Iindyikitya Zokufa Kwinkulungwane Yama-20
UKUFA OKUMNYAMA okwakugqugqisile kwiYurophu yenkulungwane ye-14 akuzange kukhokelele kwisiphelo sehlabathi, njengoko abantu abaninzi babeqikelela ukuba kuya kuba njalo. Kodwa kuthekani ngexesha lethu? Ngaba oobhubhani nezifo ezigqubayo kulo mhla wethu zibonisa ukuba siphila kwixesha iBhayibhile elibiza ngokuba ‘yimihla yokugqibela’?—2 Timoti 3:1.
Usenokucinga uthi, ‘unotshe.’ Ngoku inkqubela kwezonyango nakwezenzululwazi iye yanendima enkulu ekusincedeni siqonde size silwe nezifo kunanini na kwimbali yoluntu. Izazinzulu kwezonyango ziye zavelisa intaphane yamayeza okubulala iintsholongwane nezitofu zokugonya—izixhobo ezinamandla zokulwa nezifo kwakunye neentsholongwane ezingunobangela wazo. Ukuphuculwa kweendlela zokunyamekela abaguli ezibhedlele kwakunye neendlela zokucocwa kwamanzi okusela, inkqubo yogutyulo nendlela yokulungiselela ukutya, zezinye izinto eziye zanceda kwidabi nxamnye nezifo ezasulelayo.
Kumashumi eminyaka ambalwa adluleyo, abaninzi babecinga ukuba kwakusele kumbovu ukuba lo mlo uqatyeliswe. Ingqakaqha yayisele itshayelwe, ibe kwakusajongwe ukuba kutshayelwe nezinye izifo. Inkumbula yezifo yabethwa yaya kuxela ngamayeza. Iingcungela zezempilo zazikhangele kwikamva ngelikhulu ithemba. Izifo ezasulelayo zaziya kulaliswa ngophothe; kunqunqelw’ egoqweni esinye emva kwesinye. Inzululwazi kwezonyango yayiza kubuya ithwel’ intshinga kweli dabi.
Kodwa zakha phantsi isitya sizele. Namhlanje izifo ezasulelayo zinkqenkqeza phambili ehlabathini ngokubulala, ngowe-1996 kuphela zithumela kwaNtsonga-nyawana abantu abangaphezu kwama-50 ezigidi. Kunokuba nethemba njengakuqala, abantu abalali buhlayo bexhalabele ikamva. IThe World Health Report 1996, eyenziwa yiWorld Health Organization (WHO), ilumkisa ngelithi: “Inkqubela enkulu eye yaphunyezwa kwishumi leminyaka lakutshanje ephathelele ukuphuculwa kwempilo yabantu kungokunje iphakathi kwenyama nozipho. Sisecicini lokuba izifo ezasulelayo zibe yeyona ngxaki inkulu emhlabeni wonke. Akukho lizwe liya kusinda.”
Izifo Zakudala Ziqengq’ Ugodo Ngakumbi
Enye into exhomis’ amehlo kukuba izifo ezaziwayo, ekwakucingwa ukuba zibethwe zaya kuxela, ziphinde zabuya kakubi, ziqengq’ ugodo ngakumbi ibe kunzima ukuzinyanga. Umzekelo woku sisifo sephepha, isifo ekwakha kwacingwa ukuba noko siyathinteleka kumazwe asele ehambele phambili. Kodwa isifo sephepha asizange siphele; kungokunje sishiya itshoba lilel’ umbethe kubantu abamalunga nezigidi ezithathu ngonyaka. Ukuba indlela yokusithintela ayiphuculwa, kulindeleke ukuba abantu abangama-90 ezigidi babe nesi sifo ebudeni beminyaka yee-1990. Isifo sephepha esikwaziyo ukumelana namayeza siyanwenwa kumazwe amaninzi.
