Kutsiva Kweutachiona

ZANA ramakore rechi20 rakaona kufambira mberi kunoshamisa musayenzi yezvokurapa. Kwezviuru zvamakore, vanhu vave vachidokuva vasina betsero chaizvoizvo mukurwisana nedambudziko reutachiona hunouraya. Asi zvinhu zvakavamba kuchinja pakati pema1930 apo vezvesayenzi vakawana sulfanilamide, mushonga wokutanga waigona kukunda utachiona pasina kukuvadza munhu wakatapurwa zvakakomba.a

Mumakore akatevera, vezvesayenzi vakatanga mirimo mitsva ine simba yokurwisa hosha dzinopomeranwa—chloroquine yokurwisa marariya uye mishonga yokukurira mabayo, scarlet fever, uye tibhii. Pakasvika 1965 zvigadzirwa zvemishonga zvakasiyana-siyana zvinopfuura 25 000 zvakanga zvagadzirwa. Vezvesayenzi vazhinji vakagumisa kuti hosha dzinoparirwa neutachiona dzakanga dzichisiri dzeitiro hanya huru kana kuti fariro yokunzvera. Pashure pezvose, kufundirei hosha dzisati dzichizovapozve nokukurumidza?

Munyika dzakabudirira dzenyika yose, nhomba itsva dzakaderedza zvikuru kuuraya kwegwirikwiti, mahumunya, uye gwirikwiti rechiGermany. Nhimbe huru yokubaya nhomba yokudzivirira kuva nemhetamakumbo, yakavambwa muna 1955, yakabudirira kwazvo zvokuti zvinoitika zvehosha yacho muWestern Europe neNorth America zvakaderera zvikuru kubva pa76 000 mugore iroro kusvikira kuzvisingasviki 1 000 muna 1967. Nhomba, hosha inouraya huru, yakabviswa zvachose chose munyika yose.

Zana rino remakore rakaonawo kugadzirwa kweelectron microscope, mudziyo une simba kwazvo zvokuti unogonesa masayendisiti kuona mavhairasi maduku zvikuru kunzara yemunhu nekane miriyoni. Mamicroscope akadaro, pamwe nedzimwe fambiro mberi dzokugadzirwa kwezvinhu, zvakakuita kuti kuve kunobvira kunzwisisa ndokurwisa hosha dzinopomeranwa sezvisakamboitika nakare kose.

Rukundo Rwairatidzika Sorwechokwadi

Somugumisiro wekuwana uku, nzanga yezvokurapa yakanga yakazara nechivimbo. Utachiona hwehosha dzinopomeranwa hwakanga huchikundwa nemishonga yazvino uno. Zvirokwazvo rukundo rwesayenzi pautachiona rwaizova runokurumidza, rusingakundikani, rwakakwana! Kudai mushonga wehosha yakati wakanga usati wave kutowanika, waizodaro nokukurumidza.

Pakuvamba sa1948, munyori wehurumende weU.S. George C. Marshall akaganza kuti kukundwa kwehosha dzose dzinopomeranwa kwakanga kwave pedyo nokuitika. Makore matatu gare gare, World Health Organisation (WHO) yakataura kuti marariya yokuAsia nokukurumidza yaizogona kuva hosha “isisirizve youkoshi ukuru.” Pakasvika pakati pama1960, chitendero chokuti nhambo yedambudziko nenhenda yakanga yapfuura chakanga chakapararira zvakafara kwazvo zvokuti mukuru mukuru wezvokurapa weU.S. William H. Stewart akaudza vakuru vakuru veutano kuti yakanga yava nguva yokuvhara bhuku rezvirwere zvinopomeranwa.

Hosha Dzekare Dzinodzoka

Zvisinei, bhuku rehosha dzinopomeranwa rakanga risina kugadzirira munzira ipi neipi kuvharwa. Utachiona hahuna kunyangarika panyika nemhaka chete yokuti sayenzi yakanga yagadzira mirimo nenhomba. Huri kure nokukundwa, utachiona hunouraya hunozivikanwa zvikuru hwakadzoka namatsive! Mukuwedzera, humwe utachiona hunouraya hwakabuda—utachiona hwaisazivikanwa kare nanachiremba. Nokudaro, utachiona hwose huri huviri hutsva nehwekare huri kupararira nokukurumidza, huchityisidzira, huchitambudza, kana kuti huchiuraya mamiriyoni asingaverengeki avanhu munyika yose.

