Utofelo-gazi—Ngaba Luyindlela Yokusinda?
NGOWE-1941 uGqr. John S. Lundy wamisela umgaqo wotofelo-gazi. Kubonakala ukuba engenabo nabuphi na ubungqina obungokwezamayeza obabumxhasa, wathi ukuba ihemoglobin yomguli, inxalenye yegazi ethwala ioksijini ihlela kumlinganiselo okwiigram ezilishumi okanye ngaphantsi kweelitha ezili-0,10 legazi, ngoko lo mguli ufuna utofelo-gazi. Emva koko elo nani laba ngumgaqo osetyenziswa ngoogqirha.
Lo mlinganiselo weegram ezilishumi uye wacelwa umngeni kangangeminyaka emalunga nama-30. Ngowe-1988 iThe Journal of the American Medical Association yakubonisa ngokungqalileyo ukuba ubungqina abuwaxhasi la mazwi. Ugqirha oyingcali ekulaliseni umntu xa etyandwa uHoward L. Zauder uthi oku “kufihlakele kwisithethe, kugutyungelwe bubumnyama yaye akuqinisekiswa bubungqina obungokwezamayeza okanye obolingelo.” Abanye basuka nje bathi yintsomi.
Phezu kwako nje konke ukubhencwa kwayo okungaka, le ntsomi isahlonitshwa ngokubanzi njengamazwi ayinyaniso. Koogqirha abaninzi abaziingcali ekulaliseni umntu xa etyandwa nabanye oogqirha, umlinganiselo wehemoglobin ongaphantsi kweegram ezilishumi usisizathu esibangela kutofelwe igazi ukuze loo mntu abe negazi elaneleyo. Phantse ukuba oku kuyazenzekela.
Alithandabuzeki elokuba, oko kusinceda ukuba sisazi isizathu sokusetyenziswa ngokugqithisele kangaka kwegazi neemveliso zalo namhlanje. UGqr. Theresa L. Crenshaw, owakhonza kwiBhunga LasebuRhulumenteni Eliphanda Ngobhubhani Wentsholongwane Etshabalalisa Inkqubo Yokuzikhusela Komzimba Womntu, uthelekelela ukuba, eUnited States kuphela, utofelo-gazi olungeyomfuneko lwenziwa kangangezihlandlo ezimalunga nezigidi ezibini minyaka le nokuba ukutofelwa kwegazi eligciniweyo okwenziwa malunga nezihlandlo ezisisiqingatha kunokuphetshwa. UMbutho waseJapan Wempilo Nentlalo-ntle wakugxeka “ukusetyenziswa ngokungenankathalo kotofelo-gazi” eJapan, ndawonye “nenkolelo emfamekileyo yokusebenza kwalo.”
Ingxaki yokuzama ukunyanga ukungabi nagazi laneleyo ngokutofela igazi ikukuba utofelo lusenokuba lolubulala ngakumbi kunokuba kusenjenjalo ukungabi nagazi laneleyo. AmaNgqina kaYehova, akwalayo ukutofelwa igazi ngokuyintloko ngenxa yezizathu ezingokonqulo, aye anceda ekuyingqineni le ngongoma.
Usenokuba uyibonile imixholo ephambili yephephandaba inikela ingxelo yokuba omnye wamaNgqina kaYehova uye wafa ngenxa yokwala ukutofelwa igazi. Kulusizi ukuthi, kunqabile ukuba iingxelo ezinjalo zilichaze lonke ibali. Kusoloko ikukwala kukagqirha ukutyanda, okanye ukutyanda ngokukhawuleza ngokwaneleyo, okubangela ukufa kweNgqina. Bambi oogqirha bayala ukutyanda bengenayo inkululeko yokutofela igazi ukuba umlinganiselo wehemoglobin ungaphantsi kweegram ezilishumi. Noko ke, oogqirha abaninzi baye bawatyanda ngokunempumelelo amaNgqina ihemoglobin ikumlinganiselo weegram ezintlanu, ezimbini, kwanezingaphantsi koko. Ugqirha Richard K. Spence uthi: “Endikufumanisileyo ngamaNgqina kukuba ukuba kumlinganiselo ophantsi kwehemoglobin akuthethi kufa konke konke.”
Izinto Ezininzi Ezinokusetyenziswa Endaweni Yalo
‘Yamkela igazi okanye uza kufa.’ Le yindlela abanye oogqirha abalujonga ngayo ukhetho ajamelana nalo umguli oliNgqina. Ukanti, eneneni, zininzi izinto ezinokusetyenziswa kunotofelo-gazi. AmaNgqina kaYehova akafuni kufa. Anomdla kolunye unyango. Ngenxa yokuba iBhayibhile ikwalela ukutofelwa igazi, ngokulula awakugqali ukutofelwa igazi njengenye into enokukhethwa.