Omnye umzekelo wesifo esibuye kakubi sisifo seengcongconi. Kwiminyaka engama-40 eyadlulayo oogqirha babenethemba lokukhawuleza basitshayele isifo seengcongconi. Namhlanje esi sifo sishiya liqhamil’ itshoba kubantu abamalunga nezigidi ezibini nyaka ngamnye. Isifo seengcongconi besisenz’ unothanda, okanye besisoloko sigquba kumazwe angaphezu kwama-90 ibe ama-40 ekhulwini abemi behlabathi asenokwasulelwa siso. Izibulali-zinambuzane zitsho zincame kwiingcongconi ezinezifunxi-gazi ezithwele isifo seengcongconi, nezifunxi-gazi azibulawa ngamayeza kangangokuba oogqirha banoloyiko lokuba isifo seengcongconi kungekudala sisenokunganyangeki.
Izifo Nobuhlwempu
Ezinye izifo zithe gqolo zibulala phezu kwazo nje izixhobo ezinamandla zokuzithintela. Ngokomzekelo, khawucinge ngokudumba kwenwebu yobuchopho nomnqonqo. Zikho izitofu zokukhusela oku kudumba namayeza okukunyanga. Ukubuya kwako kwayidlavula imimandla yaseAfrika engezantsi kweSahara ebutsheni bowe-1996. Isenokuba yinto nje owakha wayithi rhithi; kodwa, kwabulala abantu abangaphezu kwe-15-000—ingakumbi abantu abangamahlwempu, uninzi lwabo ingabantwana.
Iingxaki zokuphefumla, eziquka inyumoniya, zibulala abantu abazizigidi ezine nyaka ngamnye, uninzi lwabo ngabantwana. Imasisi ibulala abantwana abasisigidi ngonyaka, nonkonkonko ubulala abangama-355 000 abangakumbi. Uninzi lwaba bantu bafayo bebenokukhuselwa zizitofu ezingabizi mali ininzi.
Bamalunga namawaka asibhozo abantwana abafa suku ngalunye ngenxa yokuphelelwa ngamanzi emzimbeni ngenxa yokuhambisa kwesisu. Phantse bonke aba bantu bafayo bebenokukhuselwa yinkqubo efanelekileyo yogutyulo okanye amanzi okusela acocekileyo okanye ukwenziwa kweoral rehydration solution.
Uninzi lwaba bantu bafayo lukumazwe asakhasayo, apho kugquba ubuhlwempu. Malunga nabantu abazizigidi ezingama-800—inxalenye yabemi behlabathi—abanandlela yokufumana unyango. IThe World Health Report 1995 yathi: “Oyena mbulali mkhulu ehlabathini neyona nto yaphula impilo ize ibandezele abantu emhlabeni wonke ibekwe ngasekugqibeleni kwi-International Classification of Diseases. Inenombolo engu-Z59.5—ukuhlwempuzeka ngokugqithiseleyo.”
Izifo Ezisandul’ Ukufunyaniswa
Kukho nezinye izifo ezisandul’ ukufika, ezifunyaniswe kutshanje. Kutshanje iWHO iye yathi: “Ebudeni beminyaka engama-20 eyadlulayo, ubuncinane zingama-30 izifo eziye zathi gqi sele ziphethel’ imbengwane impilo yamakhulu ezigidi zabantu. Uninzi lwezi zifo alunyangeki, akukho yeza okanye sitofu silungiselelwe zona ibe kungangenkankulu ukuba zithintelwe okanye zinyangwe.”
Ngokomzekelo, khawucinge ngeHIV noGawulayo. Bezingaziwa kwiminyaka emalunga neli-15 eyadlulayo kodwa ngoku kulo naliphi na ilizwekazi ziphuma nodlolwazana. Sithetha nje, malunga nabantu abakhulileyo abangama-20 ezigidi banentsholongwane yeHIV, ibe abangaphezu kwe-4,5 lezigidi baye bahlaselwa nguGawulayo. Ngokutsho kweHuman Development Report 1996, uGawulayo ngoku ngunobangela ophambili wokufa kwabantu abakhulileyo abangaphantsi kweminyaka engama-45 ubudala eYurophu nakuMntla Merika. Ehlabathini lonke, abantu abamalunga nama-6000 bayasulelwa suku ngalunye—umntu omnye kwimizuzwana eli-15. Uqikelelo lubonisa ukuba inani labantu abanoGawulayo liza kuqhubeka linyuka ngokukhawuleza. Ngokutsho kwelinye iziko laseUnited States, ngonyaka wama-2010 kulindeleke ukuba iminyaka abantu abayiphilayo ihle iye kutsho kwiminyaka engama-25 eAfrika naseAsia, ndawo ezo ezibhulelw’ amasaka nguGawulayo.
