Amahla-ndinyuka Ekulweni Nezifo

NGOAGASTI 5, 1942, uGqr. Alexander Fleming wabona ukuba esinye kwizigulana zakhe, nesasingumhlobo siyafa. Le ndoda ineminyaka engama-52 ubudala yayinesifo somnqonqo, ibe phezu kwayo nje imigudu kaFleming umhlobo wakhe waba kwicoma.

Kwiminyaka eli-15 ngaphambili, ngebhaqo uFleming wafumana umngundo ombala uzuba-luhlaza. Wawubiza ngokuba yipenicillin. Wabona ukuba unamandla okubulala iintsholongwane; kodwa wayengakwazi ukuyahlula ipenicillin yokwenene, waza ke wayivavanya njengesinqanda-kubola emanxebeni kuphela. Noko ke, ngowe-1938 uHoward Florey neqela lakhe lophando kwiYunivesithi yaseOxford bazama ukuvelisa isixa esaneleyo sepenicillin ukuze ivavanywe ebantwini. UFleming watsalela uFlorey umnxeba, yaye wavuma ukumthumelela yonke ipenicillin awayenayo. Elo yayililinge lokugqibela likaFleming lokusindisa umhlobo wakhe.

Ukutofela loo penicillin kwizihlunu akuzange kwanele, ngoko uFleming wayitofela ngokuthe ngqo emnqonqweni womhlobo wakhe. Loo penicillin yazibulala iintsholongwane; yaye kwisithuba nje esingaphezu kweveki isigulana sikaFleming saphuma esibhedlele siphile qethe. Eso yaba sisiqalo sokusetyenziswa kwezibulali-ntsholongwane, yaye oko kwaba yimbalasane kumlo wabantu nezifo.

Ixesha Lezibulali-ntshongwane

Ukuqala kwazo ukwenziwa, izibulali-ntsholongwane zabonakala njengeyeza elingummangaliso. De kwaba ngoko, izifo ezazifudula zinganyangeki ezibangelwa ziintsholongwane, umngundo nezinye iintsholongwane zazinyangeka. Ngenxa yala mayeza matsha, ukubulawa kwabantu sisifo somnqonqo, yinyumoniya nescarlet fever kwancipha ngokuphawulekayo. Izifo ezasulelayo esibhedlele ezazikade zibulala abantu zanyangwa kwiintsuku nje ezimbalwa.

Ukususela kwixesha likaFleming, abaphandi baye bavelisa intaphane yezibulali-ntsholongwane ezingakumbi, yaye basaqhubeka bekhangela iintlobo ezintsha. Kule minyaka ingama-60 idluleyo, izibulali-ntsholongwane zibe ngundoqo ekulweni nezifo. Ukuba George Washington ebephila namhlanje, ngaphandle kwamathandabuzo oogqirha bebeya kunyanga umqala wakhe ngesibulali-ntsholongwane, yaye kusenokwenzeka ukuba wayeza kuphila kwisithuba nje seveki. Izibulali-ntsholongwane ziye zasinceda sonke sasinda kwizifo ezithile ezasulelayo. Noko ke, kuye kwacaca ukuba izibulali-ntsholongwane zinezazo iingxaki.

Izibulali-ntsholongwane azikwazi ukunyanga izifo ezibangelwa ziintsholongwane ezibizwa ngokuba ziivirus, njengoGawulayo okanye umbathalala. Ukongezelela koko, kukho abantu ezingabalungeliyo izibulali-ntsholongwane ezithile. Kwakhona izibulali-ntsholongwane ezinamandla zinokubulala neentsholongwane eziluncedo emizimbeni yethu. Kodwa kunokwenzeka ukuba eyona ngxaki inkulu ngezibulali-ntsholongwane kukusetyenziswa kwazo ngokugqithiseleyo okanye ukusetyenziswa kwazo ngaphantsi komlinganiselo.

Ukusetyenziswa ngaphantsi komlinganiselo wazo kuxa izigulana zingagqibanga ukusebenzisa ezo zicetyiswe ukuba zizisebenzise, mhlawumbi ngenxa yokuba zivakalelwa kukuba ziphilile okanye ngenxa yokuba olo nyango lungapheli. Ngenxa yoko izibulali-ntsholongwane zisenokungazibulali zonke iintsholongwane, kuze oko kubangele zibe namandla okuxhathisa amayeza yaye zande. Oku kuye kwenzeka izihlandlo eziliqela xa kunyangwa isifo sephepha.