NgoJuni 1988, iReport of the Presidential Commission on the Human Immunodeficiency Virus Epidemic yacebisa ukuba bonke abaguli banikwe kanye oko amaNgqina ebekucela kangangeminyaka, okukoku: “Inkcazelo evunyiweyo yotofelo-gazi okanye iinxalenye zalo ifanele iquke inkcazelo engeengozi ezibandakanyekileyo . . . nenkcazelo yezinye izinto ezifanelekileyo nezinokusetyenziswa kunonyango lotofelo-gazi oluxabisekileyo.”
Ngamanye amazwi, abaguli bafanele banikwe ukhetho. Olunye lolo khetho luhlobo lokusetyenziswa kwegazi lomntu okwamnye. Igazi lomguli liyalondolozwa ebudeni botyando lize libuyiselwe kwimithambo yomguli lowo. Apho inkqubo enjalo ikukwandiswa nje kwenkqubo yokujikeleza kwegazi lomguli, oko kuyamkelwa gqitha yinkoliso yamaNgqina. Kwakhona oogqirha bayakugxininisa ukubaluleka kokwandiswa komthamo wegazi lomguli ngezandisi-gazi ezingenagazi nangokwenza umzimba wondle iiseli zawo ezibomvu. Iinkqubo ezinjalo zobuchule ziye zasetyenziswa endaweni yotofelo-gazi ngaphandle kokwandisa inani labafayo. Enyanisweni, zisenokukuphucula ukukhuseleka.
Isiyobisi esibonakala ngathi silungile nesibizwa ngokuba yirecombinant erythropoietin kutshanje siye samkelwa njengesinokusetyenziswa ngokomlinganiselo othile. Senza ukuba umzimba ukhawulezise ukuvelisa iiseli zegazi ezibomvu, ngaloo ndlela sinceda umntu ukuba azenzele igazi elingakumbi.
Izazinzulu zisaphanda ngento ephumelelayo nenokusetyenziswa endaweni yegazi enokuxelisa amandla alo aphawulekayo okuthwala ioksijini. EUnited States, abo benza ezo zinto zinokusetyenziswa endaweni yegazi, bakufumanisa kunzima ukwamkelwa kweemveliso zabo. Ukanti, kunjengokuba omnye wabenzi bezi mveliso esitsho: “Ukuba ubucinga ukusa igazi kwiFDA (uMbutho Wokutya Neziyobisi) ukuba lamkeleke, ubungayi kuthandazela ukuba livavanywe enoba linobuhlungu kusini na.” Sekunjalo, kukho amathemba amakhulu okuba kuya kufunyanwa umchiza onempumelelo oya kwamkeleka njengento enokusetyenziswa endaweni yegazi nenokuthwala ioksijini njengalo.
Ngoko zikho ezinye izinto ezinokusetyenziswa. Ezi zikhankanywe apha zezimbalwa nje kwezo zikhoyo. Kunjengokuba uGqr. Horace Herbsman, unjingalwazi kutyando olungokwezamayeza, wabhalayo kulindixesha iEmergency Medicine esithi: “Kucace . . . gqitha ukuba sinazo ezinye izinto ezinokusetyenziswa endaweni yegazi. Enyanisweni, kunokwenzeka ukuba oko siye sanamava ako namaNgqina kaYehova kunokuchazwa njengokusixelela ukuba akuyomfuneko ukuthembela kutofelo-gazi, oluneengxaki zalo, kunokuba besicinga ngaphambili.” Kambe ke, ngokwenene akukho nanye kwezi zinto entsha. Kunjengokuba iThe American Surgeon yaphawulayo: “Isibakala sokuba utyando olukhulu lunokwenziwa ngokukhuselekileyo ngaphandle kotofelo-gazi oko kwaye kwangqineka ngokucacileyo kwiminyaka engama-25 edluleyo.”
Phofu ke, ukuba igazi liyingozi, yaye kukho izinto ezikhuselekileyo ezinokusetyenziswa endaweni yalo, ngoko kutheni izigidi zabantu zitofela igazi ngokungeyomfuneko—uninzi lwazo lungazi, enyanisweni kwabanye linyanzeliswe? Ingxelo evela kwibhunga laseburhulumenteni eliqhubana noGawulayo liphawula ngokuyinxenye ukusilela kokufundiswa koogqirha nezibhedlele ngezi ndlela. Ibek’ ityala nakwesinye isibakala esisesi: “Amanye amaziko entlangano yegazi aye athandabuza ukuvelisa obunye ubuchule bokunciphisa ukusetyenziswa kotofelo-gazi kunyango, ekubeni ingeniso yawo yokutyanda ifunyaniswa ngokuthengiswa kwegazi neemveliso zegazi.”
Ngamanye amazwi: Ukuthengiswa kwegazi kulushishino olukhulu.