Ngaba uGawulayo sisifo esikhethekileyo nesingenantanga, okanye ngaba oobhubhani bezinye izifo banokubuya baze benze isaqunge esifanayo okanye esithe kratya? I-WHO iphendula ngelithi: “Ngaphandle kwamathandabuzo, izifo ezingekaziwa kodwa ekulindeleke ukuba zigqugqise njengoGawulayo kwixesha elizayo zisagoxile.”
Oonobangela Bokukhula Kwentsholongwane
Kutheni iingcungela zezempilo zizixhoxh’ igila ngoobhubhani bezifo abasenokubakho kwikamva? Esinye isizathu sikukwanda kwabantu ezixekweni. Kwiminyaka eli-100 eyadlulayo, yayili-15 ekhulwini kuphela labemi behlabathi elalihlala ezixekweni. Noko ke, kuqikelelwa ukuba ngonyaka wama-2010, ngaphezu kwesiqingatha sabantu behlabathi siya kuhlala kwimimandla yasezidolophini, ingakumbi kwizixeko ezikhulu zamazwe asakhasayo.
Imimandla exineneyo inezinto ezininzi ezibangela izifo. Ukuba isixeko sinezindlu ezifanelekileyo kwakunye neendawo ezaneleyo neendlela zogutyulo namanzi awaneleyo kwakunye nezonyango ezisemgangathweni, asinakufane sibe sengozini yokufumana oobhubhani. Kodwa ezona zixeko zikhawulezayo ukuba nabemi abaninzi zezo zikumazwe ahlwempuzekileyo. Kwezinye izixeko abantu abangama-750 nangaphezulu basebenzisa indlu enye yangasese. Kwakhona imimandla emininzi yasezidolophini ayinazo izindlu ezifanelekileyo namanzi acocekileyo okusela kwakunye neendawo zonyango. Abantu abacukeneyo phantsi kweemeko ezingaginyisi mathe, basesichengeni sokuba izifo zizenzele nje unothanda kubo.
Ngaba oku kuthetha ukuba oobhubhani abasaza kubakho baya kuphelela nje kwizixeko ezikhulu ezixineneyo nezibhuqwa bubuhlwempu? Ulindixesha iArchives of Internal Medicine uphendula ngelithi: “Simele sazi ukuba imimandla emincinane ethwaxwa kanobom bubuhlwempu, ukuphelelwa lithemba ngenxa yeemeko ezimandundu zezoqoqosho nemiphumo yezo zinto, yeyona ingoonobangela abaphambili bezifo nokoyiswa kobuchule boluntu xa lulonke.”
Kunzima ukuba isifo siphelele kummandla omnye. Inkungu nelanga yabantu ingoonothwal’ impahlana. Abantu abamalunga nesigidi banqumla imida ephakathi kwamazwe ngamazwe. Veki nganye abantu abamalunga nesigidi basuka kumazwe ahlwempuzekileyo besiya kwatyebileyo. Njengoko befuduka, barhorhozelwa ziintsholongwane ezibulalayo. IThe Journal of the American Medical Association ithi: “Naphi na ukuqhambuka kwesifo kumele kugqalwe njengesisongelo kumazwe amaninzi, kude kube ngakumbi kulawo kuthontelana abaninzi kuwo bevela mbombo zone zomhlaba.”
Ngenxa yoko, phezu kwayo nje inkqubela kwezonyango eyenzeke kule nkulungwane yama-20, izifo ezingubhubhani ziyaqhubeka ziqengq’ ugodo, ibe uninzi loyikela ukuba kuseza kuba goswan’ okwaphukayo. Kodwa ithini iBhayibhile ngekamva?