Oogqirha namafama babekek’ ityala lokusebenzisa ngokugqithiseleyo la machiza matsha. Incwadi ethi Man and Microbes ithi: “Izibulali-ntsholongwane zisoloko zinconyelwa ngokungeyomfuneko eUnited States, yaye zide zisetyenziswe ngokugqithiseleyo kumazwe amaninzi. Ziye zasetyenziswa kakhulu emfuyweni, kungekhona ukuze kunyangwe izifo kodwa ngenjongo yokuba ikhule ngokukhawuleza; lo ngoyena nobangela mkhulu wokuba iintsholongwane zikwazi ukuxhathisa.” Le ncwadi ilumkisa ithi, umphumo woko kukuba “sisenokungakwazi ukuvelisa izibulali-ntsholongwane ezitsha.”

Noko ke, ngaphandle kwezi ngxaki zokuxhathisa kweentsholongwane, kwisiqingatha sesibini senkulungwane yama-20 kuye kwakho impumelelo eninzi kwezonyango. Kwakubonakala ngathi abaphandi bezamayeza banokukwazi ukwenza amachiza okunyanga nasiphi na isifo. Yaye ugonyo lwabangela amathemba okuthintela izifo.

Impumelelo Kwinzululwazi Yezamayeza

“Embalini ugonyo yeyona nto iye yaphumelela ekukhuseleni impilo yabantu,” yatsho njalo iThe World Health Report yowe-1999. Ukwenziwa kwamaphulo okugonya abantu ehlabathini lonke kuye kwasindisa ubomi bezigidi. Inkqubo yokugonya abantu ehlabathini iye yaphelisa ingqakaqha—isifo esiyingozi esiye sabulala abantu abaninzi ngakumbi kunabo babulawa kwiimfazwe zenkulungwane yama-20 zidityanisiwe—yaye iphulo elifana nelo laphantse layiphelisa ipoliyo. (Bona ibhokisi ethi “Ukoyisa Ingqakaqha Nepoliyo.”) Namhlanje abantwana abaninzi baye bagonywa ukuze bakhuselwe kwizifo ezininzi ezisisisongelo.

Ezinye izifo ziye zathonyalaliswa kungakhange kwenziwe migudu iphawulekayo. Izifo ezisasazwa ngamanzi njengekholera azisafane zibe yingxaki apho kukho iinkqubo ezifanelekileyo zogutyulo namanzi akhuselekileyo. Kumazwe amaninzi ukufumaneka lula koogqirha nonyango lwezibhedlele kwenza inkoliso yezifo ibonwe ngokukhawuleza ize inyangwe ingekahambeli ndawo. Ukutya okusempilweni neemeko zokuhlala ezifanelekileyo kunye nokumiselwa kwemithetho yokugcinwa kakuhle kokutya kuye kwayiphucula impilo yabantu.

Zithi izazinzulu zakufumanisa unobangela wokusasazeka kwesifo esithile, abasemagunyeni kwezempilo bathabathe amanyathelo ukuze sithintelwe. Khawuqwalasele nje omnye umzekelo woko. Ukuqhambuka kobhubhani eSan Francisco ngowe-1907 kwabulala abantu abambalwa ngenxa yokuba ngokukhawuleza eso sixeko saqalisa iphulo lokubulala ezo mpuku zazisasaza iintakumba ezineso sifo. Kwelinye icala, ukususela ngowe-1896, eso sifo sinye sabulala abantu abalishumi lezigidi eIndiya kwiminyaka eli-12 ngenxa yokuba wayengekaziwa unobangela waso.

Iintsilelo Ekulweni Nezifo

Kuyacaca ukuba, kuye kwaphunyezwa amadabi amaninzi. Kodwa enye impumelelo yezonyango iye yangcanyulwa ngamazwe afumileyo kuphela. Izifo ezinokunyangwa zisaqhubeka zibulala izigidi zabantu, kuba nje bengenayo imali yonyango. Kumazwe asakhasayo abantu abaninzi abanayo inkqubo efanelekileyo yogutyulo, yezonyango neyokufumana amanzi acocekileyo okusela. Ukuphumeza ezi ntswelo zisisiseko kuya kusiba nzima ngakumbi ngenxa yokuthontelana kwabantu abangakumbi bephuma emaphandleni besiya kwizixeko ezikhulu zalo mazwe asakhulayo. Ngenxa yabo thunywashe, amazwe ahlwempuzekileyo athwaxwa koko iWorld Health Organization ikubiza ngokuthi “kukusinda-calanye koxanduva lomthwalo wezifo.”

