Ukwenza Uphando Ngezilwanyana—Ngaba Kuyintsikelelo Okanye Kusisiqalekiso?
UKUBA uphakathi kwezigidi ezininzi zabantu abalibona ilanga ngasekuqaleni kwale nkulungwane, usenokuba uyazi kakuhle into yokuba sele uphile ithuba elide lee kunelo belithelekelelwa ngabazali bakho nangugqirha okanye umzalisikazi owayekho xa wawuzalwa. Ukuba wazalelwa eUnited States, eKhanada, okanye eYurophu, ngowe-1900 kwakulindeleke ukuba uphile iminyaka emalunga nama-47. Kwamanye amazwe kwakulindeleke ukuba umntu aphile ithuba elingaphantsi koko. Namhlanje, kumazwe amaninzi kulindeleke ukuba umntu aphile ithuba elingaphezu kweminyaka engama-70.
Kungakhathaliseki ukuba umdala kangakanani na, uphila kwixesha elahlukileyo. Oomawokhulu okanye ookhokho bakho bazibonela ngawabo amehlo imiphumo engalawulekiyo yezifo ezininzi ezabulala inyambalala yabantu kwisizukulwana sabo. Ngokomzekelo, ingqakaqa yayisuba imiphefumlo yezigidi ezingenakubalwa minyaka le yaye ishiya izigidi zabanye zineziva zikanaphakade. Imikhuhlane yayizenzela—ubhubhani nje omnye kuphela wabulala abantu abazizigidi ezingama-20 ngonyaka omnye (ngowe-1918-19). Ngemva kweMfazwe Yehlabathi I, ubhubhani wesifo seentwala wabulala abantu abazizigidi ezithathu eRashiya. Lo bhubhani wesifo seentwala wahlasela nakwamanye amazwe amaninzi ebudeni beMfazwe Yehlabathi II. Kuqikelelwa ukuba abangama-25 kubantu bonke abali-100 abasuleleka ebudeni bokuhlasela kwesi sifo seentwala bambatha ingubo kaqaqaqa.
Isifo esoyikekayo sokoma kwamalungu omzimba, kamva esaziwa ngokuba yipoliyo, saphungula inani labemi behlabathi ngokubulala abantu abanokuba ngama-30 000 minyaka le yaye sashiya abanye abangamawaka beneziphene, ngokukodwa abantwana. Kwakukho abo babeselula bangazange basinde ekuqubisaneni kwabo okokuqala necesina okanye umqala omhlophe, iscarlet fever okanye imasisi, unkonkonko okanye inyumoniya. Singatshonelwa lilanga sibala. Kuzo zonke iintsana ezili-100 000 ezazalwa ngowe-1915, kuqikelelwa ukuba ezili-10 000 zafa zingekawugqibi unyaka wazo wokuqala. Amathúmba asebuchotsheni ayengenakutyandwa. Ubuchule bokuvula imithambo (arteries) evingcwe ngamahlwili egazi babungaziwa. Oogqirha babengenamandla okusindisa amaxhoba esifo sentliziyo, yaye umhlaza wawuzenzela kanobom ngokubulala.
Phezu kwazo nje ezi zibetho zibulalayo eziye zathwaxa ihlabathi ukususela ekuqaleni kwale nkulungwane nangaphambili, ithuba ekulindeleke ukuba umntu aliphile namhlanje liye landa ngeminyaka emalunga nama-25. Ngaloo ndlela, kwimimandla emininzi yehlabathi, umntwana ozalwa namhlanje unethuba lokuphila iminyaka emalunga nama-70.
Ilahleko Eyenziwayo Ukuze Kusindiswe Ubomi
Ngethamsanqa, inkoliso yabantu abaselula abaphilayo namhlanje iye yasinda kwizifo ezininzi ezibulalayo ezabangela ukuba uninzi lookhokho bayo lufe ngaphambi kwexesha. Kodwa basenokungayoliswa kukwazi ukuba izilwanyana ezininzi ezingabahlobo babantu—izinja, iikati, imivundla, iinkawu, nazinye—zenziwa amadini ngenxa yenzululwazi yezonyango ‘khon’ ukuze abantu namhlanje babe nokuphila ithuba elide ngakumbi nobomi obusempilweni ngakumbi,’ njengoko izazinzulu zigwagwisa ngelitshoyo.
