and we seek to have an integrated center for the care of adult patients Because this disease persists, the Children''s Hospital is about 13 years old, and we have injured people, 30 years old, who check in for blood transfusion.
What are the solutions and proposals that you see to avoid or reduce these genetic diseases with blood?
One of the future solutions said obligating non-consummation of marriage to people who are ill Because there is danger and suffering for the injured, the Ministry of Health is studying a number of proposals to achieve the goal of the prenuptial examination Because if the doctor''s advice and advice not to marry and marry are not followed, this means that this examination did not achieve its goal if the cases continued to increase Because the goal is to combat and reduce this disease. He also added from the proposals that the examination be carried out in advanced stages of life, such as high school students, so that both the young man and the girl know their situation that they are carriers of the disease, or otherwise, and therefore when a young man applies to this girl, and she knows that she is healthy and is pregnant with the disease, this does not prevent marriage That is, if one of the two parties is healthy and the other is a carrier of the disease, the marriage is never forbidden.
Is sick person sickle cell anemia or thalassemia prevented from marital life in the future?
Never .. These patients are not deprived of their married life in the future. He said that if a person who is sick with the disease is married to a girl who is not pregnant with the disease, and vice versa if a person who is not pregnant with the disease is married to a girl who carries the disease, then they will have children who are not infected and healthy. Adding that one of the patients who reviewed the center will soon be married, and there is a positive aspect that we address to those who have infected children that if the patient goes through treatment and follow-up, he lives a very normal life. Postgraduate degrees, marriage, and having healthy children.
What are the efforts made to alleviate the suffering of those suffering from these diseases?
We coordinate with several parties to hold training courses for them, and we also collaborated with the Charitable Society for Social Services by training some Thalassemia patients, and they have jobs, and also from the suffering of the patient that when he reaches a certain age, where the injured have a disease, emptiness, suffering, and lack of Provides support and it causes him other problems, and therefore we seek to find