Ukucinga phambi konyawo ngenxa yokuzingca ngoyena nobangela wokungathwalisani kwamazwe ngoxanduva lwezonyango. Incwadi ethi Man and Microbes ithi: “Ezinye zezona zifo zasulelayo nezibulala abantu ehlabathini azaziwa nokwaziwa kumazwe ami kakuhle. Ezinye kuzo ziphelela okanye ubukhulu becala zifumaneka kwiingingqi ezihlwempuzekileyo zetropic nesubtropic.” Ekubeni amazwe afumileyo neenkampani zamayeza kungekho nzuzo anokuyifumana ngokuthe ngqo, amadolw’ anzima ukufak’ isandla ukuze kunyangwe ezi zifo.

Ukungakhathali kwabantu ngomnye unobangela wokusasazeka kwezifo. Awukho omnye umzekelo ocacileyo woku ngaphezu kwalowo wokusasazeka kwentsholongwane kaGawulayo, edluliselwa komnye umntu ngezinto ezilulwelo eziphuma emzimbeni. Kwiminyaka nje embalwa, esi sifo siye sasasazeka ehlabathini lonke. (Bona ibhokisi ethi “UGawulayo—Ubhubhani Wanamhlanje.”) “Abantu babekek’ ityala ngokusasazeka kukaGawulayo,” itsho njalo ingcali ngezifo ezingubhubhani uJoe McCormick. “Xa nditshoyo andizami kugxeka abantu ngendlela abaziphatha ngayo, kodwa ndithetha nje isibakala.”

Bengaqondi abantu baye basebenzisana njani nentsholongwane kaGawulayo? Incwadi ethi The Coming Plague idwelisa ezi zibakala: Ukutshintsha kwendlela yokuphila—ngokukhethekileyo ukuba neentlobano zesini nabantu abahlukahlukeneyo—kuye kwabangela ukusasazeka kwezifo ezidluliselwa ngeentlobano zesini, kwenza kwalula ngale ntsholongwane ukuba ityhutyhe abantu abaninzi. Ukuxhaphaka kokusetyenziswa kweenaliti ezinezifo nesele zisetyenziswe xa kutofelwa amayeza kumazwe asakhasayo okanye ngabo basebenzisa kakubi iziyobisi kube negalelo elifanayo. Ishishini elixabisa amawaka ezigidi lokutofelwa kwegazi okwenziwa ehlabathini lonke liye labangela ukusasazeka kwentsholongwane kaGawulayo isuka kulowo unikela ngegazi iye kungena kwabo baza kutofelwa igazi lakhe.

Njengoko kuchazwe ngaphambili, ukusetyenziswa ngokugqithiseleyo okanye ukusetyenziswa ngaphantsi komlinganiselo kwezibulali-ntsholongwane kuye kwanegalelo ekuxhathiseni kweentsholongwane. Le ngxaki inzulu yaye iya ithabatha unyawo. Intsholongwane istaphylococcus, edla ngokubangela izilonda, yayidla ngokuphela lula liyeza elenziwe ngepenicillin. Kodwa ngoku ezi zibulali-ntsholongwane ziqhelekileyo zidla ngokungasebenzi. Ngoko kufuneka oogqirha basebenzise iintlobo ezintsha zezibulali-ntsholongwane, ezibiza imali eninzi engenakufikelelwa zizibhedlele ezikumazwe akhulayo. Nezona ntlobo zintsha zezibulali-ntsholongwane zisenokungakwazi ukulwa neentsholongwane, zenze kuxhaphake izifo ezasulelayo esibhedlele kuze kufe abantu abangakumbi. UGqr. Richard Krause, owayengumalathisi kwiU.S. National Institute of Allergy and Infectious Diseases uchaza ngokunyaniseka imeko ekhoyo “njengokwanda kokuxhathisa kweentsholongwane ezibulala abantu.”

“Ngaba Siyaphumelela Namhlanje?”

Ekuqaleni kwenkulungwane yama-21 kuye kwacaca ukuba isisongelo sezifo asikapheli. Ukuthi gqolo kukaGawulayo esasazeka, ukuxhathisa kweentsholongwane emayezeni nokuqala phantsi kwezifo ezibulalayo zakudala njengesifo sephepha nemalariya kubonisa ukuba ayikapheli imfazwe nxamnye nezifo.

“Ngaba siyaphumelela namhlanje kunakwinkulungwane edluleyo?” wabuza oko omnye owaphumelela Imbasa kaNobel uJoshua Lederberg. Wathi: “Kwiinkalo ezininzi, siya sizika ngakumbi. Siye asanikela ngqalelo kwiintsholongwane, ngoku sivuna imiphumo yoko.” Ngaba ezi ngxaki sinazo zinokoyiswa ngokwenziwa kwemigudu yinzululwazi yamayeza nawo onke amazwe ehlabathi? Ngaba izifo eziphambili ezasulelayo ziya kude zoyiswe, njengokuba kwenzekayo ngengqakaqha? Inqaku lethu lokugqibela liza kuqwalasela le mibuzo.

