Friday, December 13, 2013

ALBINOS IN AFRICA

Albinism  is a rare, non-contagious, genetically inherited condition occurring in both genders regardless of ethnicity, in all countries of the world. BOTH the father and mother must carry the gene for it to be passed on even if they do not have albinism themselves.

Black woman,White skin Kenosha Robinson an albino on the fashion page of
The condition results in a lack of pigmentation in the hair, skin and eyes, causing vulnerability to sun exposure and bright light. Almost all people with albinism are visually impaired, with the majority being classified as “legally blind”. While numbers vary, in North America and Europe it is estimated that 1 in every 20,000 people have some form of albinism.

In Africa albinos have been facing persecution and discrimination whiles some other African state also see nothing wrong with people living with albinism. In some African Culture and tradition albinism is a sign of bad luck in the family and as a result they are ostracized from the family to avoid being ridiculed by the other members of their community.Among the Mandinke people of Mali a child born with albinism is an ill-omen and a shame to the family. 

It is even seen as a curse and that child is not allowed to come anywhere near their own family and is in the view of this that is why Malian renowned singer dubbed "the Man with the Golden Voice and inventor of Afro-pop" music Salif Keita was ostracized from his family despite being born of royal blood as a direct descendant of the founder of the Malian State, Sundiata Keita.
                                 Malian Albino singer, Salif Keita
 In Ghana,albinos are called "Ofiri Djato" (fair person) which is quite different from how they call a Caucasian/white person as "obroni." Albinos in Ghana don`t face any persecution at all. There are some how are even very influential in the national affairs. A celebrated legal luminary and the long time president of Ghana Boxing Association (GBA),Moses Foh-Amoaning is a well-known albino who easily mingles with people in Ghana without any discrimination.
    Attorney Moses Foh-Amoaning,Ghana`s leading Sport Analyst
Among the Akans in Ghana albino is just like any other Akan with different skin i.e black person in white skin. As young people there was this mystery story about albinos that they do not die but just get translated out of this world. It is also believed that the great Okomfo Anokye, the priest that conjured the Golden Stool for the Ashanti kingdom and is also a co-founder of Ashanti kingdom was an albino (Ofiri). Albinism in Akan culture is well understood that there is even a great deity of worship in one Akan community (i.e the Brongs) that bears the name " Kwaku Firi shrine" at Anwoase (Kwaku the Albino).

It is therefore wrong for the international community and some foreign media to treat Africa as if it is a continent that is barbaric and they just take joy in persecuting and discriminating against people living with albinism. One can only do a meaningful analysis of the problem that albinos are facing from the get rich mentalities of the youths of today in Africa who via what they see on the media are bent on using any means to get rich quicker. It is this "get rich or die trying" mentality that has also make the albinos become an endangered species in Africa as some "juju/medicine men" claims albinos blood and body-parts are very potent for rituals and can bring one instant wealth and luck.
An albino Royal in procession with his Akan Chieftaincy retinue
Now before I get into types of albinism and issues of albinos in Africa, let us ponder if albinos are the the species of homo sapiens that Caucasians originated from?

Albinos--The Origin of the Caucasian Race?

As new information comes down the pike, it is necessary to rethink theories that were once in place.  The origin and labeling of the “so called” Caucasian, Negroid, and Mongoloid Races by 19th Century scientists, started racial groupings based on skin color by naturalists and anthropologists like Johann F. Blumenbach, JA Gobineau and HS Chamberlain.  These men also equated skin color to psychological value and importance to race.  Blumenbach named whites after the Caucasus Mountains because he thought the purest white people originated there.  He didn't seem to realize the following:
Russia, Chechens, Armenians, and other Southern Russians are considered to have Black Negro origins and Caucasus Mountains people are classified as "black" and are discriminated against.  Blacks have lived in Southern Russia since prehistoric times and have occupied the Black Sea Region since the time of Senwosret/Sesostris (2000 BC) when Africans dominated the region.  (SEE 'HERODOTUS' ON THE COLCHIANS).

                                Albino woman 

FROM AFRICA – NOT TO AFRICA!

Reference: White and Albinism  http://www.youtube.com/watch?v=CEvvtt3-eBI
 
Today The American Anthropological Association declares there is no such thing as race which is merely a “social construct.” If that is the new scientific principle, then….There are plenty of scientific facts to back up this principle.  According to The South African Institute for Medical Research in review – Journal of South African Science, THE HIGH FREQUENCY OF ALBINISM IN AFRICA provides more clues to early African history.  

The Department of Human Genetics at the SAIMR is currently involved with numerous research projects, most related to human genetic disorders and population origins--one of these, ‘Albinism in African peoples’ having received particular attention because it offers new insights into the historical movement of peoples in sub-Saharan Africa. 


 
The albinism syndrome shows parallels with sickle cell anemia. The carrier of the sickle cell mutation is at an advantage in regions where malaria is, which includes large areas of Africa.
BaAka mother with albino son. The BaAka (also called the Bayaka or Aka) are a nomadic people of the Western Congo Basin in Central Africa. They are part of the wider grouping of Mbenga people, historically called pygmies. Albinism is a genetic disorder characterized by a lack of the pigment melanin, which gives colour to the skin, hair and eyes. Those affected are known as albinos. Photographed in the south-western region of the Central African Republic.redit: 

About one in 35 southern African blacks is a carrier of an albinism mutation, a surprisingly high prevalence for a genetic disorder where the homozygote is at a survival disadvantage. It is postulated that the albinism carrier may actually be at an advantage, possibly also with malaria as the selective agent. It has been suggested that mosquitoes are less likely to alight and take blood from a lighter-skinned person and thus the albinism carrier may be at an advantage over darker-skinned people. The testing of this hypothesis is opening up a new line of research into malaria studies, which may yet show some other selective agent may be responsible for the high frequency of albinism in Africa.
The new scientific genetic information derived from the Human Genome Project, an international effort to decode the information embedded in the human genome, confirmed to the world by scientists in the East Room of the White House (June, 2000).   We all evolved in the last 100,000 years from the same small number of tribes that migrated out of Africa and colonized the world".  "All human beings are 99.99% the same at the DNA level and the remaining 0.1% genetic variation that exist seldom segregate in a manner that confirms to the racial boundaries constructed by social political means.”
Many years before the Human Genome's Project announcement of its historical DNA findings on so called "race" (in June of 2000), historians have revealed that human beings, during the primitive era in ancient/antiquity Africa - The Origin of Humankind/Humanity states that due to the lack of knowledge about inbreeding (between closely related parents) they did not understand why their off spring were born with "white skin."  Scientists say "white skin" is a form of Albinism (a genetic defected offspring -- lacking melanin).  
Cystic Fibrosis was thought to be a disease that affects mostly Europeans, but there are studies that now confirm that the most likely origin of the mutation is the African Continent.