Hosha dzinouraya dzaimbofungwa kuva dzave kudzoreka dzakaonekazve, dzave kuuraya kupfuura nakare kose uye dzaoma zvikuru kurapa nemirimo. Mumwe muenzaniso itibhii (TB). WHO yakataura nguva pfupi yapfuura, kuti: “Kubvira muna 1944, mirimo yeTB yakashandiswa zvikuru muJapan, North America uye Europe kuderedza zvikuru hosha dzeTB nenzufu. Zvisinei, nhamburiko dzokudzora TB munyika dzakabudirira zvishoma dzakaregeredzwa, . . . kuchigonesa hosha kudzoka kunyika dzakapfuma muzvimiro zvine ngozi zvikuru, zvisinganzwi mirimo yakawanda.” Nhasi TB, inowanzoparirwa neutachiona hunotakurwa nemhepo hunogara mumapapu, inouraya vanhu vanenge mamiriyoni matutu gore riri rose—vanopfuura 7 000 pazuva. Panosvika gore ra2005, vanofa vangagona kuwedzera kusvikira kuvane mamiriyoni mana gore rimwe nerimwe.

Dzimwe dzaichimbouraya dziri kukwirawo. Cholera zvino yakapararira zvakafara mumativi mazhinji eAfrica, Asia, uye Latin America; inotambudza nokuuraya nhamba dzinowedzera dzevanhu. Imwe hosha itsva chose chose yakabuda muAsia.

Dengue, inoparadzirwa neutunga hunonzi Aëdes aegypti, iri kukwirawo nokukurumidza; zvino inotyisidzira vanhu vane mabhiriyoni 2,5 vari munyik7a dzinopfuura 100 munyika yose. Kubvira muma1950, chimiro chitsva chokubuda ropa chinouraya chehosha yacho chakabuda ndokupararira Munyika Dzinopisa Zvikurusa dzose. Kunofungidzirwa kuti inouraya vanhu vanenge 20 000 gore rimwe nerimwe. Senehosha zhinjisa dzinoparirwa nevhairasi, hakuna nhomba yokudzivirira hosha yacho uye hakuna murimo wokuirapa.

Marariya, iyo sayenzi yakanga yambokarira kuparadza, zvino inouraya vanhu vanenge mamiriyoni maviri gore rimwe nerimwe. Zvose zviri zviviri zvisaririra zvemarariya neutunga hwacho hunozvitakura zvazova zvakaoma zvikuru kuuraya.

Hosha Itsva Dzinoparadza

Zvichida inozivikanwa zvikurusa yehosha itsva dzakamuka nguva pfupi yapfuura kutambudza rudzi rwomunhu iAIDS inouraya. Iyi hosha isingarapiki inoparirwa nevhairasi yakanga isingazivikanwi makore anenge gumi nemaviri bedzi apfuura. Bva, kupera kwa1994 nhamba yevanhu munyika yose vakanga vatapurwa nevhairasi yacho yakanga iri pakati pemamiriyoni 13 ne15.

Dzimwe hosha dzinopomeranwa dzakanga dzisingazivikanwi kare dzinobatanidza hantavirus pulmonary syndrome. Ichiparadzirwa nembeva dzomusango, yakaoneka kumaodzanyemba kwakadziva kumadokero kweUnited States uye yakabvumikisa kuva inouraya muinopfuura hafu yezvinoitika zvakashumwa. Marudzi maviri efivha yokubuda ropa—ose ari maviri matsva, ose ari maviri anouraya—akatanga muSouth America. Dzimwe hosha dzinotyisa dzakamukawo—mavhairasi ane mazita echienzi, asiri enguva dzose—Lassa, Rift Valley, Oropouche, Rocio, Q. Guanarito, VEE, monkeypox, Chikungunya, Makola, Duvenhage, LeDantec, Kyasanur Forest brain virus, Semliki Forest agent, Crimean-Congo, O’nyongnyong, Sindbis, Marburg, Ebola.

Nei Hosha Itsva Dziri Kubuda?

Nezivo yose nemidziyo zvine sayenzi yezvokurapa yazvino uno, nei utachiona hunouraya huri kubvumikisa kuva hwakaoma kwazvo kukunda? Chimwe chikonzero kufamba kwakawedzerwa kwenzanga yanhasi. Zvokufambisa zvazvino uno zvinogona kuita kuti murakatira womunzvimbomo uve wepasi rose nokukurumidza. Kufamba kwejeti kunorerutsira hosha inouraya kufamba, yakachengetwa mukati momunhu akatapurwa, kubva kune rumwe rutivi rwenyika kuenda kune rumwe rutivi rupi norupi rwenyika mukati memaawa.