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Ukoyisa Ingqakaqha Nepoliyo

Ekupheleni kukaOktobha 1977, iWorld Health Organization (WHO) yafumanisa umntu wokugqibela owahlaselwa yingqakaqha. UAli Maow Maalin, owayengumpheki esibhedlele nowayehlala eSomalia, akazange ahlaselwe ngamandla sesi sifo, ngoko wakhawuleza waphila kwiiveki nje ezimbalwa. Bonke abantu ababedibana naye bagonywa.

Oogqirha balinda kangangeminyaka emibini eyaba ngathi itsala ixesha elide. Kwakhutshwa isixa semali esingama-R7 000 esasiza kunikwa nabani na owayenokunikela ingxelo “ngomnye umntu ohlaselwe yingqakaqha.” Akukho ngxelo yafumanekayo, yaye ngoMeyi 8, 1980, iWHO yabhengeza ngokusesikweni ukuba “iHlabathi nabo bonke abantu balo bakhululekile kwingqakaqha.” Kwiminyaka nje elishumi ngaphambi koko, ingqakaqha yayibulala abantu abamalunga nezigidi ezibini ngonyaka. Okokuqala embalini, esona sifo sasulelayo soyiswa.a

Ipoliyo, isifo esiqoba umzimba womntwana, yayibonakala ngathi inokoyiswa. Ngowe-1955, uJonas Salk wavelisa iyeza lokugonya ipoliyo, yaye eUnited States nakwamanye amazwe kwaqaliswa iphulo lokugonyela ipoliyo. Kamva kwaveliswa iyeza lokugonya eliselwayo. Ngowe-1988, iWHO yaseka iphulo lehlabathi lonke ukuze kuliwe nepoliyo.

UGqr. Gro Harlem Brundtland owayengumalathisi jikelele kwi-WHO uthi: “Xa sasiqalisa iphulo lokulwa nepoliyo ngowe-1988, ipoliyo yayihlasela abantwana abangaphezu kwe-1 000 rhoqo ngosuku. Ngowama-2001, babengaphantsi gqitha kwi-1 000 abahlaselwa yipoliyo ngonyaka.” Ngoku ipoliyo ikho kumazwe angaphantsi kweshumi kuphela, nangona kusafuneka imali engakumbi ukuze kuncedwe la mazwe asitshayele neengcambu esi sifo.

[Umbhalo osemazantsi]

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Inkwenkwana yaseEthiopia igonyelwa ipoliyo

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© WHO/P. Virot

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UGAWULAYO—Ubhubhani Wanamhlanje

Ngoku isisongelo esitsha sehlabathi kukusasazeka kukaGawulayo. Malunga neminyaka engama-20 sifunyanisiwe esi sifo, sele sasulele abantu abangaphezu kwezigidi ezingama-60. Yaye abezonyango balumkisa ngelithi ukugqugqisa kukaGawulayo ilizwe lonke “iseziziqalelo nje ezincinane.” “Liya lisanda kunokuba kwakucingwa,” inani labantu abosulelwayo yaye inxunguphalisa gqitha imiphumo yoku kumazwe athwaxwa kanobom sesi sifo.

“Inkoliso yabantu abanentsholongwane kaGawulayo iHIV ehlabathini ngabantu abasenamandla, abantu abasebenzayo,” itsho njalo ingxelo yeUnited Nations. Ngenxa yoko, kukholelwa ukuba amazwe aliqela akumazantsi eAfrika aza kulahlekelwa ngabasebenzi abali-10 ukusa kwabangama-20 ekhulwini malunga nonyaka wama-2005. Le ngxelo iphinda ithi: “Umlinganiselo wobude bobomi babantu kwisub-Saharan Africa sele ukuma-47 eminyaka. Ukuba ebengekho uGawulayo, ubuya kuba yiminyaka engama-62.”

Ukuza kuthi ga ngoku isawa phantsi yonke imigudu yokufumana iyeza lokugonya esi sifo, yaye ngabantu aba-4 kuphela ekhulwini kwizigidi ezi-6 ezinesi sifo abakwaziyo ukufumana amachiza okuzinyamekela kumazwe asakhasayo. Ukuza kuthi ga ngoku, alikabikho iyeza lokunyanga uGawulayo, yaye oogqirha boyikela ukuba inkoliso yabantu abosulelwe yintsholongwane yesi sifo iya kude ihlaselwe siso uqobo.

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Iiseli ekuthiwa ziiT lymphocyte ezinentsholongwane iHIV

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Godo-Foto

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Umsebenzi waselabolatry uhlolisisa intsholongwane ekunzima ukuyinyanga

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CDC/Anthony Sanchez