The CF studies also tie-in with population migration investigations. Since the common African mutation has also been found in Zambia and Cameroun, it too supports the Bantu Expansion Hypothesis. It is worth noting that the mutation has also been found in African-Americans, in Saudi Arabia and in Greece on the same chromosome background (haplotype), suggesting a single origin. The most likely origin of the mutation is indeed the African Continent. 
Cystic fibrosis (CF) was first described in Europe in the late 1930s. It was later shown to be surprisingly common with, on average, one in 20 individuals of European origin carrying a CF mutation. It was widely believed to be absent or very rare in Black Africans and was taught as such to generations of medical students. Only a handful of cases were described in African Blacks in a period of over thirty years, although it was well documented among African-Americans. CF was originally thought to be present in the latter because of admixture with individuals of European descent.
Albino girl

Oculocutaneous albinism (OCA) is a rare, genetically inherited condition passed on by both parents to their offspring, resulting in a significant reduction in or absence of pigmentation in the hair, skin, and eyes at birth. Individuals with albinism are very fair-skinned and fair-haired, with (most often) blue eyes that can take on tones of purple or red in bright lighting.
But due to such lack of knowledge as to why their "white skinned" off springs came about, African mothers and fathers became more and more fearful and suspicions and began to separate their growing number of "white skinned" off springs away from the "black skinned" (pigmented) population.  
Eventually most of the "white skinned" off springs of "African" mothers and fathers formed several groups and began to migrate northward through Egypt to another area of Africa which is now called Europe, seeking a more hospitable living environment and to escape the intensity of the equatorial hot climate of the great river valleys and great lakes region of Central, Eastern and Southern Africa which was then and still is South of what is now called Egypt. 
 
The "albino" group moved up in the mountainous area during the Ice Age or Glaciations period that lasted thousands of years further isolating themselves from their original parent population in Africa. And by being in such isolated living condition for such a prolonged period they also interbred (within the existing parent groups) thereby creating additional "albino" offspring from "albino" mothers and fathers who were then and still are direct descendents of African mothers and fathers.
A mutation results in a change of the DNA sequence within a gene or chromosome of an organism resulting in the creation of a new character or trait not found in the parental type.  There is blonde hair among the black Australian aborigines.  That is an example of a mutation.  Albinism is a good example of a mutation.  Other examples of mutations are blondism or whiteness among monkeys, apes, and chimpanzees.
Biblical Evidence of White Skin
There are many cases of individuals turning white in Jewish biblical history.  When God wanted to show Moses a miracle, he turned his hand "white as snow;" then God turned his hand back again to its original color of black.  In ancient Israel when a man had a white spot on his skin or white or yellow hair, or white skin somewhat reddish, he was pronounced unclean.  All people who were victims of this shameful disease were isolated outside of the camp or city and segregated.




Some theories equate Albinos with the origin of the Caucasian Race. This website has many validations for the origin of the Negroid Race, but what about the Caucasian Race? Certainly Frances Cress Welsing hit the nail on the head with her book, The Isis Papers (1991). 

The White Race has the genetic inability and absence of melanin to produce the different skin pigments seen throughout the world.  That absence of skin pigment creates the inability to produce colors.  As a result, uncolored or white skin is produced.  White Race genes are at a recessive global juncture. Recessive genes delineate body characteristics that are masked or not expressed when a contrasting dominant black or brown gene or trait is present.  The black/brown genes create people who have curly hair and whose skin is easily tanned.   


As the recessive gene disappears, anthropologists are rushing to reclassify the world's Black and Brown Races. Through "Caucasian racial engineering" some Brown Races have become hypothetically "White."  It has increased the White Race totals with a lopsided apportionment numbering system.  The system has been designed to expand and extend White Race counts, which only amount to 8 percent worldwide (United Nations Population Division, 1+). 
In “Echoes of the Old Darkland” by Charles Finch III, MD by a doctor of medicine (Yale) the following is quoted:   “We propose that the ... population that survived the last glaciations in southwestern Eurasia was largely a group of albinoids who were better adapted to the ecology than their darker relatives who had originally colonized the area.  These latter were gradually replaced by albinoids, though small groups of African aboriginal types long persisted on the North Atlantic seaboard because of the availability of Vitamin-D-rich salt-water fish.  This “goodness-of-fit” of the albinoids in this northern environment was due to the more efficient Vitamin D production and utilization in the whitened skin in these sunlight-deficient latitudes and better cold resistance. 



The Ice Age had the practical effect of isolating this marginal group from other populations for a prolonged period, promoting a consanguinity that would have allowed the recessive albinoid genes to express and propagate themselves.  Creation of a new race via de-pigmentation is consistent with the tendency in nature of new species and subspecies to form out of marginal groups that have become isolated from their “parent” populations and subjected more or less abruptly to extreme environmental conditions, which generate intense selection pressure.” (Op. cit. p. 35)  Albinoid mutation seems as good a speculation since the fossil data and genetic data both seem to rule in favor of a common, Black African ancestry for all mankind.
Albino models

People with Natural Blonde Hair are Disappearing and will be Extinct in 200 Years.
New research suggests that people with blonde hair will be completely extinct in 200 years.  Blonde hair occurs only in people from northern Europe.  The blonde gene that causes blonde hair color must be on both sides of the family, and according to the World Health Organization, there is now too few people who carry it.
Professor Jonathan Rees from Edinburgh University is leading a two-year study into the genetics of blondes.  Scientists say blondes will survive longest in Scandinavia where they are most concentrated, and they predict the last one alive will be from Finland.

Globally, the White Race risks "genetic color elimination."  Caucasians /8 per centers are rapidly presenting the world with a conjured-up system of so-called "statistical numbers of non-truth" as a way to implant new suppositions and beliefs. The non-truth firepower has the ability to deliver psyche-up, illusory gunfire amounting to numerical warheads on the target of more Caucasian deceit.  The duplicity will end up fabricating a sort of actuality--statistical ballistic weaponry warfare to MAXIMIZE the dwindling White Race group numbers.   


The original Indo-Europeans referred to, as Aryans were nomads who herded animals in the steppes north of the Black Sea, in what is now the Ukraine.  Between 5,000 and 6,000 years ago, the Aryans migrated into Europe on horseback and conquered a series of cultures.  The Encyclopedia Britannica concurs with British historians.  When trying to trace pre-historic man to Europeans, it was found that Indo-Iranian languages make up a major branch of the Indo-European family of languages (Bower, 120+).  
The Sinhalese Language is an Indo-European language of the Indo-Aryan family.  The earliest surviving specimens of the language are brief inscriptions on rocks in Brahmi Letters from 200 BC.  The most considerable amount of dated Aryan language dates to about AD 1000 (Encyclopedia Britannica, 567).  