[Amagama acatshulweyo akwiphepha 4]
Izifo ezasulelayo zinkqenkqeza phambili ehlabathini ngokubulala, ngowe-1996 kuphela zithumela kwaNtsonga-nyawana abantu abangama-50 ezigidi
[Ibhokisi ekwiphepha 6]
Ukuxhathisa Izibulali-zintsholongwane
Kuya kusiba nzima ukunyanga izifo ezininzi ezasulelayo ngenxa yokuba ziyazixhathisa izibulali-zintsholongwane. Nantsi into eyenzekayo: Xa umntu engenwa ziintsholongwane, ziyaqhubeka ziphindaphindana, zidlulisele imizila yazo kwinzala yazo. Xa kuveliswa intsholongwane entsha, kukho amathuba okuba itshintshe—impazamo nje engephi eya kubangela ukuba le ntsholongwane ibe neminye imizila. Ambalwa kakhulu amathuba okuba ukutshintsha kwemizila yentsholongwane kuyiphe amandla athe chatha okuxhathisa izibulali-zintsholongwane. Kodwa iintsholongwane zitsho ngezigidi xa zizala, izizukulwana ezithathu ngeyure nje. Ngenxa yoko, kwenzeka umhlola—ngamanye amaxesha, kuzalwa intsholongwane ekunzima ukuyibulala ngesibulali-zintsholongwane.
Ngoko xa umntu onentsholongwane esitya isibulali-zintsholongwane, iintsholongwane ezingakwaziyo ukuxhathisa ziyafa, ibe lo mntu uye avakalelwe kukuba noko izinto azimnta’ kaNgqika. Noko ke, iintsholongwane ezikwaziyo ukuxhathisa zakhela apho. Kodwa ngoku azisakhuphisani noogxa bazo ngokutya nendawo yokuhlala. Zikhululekile ukuba zingavelisa ngaphandle kokuphazanyiswa. Ekubeni intsholongwane enye inokuphindaphindeka ibe ziintsholongwane ezili-16 lezigidi ngosuku nje olunye, emva kwethutyana lo mntu uphinda agule. Noko ke, ngoku, unothotho lweentsholongwane ezikwaziyo ukuxhathisa iyeza ebelilungiselelwe ukuzibulala. Ezi ntsholongwane zinokwasulela nabanye abantu ibe ekuhambeni kwexesha zinokutshintsha kwakhona zize zikwazi ukuxhathisa nezinye izibulali-zintsholongwane.
Inqaku lomhleli lathi kulindixesha iArchives of Internal Medicine: “Ukwanda ngesantya esiphakamileyo kokuxhathisa kweentsholongwane, umngundo nezifunxi-gazi nxamnye nenkqubo yokulwa neentsholongwane esiyisebenzisayo namhlanje kwenza ubani angayifuniseli into yokuba siza koyiswa kwidabi nxamnye neentsholongwane, kodwa into esala ingumnqa yeyokuba siza kude soyiswe nini.”—Akekeliswe sithi.
[Ibhokisi ekwiphepha 7]
Ezinye Izifo Ezitsha Ezasulelayo Ezabakho Ukususela Ngowe-1976
Apho Isifo
Unyaka Saqala Okanye
Esafunyaniswa Safunyaniswa
Ngawo Igama Lesifo Khona
1976 Inyumoniya eyiLegionnaires. EUnited States
1976 Isifo samathumbu esiyiCryptosporidiosis. EUnited States
1976 IEbola hemorrhagic fever. EZaire
1977 IHantaan virus. EKorea
1980 IHepatitis D (Delta). EItali
1980 IHuman T-cell lymphotropic virus 1. EJapan
1981 UGawulayo. EUnited States
1982 I-E. coli O157:H7. EUnited States
1986 IBovine spongiform encephalopathy*. EUnited Kingdom
1988 ISalmonella enteritidis PT4. EUnited Kingdom
1989 IHepatitis C. EUnited States
1991 IVenezuelan hemorrhagic fever. EVenezuela
1992 IVibrio cholerae 0139. EIndiya
1994 IBrazilian hemorrhagic fever. EBrazil
1994 IHuman and equine morbillivirus. EOstreliya
*Ezihlasela izilwanyana kuphela.
