London Dysmorphology Database

should increase charges for services; bill for all services provided to family members; charge for all genetics professionals' time, including that of counselors and social workers; and even request payment at the time of service" (p 359). Unfortunately, much of the burden of genetic disease even in the First World is borne by the poor, so-called minority groups (blacks in the Americas, Asians, Caribbeans, and Greek Cypriots in the UK), those least able to afford private health care. Medical geneticists in the UK, notably Bernadette Modell, have pleaded that such people must be spared the cost of screening tests and genetic counselling, if they are to be helped to cope successfully with their genetic problems, the most important of which are the haemoglobinopathies. The book is a mine of information and an excellent index will facilitate its use as a valuable reference for physicians and other health care professionals working in Africa or in countries with significant numbers of people of African descent; the more than 800 references will help direct their further reading. There are useful appendices in which are listed genetic variants and disorders commoner or rarer in blacks than in other peoples, charts of developmental indices in African-American children, and a list of polymorphic traits of exceptionally high or low frequency in peoples of African origin, although this table lacks references.