Linguistics link the Iranian language to African languages.  Iranian languages include the Arabic language. Arabic belongs to the Semitic language group.  Semitic includes Ethiopic and Hebrew--people who lived in one of Black Africa's greatest civilizations.  The implication being made is the following:  Caucasians cannot validate their rudiment White civilization.   It has been proven that civilization started in the great river valleys of Africa in the Fertile Crescent.  The human race was born in Africa, and it is only logical that the evolution of White men started in Africa.  

Tanzanian Albino kid

Snowflake, the only albino gorilla ever observed. Captured from the wild by poachers in 1967, Snowflake, originally from Equitorial giunea forest lived out most of his life at the Barcelona zoo. He died at the ripe old age of 40 due to skin cancer, probably related to his albinism. He outlived all of his 22 children, none of whom were albino, but lived to see his many grandchildren - a rarity for gorillas 

The Encyclopedia Britannia outlines the lack of or absence of historical sources to trace the process of Swedish Expansion and the Viking Era around AD 400.  The same is true for Denmark.  It is written--The first trustworthy written evidence of a kingdom of Denmark belongs to the early Viking Period.  Roman knowledge of this country was fragmentary and unreliable.  The same is said for the other Scandinavian countries.   

Currently, the Smithsonian Museum is inviting people to examine the Atlantic Saga of the well-known culture of the Scandinavian Viking Age (AD750-1050) as they discover America.  They landed in Newfoundland, Canada exactly 1,000 years ago.  It is being hailed as a "discovery."  An endnote has been added that there is generous support from the Nordic Council and Ministers of Volvo.
 
The Caucasoid/8 per centers' numerical deficiency has created a sort of numerical abundance because White groups now have psychologically increased their numbers with the many different White classifications of:  German White Race, English White Race, French White Race, and Russian White Race.  This justifiably amounts to many White Races even though theoretically there has been a three-race theory staunchly in place since the 19th Century. 
The same psychological numerology works to minimize black/brown groups and forms the White "labeled minority classifications" geneticists refer to when "feeling their oats on the genetic highway to a White majority."  Dividing black/brown people into groups and referring to the groups as "non-white" or "people of color," presents a purely natural tendency to think of black/brown people as lesser because of the fewest number of numerical classifications.  Therefore, Black and Brown people have become minorities in the mastermind scheme when the statistical numbers of abundant craftiness are presented globally. 



From sea-to-shining-sea.  History shows that discrimination in this country occurs in all races that are not considered Caucasian.  Asians, for example, have experienced a long history of discrimination even though the Asian Race is coined as the "Prototype Minority" worthy enough to grace the White American dominion.  In 1854 the California Supreme Court ruled that Chinese citizens were not permitted to testify against Whites.  In 1882 the Chinese Exclusion Act banned all immigration from China. 


In 1913, California declared Asians ineligible for citizenship and prohibited property ownership. In 1924 the National Origins Act excluded most Asians from migrating to the US. With the outbreak of World War II one hundred and ten thousand (110,000) Japanese Americans were relocated to internment camps.  It was only in 1952 that Asians born outside the US were permitted to become citizens--but now have been termed the “ideal minority.”  Today most Blacks and Latinos continue to be subjected to extreme economic and social discrimination; whereas, most Asian Americans are not.  Asian Americans have been labeled the "ideal minority."  


King James invented "discrimination of the divine" when he and his team of 47 European interpreters translated the King James Version of The Holy Bible.  Purity, virtue, and goodness spew from every pictorial page of White European Biblical characters. The Bible reveals a blue-eyed White Jesus hanging on a cross, a golden-haired White Moses showing the "Tablets of Law to the People," and praying at Mt. Sinai upon every turn of a page.
I am King James, and I proclaim "Ham, the youngest son of Noah, to be the father of the Black Race."  
Ham is the father of the Black Race because he was cursed and "condemned to Hell" states King James and his team of European Interpreters.  In Gen. 9:18-29 Ham is the recipient of a curse--"Let Canaan be cursed."   
Hey, that means Canaanites were Black.  What do ya know!!!  Berber describes the indigenous Caucasoid people of Northern Africa in the scholarly White dictionary and encyclopedia, but Berber is defined as people who speak Hammitic/Semitic Languages.  Hey, does that mean Berbers were Black?   The Cushite (Ethiopian) and ancient Egyptian also spoke Semitic Languages. 


Ham--the Originator of the Black Race "the accursed" and all of his descendants will be damned. Eurocentric church officials developed a mind-set of  "heathen Blacks" to devise and formulate deceptive historical attitudes and viewpoints. 
The Aryan Nation believes its group does the on-going work of Jesus the Christ in re-gathering His people, calling His people to a state for their nation to ring in His Kingdom.  The Aryan Nation believes that Adam, man of Genesis, is the placing of the White Race upon this Earth.  Not all races descend from Adam.  Adam is the father of the White Race only.  (Adam in the original Hebrew language is translated:  "to show blood in the face; turn rosy." Genesis 5:1). 
  
The Book of Enoch Hamitic/Ethiopic Authorship: The Book of Enoch--which is considered to be the earliest biblical record of antiquity and the earliest book of Hamitic authorship is widely quoted throughout the King James Version of the Bible.  The Book of Enoch was found among the Dead Sea Scrolls in the caves of the Qumran.  Enoch was Noah’s grandfather and Methuselah’s father.  Methuselah was the oldest man in the Bible living to be 969. 
  
After reading the Book of Enoch, it is evident that the entire Creation of Heaven and Earth depicted by King James and his translators has not been taught in America’s churches.  Why?  Did King James and his translators use manipulatives to gain control and purposely hide Hamitic/Ethiopic authorship?  If this book was written before the book of Genesis, and is Hamitic--aren’t we back-to-Black? Webster’s Warped Dictionary verifies that Ham was the Originator of the Black Race.  (Brown, Ronald K. BOOK OF ENOCH, San Antonio, Texas 78210).  
Reuters Photo - September 2009
Associated Newspapers, LTD
Black Brazilian Parents have three Albino Children

According to the Enoch--one of the Lost Books of the Bible, there were a Race of Angels numbering 200 who were sent to Earth to watch over mankind.  The “Watchers” looked upon the women of the Earth and found them fair and pleasing to the eye. The women gave birth to what is known as (Nephilims) Giants of the Earth.  The Book of Enoch comprises the following topics:
  • Second Coming of Jesus Christ and Judgment
  • Skills and Knowledge Taught by the Fallen Angels
  • Children of Angels to be destroyed
  • Disobedient Angels Incarcerated Till Judgment Day
  • Prophecy of A New Heaven and A New Earth
  • MESSIANIC REVELATIONS
    PROPHECIES OF THE RESURRECTION OF THE DEAD
  • GOD Promises to Dwell with the Saints
The King James Version of the Bible starts with Genesis and the creation of Heaven and Earth.  In Genesis 4:15 God orders Cain out of the Garden of Eden.  Cain goes out from the presence of the LORD, and dwells in the land of Nod, on the East of Eden.  There he knew his wife and conceived.  “The Land of Nod” appears right there in the Fourth Chapter of Genesis.    If Adam and Eve were the first two people on earth, what was the Land of Nod?  The word “Genesis” is be-rasheet in Hebrew, an African/Edenic language that Western philologists in the 18th Century classified as part of the family of languages.  Be-rasheet means “in the beginning” in a time when God created all things. (African Heritage Bible, 1).  

