Statistics on the prevalence of marriages between close relatives today are scarce. Once common practice in Western societies, estimates suggest the Middle East, along with Africa, continue to have the highest levels in the world. In Egypt, around 40% of the population marry a cousin; the last survey in Jordan, admittedly way back in 1992, found that 32% were married to a first cousin; a further 17.3% were married to more distant relatives. Rates are thought to be even higher in tribal countries such as Iraq and the Gulf states of Saudi Arabia, Yemen and Kuwait.

Today the first reason men and women look to wed within the family is because they know a lot about their relatives: who they are, what they earn, any past blunders. And large families mean they have lots of them. “People are looking for ethics and manners,” says Atef al-Shitany of Egypt’s health ministry. Tying the knot within also ensures property remains in the family. In Upper Egypt, a rural farming area, rates are the highest in Egypt.

Unlike in the West, there is no social stigma; quite the opposite. A 38-year-old Egyptian woman, who has two sons with micro-syndrome (which causes cataracts, small genitalia and learning difficulties) due to her marriage to a cousin, says relatives nonetheless criticise her for allowing her 18-year-old daughter to get engaged to a “stranger”—the fiancé is not a relation.