Phantse zonke izifo eziye zapheliswa okanye zaba nokunyangeka kule nkulungwane—ipoliyo, umqala omhlophe, uqilikwane, imasisi, irubella, ingqakaqa nezinye—ziye zoyiswa ngokusetyenziswa kwezilwanyana ekwenzeni uphando. Iipilisi zokudambisa iintlungu, ukutofela nokuselisa iyeza, unyango ngemitha nonyango lomhlaza ngemichiza, konke kwavavanywa kwaza kwangqineka kusebenza okokuqala kwizilwanyana. Yaye ezi zezimbalwa nje zeendlela zonyango.
UGqr. Robert J. White, oyingcaphephe edumileyo yemithambo-luvo wathi, “Phantse akukho lunyango lubalaseleyo okanye umgaqo wezotyando kunyango lwezi mini obunokuveliswa ngaphandle kokusetyenziswa kwezilwanyana ekwenzeni uphando.” “Ukusetyenziswa kwezinja nezinye izilwanyana kwakhokelela ekuvelisweni kweyeza lokunyanga isifo seswekile, kutyando lwentliziyo, ekuvelisweni kwesixhobo esilawula ukusebenza kwentliziyo nasekufakweni kwelinye ilungu emzimbeni womntu. Ipoliyo . . . phantse ukuba ipheliswe ngokupheleleyo eUnited States ngokusetyenziswa kwamayeza okugonya awabonwa esebenza ngokugqibeleleyo kwiinkawu. Ngokusebenza ngezilwanyana, abaphengululi baye bawunyusa umlinganiselo wokunyanga abantwana abahlaselwa yilymphocytic leukemia ebulalayo ukususela kwisine ekhulwini ngowe-1965 ukusa kuma-70 ekhulwini namhlanje,” watsho njalo lo gqirha ukwamnye.
Indima yokusebenza ngezilwanyana ekwenzeni uphando ingqinwa nguHarold Pierson, owayencedisa kwilebhu nowayesebenza ngaphantsi koGqr. F. C. Robbins kwiYunivesithi iWestern Reserve, eCleveland, eOhio, eUnited States. Waxelela uVukani! ukuba ucwangciso lwabo lokufumana iyeza eliselwayo lokuthintela ipoliyo lwabandakanya ukusetyenziswa kwezintso zenkawu. Isicwili esasithatyathwe kwintso enye sasinokusetyenziswa izihlandlo ezingamawaka ekwenziweni kovavanyo. Wacacisa esithi: “Ezo nkawu zaziphathwa njengabantu yaye xa zityandwa kwakusoloko kubulawa iziva-mvo zazo. Ngokuqinisekileyo le yayingeyonkohlakalo yangabom. Noko ke, ngenxa yokuba zathi zatyandwa, zaba ngamaxhoba angazithandeliyo enkohlakalo yenzululwazi.”
Utyando Lwentliziyo Nesifo Sika-Alzheimer
Umphumo ongqalileyo wokusetyenziswa kwezilwanyana ekwenzeni uphando, ube kukuveliswa kobuchule obutsha kwezotyando ukuze kuvulwe imithambo evingcwe lulwelo lotywala olutyekezwayo, ngaloo ndlela kuthintelwa izifo ezininzi zentliziyo—unobangela wokufa onkqenkqeza phambili kwelaseNtshona. Ngokwenza ulingelo kwizilwanyana kuqala, oogqirha bafunda indlela yokususa ngokunempumelelo amathumba amakhulu kubuchopho bomntu nokubuyiselwa kwakhona kwamalungu anqumkileyo—iingalo, imilenze, izandla neminwe. UGqr. Michael DeBakey, owenza utyando lokuqala olwaphumelelayo kwimithambo yentliziyo, wathi: “Kwelam icala lokwenza uphando ngezonyango, phantse yonke inkqubela yokuqala kutyando lwentliziyo nemithambo yayo yayisekelwe kulingelo olwenziwa ngezilwanyana.”