Leprosy among the Hebrews and Snow White Miriam

In 14th century B.C., plagues were endemic through the Middle East and Egypt.  The Book of Numbers tells us that Miriam and Aaron, sister and brother to Moses, revolted against their brother’s leadership.  Miriam and Aaron spake against Moses because he had married an Ethiopian woman.  And they said, Hath the Lord indeed spoken only to Moses?  Hath eh not spoken also by us?”  Their challenge to Moses angered God.  As a punishment “Miriam became leprous, white as snow”  (Greenberg, 197).
The original man can be linked directly to the "Neanderthal" and "Cro-Magnon" Man 10,000 years ago through archeological measurements in size and stature to the Bushmen-Hottentot population of South Africa.  Any US or European research book or encyclopedia show the reader a White man who is half man and half animal.  Charles Darwin (Mr. Charlie) and other evolutionists would rather have the world believe man evolved from apes than from a Black man. 


As Europeans were busy labeling the entire Black Race as cursed and accursed, a fair-haired English physicist came up with the color spectrum in 1666 that disputes the "White European Hamitic Theory."   The theory clearly denotes that if Noah and his wife were Caucasoid, it would have been impossible to produce three different races of people.  The Keys to the Colors Theory was proven by Newton over 300 years ago, but Warped Webster's Dictionary still defines Ham as the "Father of the Black Race." 
Reference books will tell you the majestic Sir Isaac Newton was credited with the discovery of the color spectrum.  The theory presents solid proof that black is the foundation or base for all colors.  Newton was the celebrated White English physicist who took a glass prism and passed a beam of sunlight through it.  When the light passed through the prism, it formed a rainbow he later called the color spectrum.
By mixing the three primary colors of red, blue, and yellow together, the color black is produced.  Black is the color from which all other colors are produced and is dominant.  White, on the other hand, is the color of maximal lightness from which no other colors can be produced and is recessive.  Just because white reflects all colors does not mean it is possible to get all colors from white. A little every day thing like the exalted Sir Isaac Newton's so called discovery of the color spectrum shows more validity as it points to an African origin than the many years of research and long drawn out scientific theories to disparage and dismiss Black culture and history. 

Congolese Albino rapper N`kashh

While scientists interpret, record, and test their theories, all they need is a small box of Crayola Crayons containing three crayons and a sheet of paper to prove the Keys to the colors.  
Albinos occur in all races of mankind and in all animal groups.  The albionotic condition arises from a distinct hereditary interference with the normal function of melanocytes.  The enzyme tyrosinase is necessary for the formation of melanin and determines the color of the skin, hair, and eyes.  Most children with albinism are born to parents who have normal hair and eye color for their ethnic backgrounds. 
White skin is a form of albinism.  There is no difference, microscopically speaking, between the white skin of a Caucasoid person and the skin of a person designated as an Albino.  Black people with albinism tend to have hair of a deep bright yellow, cream-colored skin, and green or hazel eyes.  The social problems of Blacks are compounded if a child is born and is an Albino.  In the Caucasian Race blonde hair, blue eyes, and alabaster skin are considered so highly desirable that brunettes often bleach their hair or wear colored contacts to look like Albinos.  


One of the most glorious periods of English History was that of the reign of Queen Victoria (1819-1901).  The Victorians wore white wigs and powdered their skin to a chalky white probably in awe of their ancestors. Similarly, the powdered white wig worn by American colonial era illuminati reflected the wearer's ability to afford luxury items and identified him as one of the educated elite.
In Biblical times people with albinism were banished or thrown out, and forced to live in colonies just as people with leprosaria or Hansen's Disease were forced to live in leper colonies and away from other people. The Black Race believed that God was delivering judgment on a family with albinism and that the individual with albinism is cursed or is the embodiment of sin.
White-skinned people came into existence thousands of years ago as the Albino mutant offspring of black-skinned mothers and fathers in Africa.  A sizable number of these Black parents produced, rejected and then cast out of the community their genetic defective albino offspring to live away from the normal black skin-pigmented population. There were colonies of albinos formed which eventually migrated northward to Europe, to escape the intensity of the equatorial sun of the Southern hemisphere (Welsing, 23).


During Biblical times Albinos were ostracized.  The same thing is happening today when Albinism occurs in society.  Albinos are ostracized by their own families--especially in Black families where the difference in skin color is more distinct. The ostracizing of Albinos during Biblical times is the only logical explanation of how the White Race came into existence.  The Albino colonies produced more and more Albinos until there was an Albino Race. 

  

The Finnish, Swedish, and Danish people are "as White as pure driven show" with blonde hair that is almost White.  The two groups of people show a strong evidence they were part of the composition of the Albinic/White Race that moved northward.  White European geneticists that the union of two albinos will produce children that are affected with albinism have validated it.  

The parents of albinos are often consanguineous since it increases the likelihood that both will possess the same gene.  The Albion tic condition creates an extreme sensitivity of eyes and skin to the sunlight.  
There was a migration of the African Albinos northward to what the world recognizes as Europe.  During Biblical times Europe was part of Africa.  Europeans themselves designated and divided Africa into the regions of the "Middle East" and "Europe."
Skin color is determined by melanin.  The large molecule of the pigment melanin is formed in the skin cells from a much smaller molecule called tyrosine.   Tyrosine is colorless and is present in all cells.  In the skin cells of most human beings there is at least one gene whose job is to manufacture tyrosine.  

If the gene is of a type that can form considerable quantities of tyrosinase, the skin cell is like a well-staffed factory.  

Considerable quantities of melanin are formed, and the person possessing that gene has dark-brown skin, black hair, and dark-brown eyes.   If the gene were a type that manufactured only a small amount of tyrosinase, the reverse would be true.  Little melanin would be formed, and the person would have fair skin, light hair, and light eyes.
An Albino's genes do not form tyrosinase at all.  No tyrosinase occurs in their cells and no melanin can be formed.  Such people have very fair skin, white hair, and no pigment at all in their eyes.  The eyes look reddish because small blood vessels can be seen through the transparent colorless iris of the eye (Boyd & Asimov, 72). 