[Inkcazelo]
Source: WHO
[Ibhokisi ekwiphepha 8]
Izifo Ezidala Ziyabuya Kwakhona
Isifo Sephepha: Bangaphezu kwezigidi ezingama-30 abantu ekulindeleke ukuba babulawe sisifo sephepha ebudeni beli shumi leminyaka. Ngenxa yokungasebenzi konyango lwesi sifo emva phayaa, ngoku isifo sephepha esikwaziyo ukuxhathisa amayeza sisisongelo sehlabathi lonke. Ezinye iintsholongwane azisenziwa nto ngamayeza awayezibetha ziye kuxela emva phayaa.
Isifo Seengcongconi: Esi sifo sithwaxa abantu abangaphezu kwama-500 nyaka ngamnye, size sishiye abantu abazizigidi ezi-2 benabel’ ingubo kaqaqaqa. Ukuthintelwa kwaso kuye kwaphazanyiswa kukungabikho kwamayeza nokusetyenziswa kakubi kwawo. Oku kuye kwaphumela ekubeni, izifunxi-gazi ezithwele isifo seengcongconi zikwazi ukuxhathisa amayeza awayekade ezibulala. Eyona nto iyenza ibe mandundu le ngxaki kukuxhathisa kweengcongconi izibulali-zinambuzane.
Ikholera: Ikholera ibulala abantu abali-120 000 ngonyaka, ingakumbi eAfrika, apho oobhubhani basasazeka ngakumbi nalapho baxhaphake kakhulu khona. Nangona ibingaziwa kuMzantsi Merika kangangamashumi eminyaka, ikholera yathwaxa iPeru ngowe-1991 ibe ukususela ngoko iye yasasazeka kulo lonke elo lizwekazi.
IDengue: Le ntsholongwane ithwalwa yingcongconi ithwaxa abantu abaqikelelwa kuma-20 ezigidi nyaka ngamnye. Ebudeni bowe-1995 oyena bhubhani wedengue wawugqugqisa kuMbindi noMzantsi-Merika nakwiiCaribbean kwiminyaka eli-15 wawubhok’ isicuku ubuncinane kumazwe ali-14 apho. Ubhubhani wedengue uyanda ngenxa yokwanda kwabemi ezixekweni, ukwanda kweengcongconi ezithwele idengue nokuba ngoonothwal’ impahlana kwenkungu nelanga yabantu abanesi sifo.
Umqala Omhlophe: Iinkqubo zokugonywa kukawonke wonke ezaqalisa kwiminyaka engama-50 eyadlulayo zasenza esi sifo sanqaba kwimimandla ehambele phambili kwezoshishino. Noko ke, ukususela ngowe-1990 ubhubhani womqala omhlophe uye wadlavula amazwe ali-15 kwiMpuma Yurophu nakwindawo eyayisakuba yiSoviet Union. Umntu omnye kwabane onesi sifo uye wafa. Ebudeni benxalenye yokuqala yowe-1995, kwanikelwa ingxelo engabantu abamalunga nama-25 000 abanesi sifo.
Ubhubhani: Ebudeni bowe-1995, ubuncinane kwanikelwa ingxelo kwiWorld Health Organization (WHO) engabantu abali-1400 abathwaxwa ngulo bhubhani. EUnited States nakwezinye iindawo, esi sifo siye sanwenwela kwiindawo ebezingenabo oobhubhani kangangamashumi amaninzi eminyaka.
[Inkcazelo]
Umthombo: I-WHO
[Umfanekiso okwiphepha 5]
Phezu kwayo nje inkqubela kwezonyango, inzululwazi yezamayeza iye yoyisakala ekuthinteleni ukusasazeka kwezifo ezasulelayo
[Inkcazelo]
WHO photo by J. Abcede
[Umfanekiso okwiphepha 7]
Izifo zisasazeka ngokukhawuleza xa abantu behlala kwindawo exineneyo naphantsi kweemeko ezingaginyisi mathe
[Umfanekiso okwiphepha 8]
Abantu abamalunga nama-800 ezigidi kumazwe asakhasayo abakwazi ukufumana unyango