Ethetha ngesifo sika-Alzheimer, uGqr. Zaven Khachaturian weZiko Lesizwe Lokunyamekela Abakhulileyo laseUnited States wathi: “Kwiminyaka esibhozo edluleyo, sasikwelona nqanaba liphantsi. Kuye kwakho inkqubela engakholelekiyo ekuphandeni ngesifo sika-Alzheimer ngenxa yokuzibhokoxa kwethu kuphengululo olusisiseko ngokuphathelele ukusebenza kwengqondo olwaqaliswa ngeminyaka yee-1930.” Owona msebenzi mkhulu wabandakanya izilwanyana, yaye ugqirha waphawula ukuba zinendima ephambili kwinkqubela eyenziwayo.
UGawulayo Nedumbe
Olona phando lubaluleke gqitha ngoku, nolubangela ukuba izazinzulu neengcali zokugonyela izifo zingalali buhlayo, kukufuna iyeza lokulwa isifo esoyikekayo uGawulayo, eso zimbi zeengcaphephe ziqikelela ukuba ngowe-1991 siya kuqengq’ ugodo kubantu abamalunga nama-200 000 eUnited States kuphela. Ngowe-1985 izazinzulu kwiZiko Lenqila Lokuhlolisisa Izilwanyana laseNew England zaphumelela ekufumaneni intsholongwane eyiSTLV-3 (iSAIDS, uhlobo oluthile lukaGawulayo) kuhlobo lweenkawu oluyimacaque nasekuyisebenziseni kwezinye. UGqr. Norman Letvin, oyingcali yokugonyela izifo kwiZiko Lenqila Lokuhlola Izilwanyana watyatyadula wenjenje: “Ngoku njengoko le ntsholongwane iye yafunyanwa, sikho isilwanyana esiza kusisebenzisa ukuze sivelise amayeza okugonya iinkawu nabantu. Kuyinto enokwenzeka ukufunda okuninzi gqitha kwizilwanyana ezimbalwa kakhulu kuhlolisiso olucwangcisiweyo kunokuba ubunokwenjenjalo ekuqwalaseleni amakhulu abantu abanoGawulayo.”
OoGqirha kwiZiko Lenqila Elilihlola Izilwanyana likaYerkes kwiYunivesithi iEmory eAtlanta baba ngabokuqala ukubonisa ukuba, ngokuhlolisisa kwabo besebenzisa uhlobo lweenkawu ekuthiwa ziirhesus, yinto ekunokwenzeka ukufakwa kwesicwili esivelisa idopamine ebuchotsheni njengendlela yokunyanga idumbe. Ukususela ngowe-1985 iingcali zokutyanda imithambo-luvo bezisenza utyando ebantwini kwiSibhedlele seYunivesithi yase-Emory. OoGqirha banoluvo lokuba oku kunokukhokelela kwindlela yokufumana unyango lwesi sifo.
Umntu uye waphethukela kwizilwanyana kwilinge lakhe lokufumana iimpendulo kwimibuzo edidayo engendlela yokuphucula nokuzimasa, kwanokuba kokwexeshana nje, ubomi bakhe obungafezekanga. Noko ke, ukusetyenziswa kwezilwanyana ekwenzeni uphando ngezonyango kuphakamisa iimbambano eziphawulekayo zemilinganiselo yokuziphatha ezo kungeyondlwan’ iyanetha ukuzicombulula.
[Ibhokisi ekwiphepha 5]
Ukwenza Uphando Ngezilwanyana—Kudala Kusenziwa
UKUSETYENZISWA kwezilwanyana okwandileyo ngoogqirha nazizazinzulu ukuze ziqonde ukusebenza kwamalungu omzimba womntu asinto efike kule nkulungwane yama-20. Izilwanyana bezisetyenziswa ekuphandeni ngezonyango kangangeminyaka ubuncinane engama-2 000. Kwinkulungwane yesithathu Ngaphambi kweXesha Eliqhelekileyo, eAlexandria, eYiputa, iingxelo zibonisa ukuba isithandi sobulumko nesazinzulu uErasistratus sasebenzisa izilwanyana ukuhlolisisa ukusebenza komzimba saza sakufumanisa kusebenza nasebantwini. Kwinkulungwane yesine, isazinzulu esingumGrike nesidumileyo uAristotle ngokuhlolisisa kwakhe izilwanyana waqokelela inkcazelo ebalulekileyo mayela nokwakhiwa nokusebenza komzimba womntu. Kwiinkulungwane ezintlanu kamva ugqirha Galen waseGrisi wasebenzisa iinkawu neehagu ukuze angqine ingcamango yakhe yokuba imithambo ihambisa igazi kungekhona umoya.