Classification of albinism

Traditionally, albinism has been classified according to clinical phenotype, and the 2 main categories are oculocutaneous albinism (OCA) and ocular albinism (OA).
The albinism subtypes were reclassified in 2009. With the availability of new molecular genetic studies, the classification of albinism has shifted emphasis to genotype as opposed to phenotype alone.[1] Hence, this has led to redefining existing phenotypic categories and the addition of new subtypes based on specific genetic mutations. The following is a brief overview of the current classification of albinism.
OCA is characterized by the reduction or absence of melanin in the skin, hair, and optic system (including the eyes and optic nerves). The lack of skin pigment results in a pale skin appearance and an increased risk of skin cancer. As shown in Table 1, OCA is divided further into several subtypes based on the distinct genetic mutation.
Table 1. Oculocutaneous Albinism Types (Open Table in a new window)
OCA SubtypesGene PositionAffected Protein
OCA 1
  • OCA 1A (tyrosinase-negative OCA)
  • OCA 1B (yellow-mutant/Amish/
  • xanthous, temperature-sensitive)
  • OCA 1A/1B heterozygote
11q14-21Tyrosinase
OCA 2



(tyrosinase-positive OCA, brown OCA)

15q11-13P protein
OCA 39p23Tyrosinase-related protein
OA is characterized by changes in the optic system only with no clinical difference in skin and hair color. As shown in Table 2, two major disorders exist in this category, ocular albinism 1 (OA 1) and autosomal recessive ocular albinism (AROA).
Table 2. Ocular Albinism Types (Open Table in a new window)
OA SubtypesGene PositionAffected Protein
OA 1 (X-linked recessive OA/Nettleshop-Falls type)X p22.3-22.2The protein product of the OA 1 gene named OA 1 (and also identified as GPR143 in GenBank)[2, 3]
AROANot a distinct positionTyrosinase in some cases;



P protein in some cases

The research work below done on albinism in Africa would be of beneficial importance to people living in Africa and overseas and are interested in educating some African society where individuals see albinos as potent ritual body-parts. The problem that albinos face in Africa is not actually about their hatred for albinos but rather it is being fueled by the so-called potency of their body-parts in rituals. So the education should rather be on the health implications of one giving birth to albinos.
 

ALBINISM IN AFRICA AS PUBLIC HEALTH ISSUE

Abstract

Background

Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition and OCA2, tyrosine-positive albinism, is the most prevalent type found throughout Africa. Due to the lack of melanin, people with albinism are more susceptible to the harmful effects of ultraviolet radiation exposure. This population must deal with issues such as photophobia, decreased visual acuity, extreme sun sensitivity and skin cancer. People with albinism also face social discrimination as a result of their difference in appearance. The World Health Organization is currently investigating the issues concerning this vulnerable population. 
                           Yvonne Edozien,An African Oyinbo/Albino, read her story here:NaijaBella.

Methods

Systematic electronic search of articles in PubMed concerning albinism in Africa. Furthermore, a World Health Organization (WHO) pilot survey of albinism was drafted in English, French and Portuguese, and distributed to African countries through WHO African Regional Offices (AFRO) in an attempt to gather further information on albinism.

Results

Epidemiologic data on albinism, such as prevalence, were available for South Africa, Zimbabwe, Tanzania and Nigeria. Prevalences as high as 1 in 1,000 were reported for selected populations in Zimbabwe and other specific ethnic groups in Southern Africa. An overall estimate of albinism prevalences ranges from 1/5,000 – 1/15,000. In addition, both the literature review and the survey underscored the medical and social issues facing people with albinism.

Conclusion

The estimated prevalence of albinism suggests the existence of tens of thousands of people living with albinism in Africa. This finding reiterates the need for increased awareness of and public health interventions for albinism in order to better address the medical, psychological and social needs of this vulnerable population. 
                  Albino girl Yvonne Edozien of Nigeria


Background

Oculocutaneous albinism (OCA) encompasses a heterogeneous group of genetic conditions with an autosomal recessive inheritance. It is characterized by hypopigmentation of the skin, hair and eyes due to a reduced or lack of cutaneous melanin pigment production [1]. Consequently, in Africa, the affected individuals have sandy coloured hair, white chalky skin and light brown or blue eyes, making them more susceptible to the harmful effects of ultraviolet (UV) radiation.
There are two types of OCA: tyrosinase negative (OCA1) and tyrosinase positive (OCA2). In OCA1, there is little or no melanin production due to the lack of a functional tyrosinase, the critical enzyme required in the melanin biosynthetic pathway. In the more prevalent OCA2 type [1] there is some level of tyrosinase activity, thereby producing some red-yellow photomelanin pigment that gives rise to sandy coloured hair and light brown irises [1]. 
There is growing evidence of social discrimination and stigmatization directed towards this population [4,5]. Along with their differences in appearance, a lack of knowledge about albinism in the community leads to such stigma. For example, the etiological beliefs about albinism continue to be heavily influenced by culture and superstition, rather than genetics [6]. 

The goal of this review is to discuss the current knowledge on public health aspects of albinism in Africa, focusing on the epidemiology as well as medical and social issues. We also recommend further actions to alleviate this situation for the affected populations and countries. As a basis for the review we conducted a systematic literature search on albinism in Africa and conducted a survey among African WHO Member States. 

Methods

Identification of publications

We conducted a literature search using PubMed with no date or language limitations. The search was conducted from June to July of 2005. The key terms used in this first set of searches included: albinism, albino(s), Africa, epidemiology, population study, prevalence, health, cancer, social and psychological

Inclusion and exclusion criteria

References which were not peer reviewed, did not specifically relate to Africa and/or albinism, were duplicates or focused only on basic scientific aspects of albinism, were excluded. For a small number of articles, only the abstracts were included because the full texts were unavailable. 
After reviewing the remaining abstracts and full texts of our first search, we only found pertinent information for the following countries: South Africa, Zimbabwe, Tanzania, Nigeria. Therefore, we extended the search in a country-specific manner and used key words including the countries listed above, along with the term "albinism". Efforts were made to contact some of the authors who study and had published articles concerning Albinism in Africa. Additionally, a manual search of reference lists was conducted but no additional useful references were identified.
We attempted to follow the guidelines outlined by the MOOSE group [7] but since the information obtained through our study was not intended to be strictly quantitative but rather a narrative summary, we included only the pertinent points of the MOOSE criteria. 

WHO albinism information survey

A pilot questionnaire was drafted to augment the limited results of the literature search on albinism. This is shown in Appendix 1. The topics covered included data availability, medical issues, health care access, social stigmatization, economic status and community support/outreach programs. The survey was available in English, French and Portuguese and distributed via the WHO African Regional Office (AFRO) to its African Member States.

