Ingculaza—Inhlekelele Yentsha
UMQEDAZWE wengculaza awukhethi budala noma igebe elihlukanisa izizukulwane. Imibiko yomhlaba wonke inikeza ubufakazi obudabukisayo bokuthi “Ingculaza Iyanda Entsheni, Umkhakha Omusha Oshaqisa Ochwepheshe,” njengoba kwamenyezelwa esihlokweni seNew York Times esasikhuluma ngengculaza. Izinga legciwane lengculaza entsheni “lizoba usizi olulandelayo,” kusho uDkt. Gary R. Strokash, umqondisi wemithi yokwelapha intsha wesikhungo esaziwayo sezokwelapha saseChicago. Wathi, “Kuyadabukisa futhi kuzobhubhisa.” “Akungabazeki,” kudabuka uDkt. Charles Wibbelsman, isikhulu somtholampilo wentsha eKaiser Permanente Medical Center eSan Francisco, “ukuthi umqedazwe wengculaza yawo-1990, uma ungekho umuthi wokuwugomela, uzoba . . . sentsheni.” Kukhuluma ngentsha enesifo sengculaza, ukuphawula komqeqeshi odumile kwezengculaza eNew York kwakuwukuthi: “Sicabanga ukuthi kuyinhlekelele eyisimo esiphuthumayo.”
IToronto Star yaseCanada, yaqokomisa isimo sokubona ingozi njengoba ingculaza yanda phakathi kwentsha. “Okwamanje, kubi kakhulu kunokuba noma ubani eqaphela,” kwasho omunye udokotela. “Ngicabanga ukuthi kuyinkinga eyinsambatheka esingakwazi ukwenza lutho ngayo kangako. Ngokuhamba kwesikhathi sizothola ukuthi yimbi kangakanani.” Amazwi alula kadokotela aba umbono izikhulu zezempilo kanye nabaholi bakahulumeni abavumelene ngawo kuwo wonke umhlaba njengoba ubhadane lwengculaza ludlanga.
Kuze kube muva nje, ochwepheshe bengculaza abazange bagxile entsheni njengesengozini kakhulu yokungenwa iHIV (human immunodeficiency virus), ebangela ingculaza. “Sikhuluma ngento leyo onyakeni owodwa nje owedlule eyayicatshangelwa ukuthi ingase yenzeke,” kwasho omunye udokotela waseDolobheni laseNew York. Nokho, “odokotela ababengenaso ngisho nesisodwa isiguli eseve eshumini nambili esinalesifo manje baneziningi kakhulu,” kubika iNew York Times.
Abacwaningi banomuzwa wokuthi nakuba ukwaziswa okutholakalayo ngokuphathelene nentsha enegciwane lengculaza kushaqisa, kumane nje kuwumbono ongacacile wokuningi okuthukuse induku emqubeni, njengoba ngokuvamile izimpawu zingabonakali kuze kube yilapho sekudlule isilinganiso seminyaka esukela kweyisikhombisa kuya kweyishumi ngemva kokungenwa igciwane. Ngakho labo abangenwa igciwane leHIV besanda kweva eshumini nambili bangase bangabi nazo izimpawu zengculaza esibonakala ngokugcwele kuze kube yilapho sebebadadlana noma besanda kweva eminyakeni engu-20.
Ngokwesibonelo, ekuhlolweni kwamuva kwazo zonke izingane ezazalwa kulelidolobha kusukela ngo-1987, uMnyango Wezempilo waseNew York State wathola ukuthi ingane eyodwa kwezingu-1 000 ezizalwa abaneminyaka engu-15 zazinamasosha omzimba okulwa negciwane lengculaza, okubonisa ukuthi umama womntwana wayenalo. Ngokushaqisayo, ukuhlola okufanayo kwembula ukuthi ingane eyodwa kwezingu-100 ezizalwe omama abaneminyaka engu-19 yayinamasosha omzimba okulwa negciwane lengculaza. Okunye ukuhlola okwenziwa iCDC (U.S. Centers for Disease Control [Izikhungo Zokunqanda Izifo]) kwembula ukuthi amaphesenti angu-20 abesilisa baseMelika kanye namaphesenti angu-25 abesifazane bakhona abatholwa ukuthi banengculaza baseminyakeni yawo-20. Ukuhlola kweCDC kubika ukuthi ezimweni eziningi, isifo satholakala esikhathini sokuthomba.
Nokho, lokhu kungenzeka kanjani, lapho abantwana abazalwa benegciwane lengculaza bethukela bephila baze beve eshumini nambili, uma kuke kwenzeke? Izizathu ziyashaqisa!
Abacwaningi nodokotela bayashesha ukufakazela ukuthi intsha yanamuhla “ibushisekela ngokweqile ubulili, njengoba amanani ezifo ezidluliselwa ngobulili phakathi kwayo ebonisa,” kubika iNew York Times. Isikhungo Sokuzikhethela Komphakathi sibika ukuthi unyaka ngamunye umuntu omusha oyedwa kwabayisithupha uthola isifo esidluliselwa ngobulili nanokuthi intombazane eyodwa kwayisithupha afunda esikoleni esiphakeme ibushisekela kakhulu ubulili okungenani iye yaba namasoka amane ahlukahlukene.
