By local standards, they were an ideal match: first cousins, raised in the same house since birth and, within a year of their marriage...

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KABUL, Afghanistan — By local standards, they were an ideal match: first cousins, raised in the same house since birth and, within a year of their marriage, the proud parents of a plump baby boy.

But not long after their son’s first birthday, Ahmad and Mazari Ayubi noticed that little Masi’s head was starting to wobble. By the time he was 2, the boy was paralyzed and mentally retarded, and Mazari began to suspect what the doctors would later confirm:

“It’s because (Ahmad) and I are related that this happened,” she said sadly, cradling the youngest of three more children born with the same disorder. “Perhaps it is better for cousins not to marry.”

Two sons, including Masi, have already died, and two daughters grow more disabled by the day.

Such doubts are the first hairline cracks in what remains a bedrock tradition in Afghanistan. Although national statistics on the prevalence of marriage between first cousins are unavailable, anecdotal evidence from health workers, government officials and Afghan families suggests a widespread, deeply ingrained practice.

“There is a saying in our country that a marriage between cousins is the most righteous because the engagement was made in heaven,” said M. Marouf Sameh, chief of obstetrics and gynecology at Kabul’s Rabia Balkhi Women’s Hospital.

First-cousin marriages are prohibited in two dozen states in America — including Washington state.

Sameh estimated that at least 10 percent of his patients are married to a first cousin. Doctors at several other hospitals and clinics reported even higher rates of cousin marriage among their patients — almost always matches arranged by their families.

Some parents want to keep their property within the family or lower the “bride price” that men must pay their in-laws.

Others say they’re simply trying to find their child a good mate. Choosing a stranger is something of a gamble. Far better, goes the thinking, to pick a nephew or niece whose character you’ve been able to observe over years — accepted wisdom not only in Afghanistan, but in many societies across Asia, Africa and the Middle East.

Even Sameh, whose marriage was not arranged, fell in love with a first cousin. In a society where women are traditionally prohibited from mingling with unrelated men, he explained, “those were the only girls I was allowed to spend time with.”

Only after becoming a doctor, Sameh said, did he learn that couples who are closely related have a higher chance of conceiving children with birth defects and diseases such as the brain disorder affecting the Ayubi children.

Like the vast majority of children of first cousins, Sameh’s own sons and daughters are healthy. But, alarmed at the high incidence of congenital birth defects among his patients, Sameh has started speaking out on radio and TV programs about the risks.

Masooda Jalal, the minister of women’s affairs, said she was seeking funds to start a nationwide awareness campaign.