Results

Systematic literature review

The search yielded a total of 306 publications. 76 publications without abstract, mainly letters and commentaries, were excluded. After application of the inclusion and exclusion criteria, only 15 publications with full texts remained. These publications were chosen because they contained epidemiological information and/or data on medical/social consequences of living with albinism. The epidemiological, medical and social concerns facing this population were analysed, by country. Prevalence data by country were abstracted and entered into a table. Information on non-quantitative issues of interest for this review were abstracted in a similar way and summarized for presentation and discussion. 

Epidemiology: prevalence

Seven publications (6 cross-sectional, 1 follow-up study) contained epidemiological data on prevalence for South Africa, Zimbabwe, Tanzania and Nigeria, as shown in Table 1. The prevalence of albinism from these studies ranged from as low as 1 in 15,000 in the East Central state of Nigeria [8] to as high as 1 in 1,000 in the Tonga tribe of Zimbabwe [9]. A paper from Cameroon [10] lacked clarity in its study design making the epidemiological data difficult to interpret. Generally, albinism is considered to be a relatively common hereditary condition among the southern African populations. 
Table 1. Estimated prevalence and number of people with albinism by country

South Africa

In 1982 Kromberg et al. studied prevalence in the ethnic groups in Soweto and Johannesburg, South Africa. 206 individuals with albinism were surveyed and the 1970 census data for Johannesburg (803,511) was used to calculate the overall prevalence of 1 in 3,900 [11]. In terms of ethnicity, the prevalence was lowest (1/4,794) among the Xhosa people and highest (1/2,041) in the Southern Sotho population. Albinism prevalences among the Swazi (1/2,716) and the Tswana (1/3,481) were slightly lower [11].
High prevalence does not seem to exclusively occur in urban regions. A prevalence of 1 in 1,515 was reported from a prospective study of congenital anomalies of liveborn neonates in Sovenga, a more rural region in Northern Transvaal, South Africa [12]. This is somewhat higher than the national rate of 1 in 3,900 [11].


 Zimbabwe

A school-based study in Zimbabwe ascertained 157 albinism cases among 772,758 primary school pupils, giving a prevalence of 1 in 4,922. Similar results (1/4,476) were found among secondary school students. However, there was a substantial difference in the prevalence when the data were analysed by provinces: the prevalence in Matabeleland South (1/7,539) was only half of that found in Mashonaland East (1/3,843) [13]. 
Similar to South Africa, there was also a sizeable difference between rural and urban populations in Zimbabwe, most of which was due to Harare's high prevalence of 1 in 2,792 and 1 in 2,661 in the primary and secondary schools, respectively. Overall, urban schools, including Harare, had a prevalence of 1 in 3,268 compared to 1 in 4,694 in the rural schools [14]. 

As mentioned previously, an extremely high prevalence of 1 in 1,000 was reported among the small Tonga tribe, who resides in an isolated rural community of Zimbabwe [9].

Tanzania

Although there have been some studies addressing the health conditions of people with albinism in Tanzania, the data available on prevalence are not as extensive as for South Africa or Zimbabwe. 
A study of individuals with albinism who were registered in the Tanzania Tumour Centre in Dar-es-Salaam estimated a prevalence of 1 in 1,400. However, this estimation is difficult to extrapolate to the entire population, given the data's limitation only to those individuals enrolled in the registry [17].



Most of the albinos in Tanzania are found to be economically poor as they are unable to indulge in meaningful economic activities due to their vision problems and sensitive skin, particularly because they have cannot stand the sun. Because of being poor, the unfavorable sun and as the temperature rises due to global warming, this makes their condition worse as the inherited disorder gets worse and worse, day after day.
Since they cannot afford to use skin protection and many of them develop life-threatening skin cancers and also most of them become blinded by the sun. As a result, the life span of Tanzania albinos is slightly lower compared to others." 


Tanzanian mother with her albino child

Location of Albinos in Tanzania

Albinos are scattered all over the country. However, the biggest population is found in the north west of Tanzania near the Lake Victoria. The towns include Kasulu, Kahama, Shinyanga, Mwanza and Geita. They are also found in neighboring countries of Burundi, Rwanda and Uganda. The total number of albinos in Tanzania is estimated to be 200,000.


Most of the albinos are Wasukuma by tribe. In Tanzania, many locals believe that when a person is born with albinism is a result from his or her family being cursed. Some people also think that albinos are ghosts and that they do not die but vanish unlike other human beings. Majority of albino are now hiding in fear as they are not fully accepted by the community and now due to people’s new belief that their body parts can bring luck charms in their lives. Their body parts, these include skin, hair, arms and legs are now priced and sold in a black market in Tanzania."

see:http://www.mtholyoke.edu/~marik22b/classweb/worldpolitics/page%201.html
                               Masai woman and her albino baby

Nigeria

Nigeria's data on the epidemiology of albinism were also sparse. A prevalence of 1 in 15,000 has been reported for the East Central state through a study investigating people with albinism attending the hospital with dermatological problems. To these individuals, a questionnaire concerning demographical information such as age and gender as well as knowledge of other persons with albinism was distributed. Then, the authors expanded the investigation to educational, health and religious institutions and markets in order to reach a broader population [8]. The prevalence in this study is considerably lower than what has been reported for the other countries, but comparisons are hampered by the study design employed. 

Regional differences: urban vs. rural

Findings of higher prevalence in urban areas may be due to various factors. Given the higher population density, it may have simply been more feasible to collect comprehensive data from urban areas. Migration to urban areas for education, health care and indoor occupations may also be contributing factors. 
In addition, since many of the studies were school-based, one must consider the role of attendance. For example, urban families may have a greater ability to send their children with albinism to school. There may be more schools in urban areas that accommodate for the visually disabled and for the UV protection needs of this population. On the other hand, some families may only be able to send one or a limited number of children to school, in which case it is possible that the affected child will not be chosen in the majority of families. All of the above situations introduce bias into the prevalence estimates. 

Regional differences: ethnicity

Ethnic differences also influence prevalence estimates. In Zimbabwe, given that the majority (83.1%) of people with albinism belonged to the Shona tribe, the diversity in the observed prevalence may be due to a founder effect or genetic drift since the Shona population have generally limited their residence to southern Africa [14]. Kromberg et al. also reported similar variations in South Africa [11]. 


   Albino footballers,Tanzania
Aside from the limited geographic mobility, consanguinity, along with other traditional marriage practices, may also be factors to consider in evaluating current and future prevalence trends of albinism [6,8,9,11]. 