“Naphezu kokunxusa kokuthi ‘vele nje uthi cha,’ oweve eshumini nambili ovamile waseMelika ulahlekelwa ubuntombi bakhe eneminyaka engu-16,” kubika iU.S.News & World Report. Lomagazini wathi: “Njengoba imbalwa intsha ehlolwayo, abaningi balabo abanalesifo abazi ukuthi banegciwane leHIV.” Esinye isazi ngengculaza sabhala, “Intsha yaseMelika iyizisulu ezilula zengculaza,” kungakhathaliseki ukuthi inokuziphatha okuxekethile ngokobulili okuhlanganiswa noma kungahlanganiswa nokusetshenziswa kwecrack cocaine, ukuthi yeqa emakhaya noma cha. “Kakade unyaka ngamunye baba neziguli eziyizigidi ezingu-2,5 zesifo esidluliselwa ngobulili.” UDkt. Gary Noble weCDC wenza lokhu kuphawula: “Siyazi ukuthi ukuziphatha kwabo ngokobulili kuphumela engozini ephawulekayo yokungenwa yileligciwane.”
Okunezela enanini elikhula ngokushesha kakade lemigudu yokudlulisela igciwane lengculaza intsha engosikhotheni, enye engakevi naseshumini leminyaka, eningi eyeqa emakhaya ibalekela abazali abanukubeza izingane. Phakathi kwayo kuye kwaba khona ukwanda okuphawulekayo kwenani laleyo eye yaphendukela ekusebenziseni icrack cocaine. Eningi iye yaphendukela ebufebeni obukhokhelwayo ukuze isekele umkhuba wayo noma ithole indawo yokulala. Ngokwesibonelo, eNingizimu Melika, “amantombazane amancane aneminyaka eyisishiyagalolunye nengu-10 ngokuvamile asebenza njengezifebe ezikhokhelwayo, ngezinye izikhathi ukuze nje athole ipuleti lokudla,” kusho umeluleki wezingane waseBrazil. Wathi: “Eningi ayazi lutho ngokuphathelene nengculaza noma ubulili.” Uthi, “Lapha kimi kuke kwafika amantombazane akhulelwe futhi ecabanga ukuthi ‘ayithole’ njengomkhuhlane.”
UDkt. Philip Pizzo, uchwepheshe wengculaza kanye nesikhulu sezifo zabantwana eNhlanganweni Yezwe Yomdlavuza, wathi amanani okungenwa iHIV entsheni eyeqayo abikezela okubi ngomqedazwe wengculaza. “Kunabeqa emakhaya abangaphezu kwesigidi abaziphilisa ngemali abayithola ngobulili. Ngokungangabazeki, abaningi babo bayophinde bazimbandakanye nomphakathi.”
Ingabe kuyamangalisa ukuthi umqedazwe wengculaza wanda ngamanani asabekayo phakathi kwentsha eyeve eshumini nambili emhlabeni wonke? Ingabe kungokungenakunqandeka? Kuzoba njalo uma nje ukunganaki nokungakhathali kuqhubeka kuboniswa yilabo abanegciwane lengculaza kanye nalabo abangakwazi ukwenqaba ubulili bangaphambi komshado. Ngokwesibonelo, cabangela lombiko ovela kuyiSunday Star yaseGoli, eNingizimu Afrika. Ekuhloleni kwamuva okwenziwa ezigulini zokuhlola izifo ezingu-1 142 ezinezifo ezithathelwana ngobulili, ezingamaphesenti angu-70 zavuma ukuthi zazinabalingani ezihlanganela nabo ubulili abasukela kwabathathu kuya kwabangu-80 ngenyanga. Futhi ezinye zazisahlanganyela ebulilini futhi zifakela ezinye leligciwane.
Ngeshwa, intsha eningi ayikhathazekile kangako ngokungenwa ingculaza. Kuyo usuku ngalunye olokulwela ukusinda—kunezindlela eziningi zokufela emgwaqweni—kangangokuba ayikwazi ukugxila kokuthile okungase kuyibulale eminyakeni ethile kusukela manje. Inomuzwa wokuthi njengoba isikhathi siqhubeka ngokuqinisekile ikhambi lokuyisindisa lizotholakala. Omunye uchwepheshe wengculaza wathi, “Intsha iyisibonelo esiyinhloko seqembu elingabheki eminyakeni engu-10 engaphambili.”
Kukhona futhi nomqondo oyiphutha noyingozi phakathi kwabaningi wokuthi abangane babo bobulili basuke bengaqambi amanga lapho bethi abanalo igciwane lengculaza. Ngokuvame kakhulu lokho kusuke kungenjalo. Ngisho naseqophelweni elibi kakhulu lalesifo, izisulu eziningi zisidlulisela kwabanye ngamabomu ngenxa yentukuthelo noma ziziphindiselela.
Okungamelwe kunganakwa yilabo abangenwa yigciwane ngezinaliti ezisetshenziselwa imilaliso efakwa ngemithambo yegazi—umgudu kakade osuqede abaningi. Futhi ekugcineni, kunosongo oluhlala lukhona lokuthola ingculaza ngokumpontshelwa igazi. Izisulu eziningi ezingenacala seziye zafa kakade zibulawa yilesifo, futhi abanye basazobulawa igazi elineHIV. Odokotela abaningi nabahlengikazi bayesaba ukuzihlaba ngezinaliti ezinegciwane lengculaza, elingashintsha ukuphila kwabo ngokungaguquleki. Ingabe kuyamangalisa ukuthi ingculaza kuthiwa iwusizi lweminyaka yawo-1990 nangalé kwayo?