Albino
Life expectancy and mortality
Several publications report a relatively greater number of individuals with albinism in the younger age groups (below 30 years). In the East Central state of Nigeria, 89% of identified people with albinism were in the age range of 0 – 30 years [8] while another study reported that 77% were under the age of 20 in the same Nigerian state [15]. A mean age of 17.8 years was reported in Soweto, South Africa [16]. 
Also in Cameroon, Nigeria and Tanzania, observations indicate a low number of people with albinism in age groups above 30 [8,10,17]. 
Whether this truly points to an increased mortality of people with albinism at a younger age (less individuals reach higher age groups) could only be evaluated on the basis of more specific mortality data. However, such data are missing.

Medical issues

In this particular population, ocular problems are ubiquitous. In some studies, visual difficulties have been reported to occur in 100 % of people with albinism [8,15]. Due to the lack of retinal pigment required for the normal development of the visual system [15] these individuals experience photophobia, myopia and other visual problems including nystagmus and strabismus. 
Aside from the visual handicaps, UV exposure is highly detrimental to the hypopigmented skin. Lack of melanin predisposes this population to severe skin damage. The majority of these lesions are in the most sun-exposed parts of the body such as the face, ears, neck and shoulders. Skin lesions include sunburns, blisters, solar elastosis/keratosis, ephelides, lentiginosis, and superficial ulcers. Ultimately, squamous cell, and less frequently basal cell, carcinomas may occur [15-18].

Psychological and social issues

In addition to their health concerns, people with albinism must also deal with psychological and social challenges. In Nigeria, one study collected written accounts of people with albinism. These individuals stated that they tended to be more withdrawn from social situations to avoid being noticed. They were more emotionally unstable and had less assertive personalities than people without albinism. Also, they considered their society to be generally unkind and rejecting, even though they did have close friends [4]. 



Much of the social discrimination appears to stem from the communities' lack of education about albinism's etiology. There is limited awareness of its genetic inheritance and therefore, traditional myths and superstitions are numerous [6]. For example, some of these beliefs link albinism with (culturally unacceptable) conception during menstruation or consider albinism as a punishment from the gods for an ancestor's wrongdoing [8]. Due to this socially rooted discrimination, the quality of life of people with albinism may be compromised. 
For example, they are more likely to drop out of school and face more difficulty in employment and marriage compared to the rest of the population.
Furthermore, their family members may also experience discrimination from the community. In light of the traditional myths concerning albinism's etiology, mothers of affected children may be subjected to a great deal of stigma and psychological distress.

WHO albinism pilot survey results

WHO drafted and distributed a survey (see 1) to the African WHO Member States enquiring about information on the epidemiology, medical and social issues affecting people with albinism. The survey was intended to provide a qualitative overview of these issues in the countries concerned. 
Additional File 1. Albinism: Information Survey WHO 2005. The pilot survey was drafted in English, French and Portuguese and then distributed through the WHO Regional Offices in order to gather further insight into the problems facing people with albinism and any available epidemiological information throughout Africa.


Table 1

Estimated prevalence and number of people with albinism by country
Author Country/Population* Study Details Prevalence Estimated Number in country**

Kromberg et al.(11) South Africa/45,026,000 Cross-sectional study. Subjects were ascertained through all 120 schools, 6 health clinics and 2 hospitals in Soweto and interviewed; 213 albinism cases found; 206 interviewed 1/3,900 11,545
Venter et al. (12) South Africa/45,026,000 Prospective hospital based study on liveborn neonates in Sovenga; 5 albinism cases 0.66 per 1,000 live births (Incidence) 29,720+
Kagore et al. (14) Zimbabwe/12,835,000 Postal survey of all secondary schools within the Harare regional office area; second mailing in 3 months; visited, if there was no response 1/2,833 4,531
Lund (13) Zimbabwe/12,835,000 Nationwide survey to schools; age range of 6–23 yrs; 278 albinism cases 1/4,728 2,715
Lund et al. (9) Zimbabwe/12,835,000 Follow up on the above study which identified a cluster of OCA2# in Tonga community; 11 albinism cases; 5 adults and 1 school girl were interviewed 1/1,000 ---
Luande et al. (17) Tanzania/36,977,000 Cross-sectional study. Questionnaire to 350 registered people with albinism in Tanzania Tumor Centre 1/1,400 ---
Okoro (8) Nigeria/124,009,000 Cross-sectional study. Questionnaires distributed to people with albinism who came to the hospital; expanded the study to educational, health, religious institutions and markets in East central state; 517 albinism cases 1/15,000 8,267

() Reference source
* Source of population data as of 2003: http://www.who.int/en/ webcite
** Although it is a crude estimate, we used the prevalence of the specific population in the study and the total population in the country to extrapolate the absolute number of people with albinism within a country
# OCA2 = Oculocutaneous albinism Type 2 (Tyrosine positive)
+ The absolute number in this case was estimated from a prevalence rate of 1 in 1,515 which was provided by the study's authors
--- The population studied makes it difficult to generalize the prevalence to the entire country. Therefore, the absolute number within the country was not estimated
Hong et al. BMC Public Health 2006 6:212   doi:10.1186/1471-2458-6-212
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The following 12 countries returned surveys: Cameroon, Congo, Equatorial Guinea, Ghana, Guinea Bissau, Mali, Mauritius, Mozambique, Niger, Rwanda, Sao Tome and Principe, and Tanzania. Respondents were either medical doctors affiliated with the Ministry of Health (Cameroon, Congo, Ghana, Tanzania) including dermatologists (Mauritius), Ministry of Health officials (Mozambique, Niger), WHO Country Officers (Guinea Bissau) or NGO personnel/other (Congo, Equatorial Guinea, Mali, Rwanda, Sao Tome and Principe).

We distributed three language versions of the WHO Pilot Survey: English, French and Portuguese. Among the survey responders, the Francophone countries included Rwanda, Niger, Mauritius, Mali, Equatorial Guinea, Congo, Cameroon. The Anglophone countries included Ghana and Tanzania and the Lusophone countries included Sao Tome and Principe, Mozambique and Guinea Bissau. The countries were divided into Francophone, Anglophone and Lusophone groups purely on (official) language grounds. There was no intent to use this grouping for comparative analyses. 

Diandra Forrest, Albino model

Prevalence data were unavailable for the majority of the countries. A few countries did report the prevalence of albinism, but there was much variation and, in comparison to published data, the reported high estimates appeared somewhat unrealistic. Furthermore, the data sources of these estimates were not specified. 
In terms of health care, survey respondents felt that much more needs to be done to address the needs of people with albinism. None of the countries, aside from Tanzania, had specialized clinics to handle the dermatological consequences of albinism. Five countries (Sao Tome and Principe, Mozambique, Mauritius, Congo and Tanzania) reported that they provide some advice on UV radiation protection for people with albinism in clinics and hospitals. Overall, however, the care was felt to be incomprehensive due to the lack of medical personnel's awareness of albinism, discrimination against people with albinism and/or a lack of resources such as sunscreens. Also, the aid was only provided if actively sought. This passive approach raises concern considering many persons with this condition may not seek regular medical attention. 
Most of the surveys reported a lack of trained medical personnel. Challenges to better health care also included the barriers existing among the health workers in approaching people with albinism (lack of sensitization), lack of finances and education among this population, high cost of protective products such as sunscreens and hats/medications and social preconceptions and marginalization. Seven of the surveyed countries (Congo, Equatorial Guinea, Guinea Bissau, Mali, Niger, Sao Tome and Principe, Tanzania) reported the use of traditional medicines by people with albinism. However, the information in the survey was limited and it could not be substantiated whether people with albinism use traditional medicines differently from the general population, both in terms of frequency and rationale. 
The discrimination of people with albinism is not only limited to the health care arena. The surveys report a great amount of stigmatization in schools from fellow students and teachers and even within their own families. Stigmatization stems from traditional explanations of albinism of which there are many (see above) [8]. In addition, the curiosity of their different skin colour plays a role. Most countries reported a lack of knowledge about this health condition among the general public. Survey respondents also felt that many people with albinism did not fully understand their own condition. This social discrimination was seen as an obstacle to building relationships and finding/maintaining an occupation. Therefore, most people with albinism were generally reported to be of lower, if not the lowest, economic status in their society. 
In light of these difficulties, it is not surprising that many surveys reported abuse and psychological problems within this population.
Albino model, Diandra Forest

However, there is some evidence of social support for people with albinism. This includes dedicated NGOs such as "SOS Albinos in Mali" and "SOS enfants vulnerables sans frontiers" in Congo. Tanzania and Congo reported that children with albinism who have visual difficulties may enroll in specialized schools for the blind. Community outreach programs exist in some surveyed countries (Congo, Cameroon and Tanzania).



Discussion

Albinism is a disorder that affects individuals and their families medically, socially and psychologically. For some, these latter issues may be more of a burden than the actual medical complaints. While the medical issues have been studied for decades, we have tried, through this review, to shed light upon the dearth of currently available epidemiological and public health data on albinism in Africa. Given this lack of data, a prevalence range for the general population from 1/5,000 – 1/15,000 seems plausible, indicating that tens of thousands of people in southern Africa are affected. Though low in comparison with other major health problems, these figures and the even larger numbers of indirectly affected persons, qualify albinism as a public health issue deserving further attention to increase the awareness of and information about this condition. 



Our survey results augment the literature review. The main focus was on health service and social issues, and responses clearly indicate a range of particular problems for people with albinism. One concern is that health care systems appear to lack responsiveness to the needs of people with albinism in most of the countries surveyed, but there are notable exceptions. In terms of social status the survey reports that people with albinism frequently are disadvantaged, and several associated factors were noted by respondents. However, also here the picture may be broader: across Africa there are numerous examples of people with albinism in high socioeconomic strata, as professionals, politicians, musicians etc. Some have used their public status to support action for people with albinism. 


In terms of our survey, there are several limitations. The number of responding countries was small and due to the dissemination mechanism employed, we had little influence on the choice of actual respondents to the survey. Therefore, it is likely that not all respondents were fully aware of the scope and depth of problems facing the population of people with albinism in their country. Accordingly, we found varying degrees of detail and specificity in the responses. The responses should be seen as anecdotal rather than based on scientific studies; in this pilot survey we did not ask for specific supporting scientific evidence. Nevertheless, the survey provided some valuable information and shed light on the gaps in knowledge. These can serve as a guide for more detailed assessments and programmes in the future. 


A multidisciplinary approach is recommended for future research and intervention programmes [6]. Epidemiological research should include more representative and better defined populations. The issue of premature mortality among people with albinism clearly needs to be explored further, as well as the hypothesized causes of urban/rural, regional and ethnic differences. Medically, health care providers need to be educated about albinism and the special needs of this patient population. Socially, efforts need to be made to increase awareness on the different aspects of this disorder. By informing the public about albinism, one can hope to gradually decrease the discrimination within the health care arena as well as in the society at large.

Public health programmes and intervention recommendations

Public health programmes need to take into account the various challenges facing people with albinism. Currently, there are some programmes in place to address the medical concerns of this population in certain parts of Africa. For example, the Regional Dermatological Training Center (RDTC) in Moshi, Tanzania runs a mobile skin care clinic where a doctor and a nurse regularly visit villages to check the skin of people with albinism and provide education on protection from UV exposure [19]. Also, in South Africa, at a school for the visually impaired, there are covered walkways, trees in the courtyard and shutters on the windows in order to decrease the UV exposure [5]. 


However, further efforts in more African countries are required to adequately address health and social needs of people with albinism. Many of the following recommendations have been mentioned in previous publications [5,6]. Our suggestions for action include: 
• Conduct research/surveys to determine the prevalence of albinism in the country
• Based on research information, develop appropriate strategies for assisting people with albinism that include the following:
Integrate albinism awareness in the school curricula, especially to correct misconceptions about the etiology of albinism
Educate counsellors in schools about albinism
Train health care providers at clinics and hospitals about albinism and the effects that UV exposure can have on this condition
Encourage community self-help support groups
Implement programmes to aid people with albinism in finding indoor occupations 
WHO's INTERSUN programme [20] provides information about the adverse health effects of excessive UV exposure and can serve as a resource for national and local authorities.



Conclusion

Albinism, especially in Africa due to extreme sun exposure, is a condition that requires further attention than in the past. Although prevalence data are scarce and further epidemiologic research is needed, the number of people living with albinism in Africa is likely to be as high as tens of thousands. Our findings underscore the need to better address the already known medical problems facing people with albinism, but also issues of social discrimination against this population. Some progress has been made thus far in terms of medical and social care but we hope to further increase the awareness of albinism throughout African societies in the future. Public health action should focus on educational, medical and occupational settings. 

Competing interests

The author(s) declare that they have no competing interests.

Authors' contributions

MR developed the project idea. EH and MR formulated the questionnaire. EH performed the literature review. EH and HZ organized and analysed the survey, drafted and critically reviewed the paper. MR provided sections to introduction and discussion. All authors reviewed and agreed on the final version. 

              Mucubal tribe albino

Acknowledgements

We thank the WHO AFRO Office for the distribution of the Albinism Information Survey, the survey respondents for their cooperation, and Dr. Patricia M. Lund for help in the preparation of this manuscript. Funding was provided by the Dean of School of Medicine at the University of California, San Francisco. No further external funding was obtained.



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               Panama albino

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