Chikonzero chechipiri, chinorerutsa kupararira kweutachiona, uwandu hwavanhu venyika yose huri kukura nokukurumidza—zvikurukuru mumaguta. Chokwadika, marara anoitwa mumaguta. Marara ane zvigaba zvepurasitiki nematayera zvakazadzwa nemvura inonaya yakanaka. Munyika Dzinopisa Zvikurusa, ikoko kunoguma nokuwanziridzwa kweutunga hunotakura hosha dzinouraya dzakadai semarariya, yellow fever, uye dengue. Mukuwedzera, sezvo sango rine miti mizhinji richigona kunyandura mwoto, naizvozvo uwandu hwavanhu vakawandisa panzvimbo imwe hunogovera mamiriro ezvinhu akanakisisa nokuda kwokupararira kwetibhii, furuwenza, uye hosha dzinotakurwa nemhepo.

Chikonzero chechitatu chokudzoka kweutachiona chine chokuita nechinjo mutsika dzevanhu. Utachiona hunopfuudzwa muvatano hwakakura zvakanaka ndokupararira somugumisiro wemwero usingaenzaniswi wevatano nevanhu vakawanda, iyo yazova chinozivisa rutivi rwokupedzisira rwezana ramakore rechi20. Kupararira kweAIDS muenzaniso mumwe chete.b

Chikonzero chechina nei utachiona hunouraya huri kubvumikisa kuva hwakaoma kwazvo kukunda ndechokuti munhu akavhozhokera matondo nemasango anogara achinaya mvura. Munyori Richard Preston anoti mubhuku rake rinonzi The Hot Zone: “Kubuda kweAIDS, Ebola, uye nhamba ipi neipi yezvinobva mumasango anogara achinaya mvura zvinotapura inoratidzika kuva mugumisiro womusikirwo wokuparadzwa kwezvipenyu nemhoteredzo yazvo zvenyika dzinopisa zvikurusa. Mavhairasi ari kuoneka mumativi akaparadzwa zvipenyu nemhoteredzo apasi. Mazhinji awo anobva mumicheto yakaparadzwa yemasango anogara achinaya mvura enyika dzinopisa zvikurusa . . . Masango anogara achinaya mvura enyika dzinopisa zvikurusa ndiwo matura makuru eupenyu panyika, ane marudzi mazhinjisa emiti yenyika nemhuka. Masango anogara achinaya mvura ndiwowo matura ayo makurusa emavhairasi, sezvo zvinhu zvipenyu zvose zvichitakura mavhairasi.”

Vanhu nokudaro vanova pedyo zvikurusa nezvipembenene nemhuka dzine ropa rinodziya umo mavhairasi anogara pasina ngozi, anobereka, uye kufa. Asi apo vhairasi ino“svetuka” ichibva kumhuka ichienda kumunhu, vhairasi yacho ingava inouraya.

Miganhu Yesayenzi Yezvokurapa

Zvimwe zvikonzero nei hosha dzinopomeranwa dziri kudzoka zvine chokuita nesayenzi yezvokurapa imene. Utachiona huzhinji zvino hunozvidza mishonga yaichimbohuuraya. Nenzira inosetsa, mishonga imene yakabetsera kuita mamiriro aya ezvinhu. Somuenzaniso, kana mushonga uchiuraya 99 muzana bedzi yeutachiona hunokuvadza mumunhu akatapurwa, chikamu chimwe muzana chipenyu chakaramba kuurawa nemushonga chinogona zvino kukura ndokuwanziridza sebundo rakasimba mumunda uchangobva kurimwa.

Varwere vanowedzera chinetso chacho apo vanorega kupedza mishonga yakarongwa munguva yakati yavakaudzwa nachiremba wavo. Varwere vangarega kunwa mapiritsi nokukurumidza sezvavanovamba kunzwa zviri nani. Nepo utachiona husina kusimba zvikurusa hungave hwaurawa, hwakasimba zvikurusa hunorarama ndokuwanziridza chinyararire. Mukati mevhiki shomanene, hosha yacho inoitikazve, asi nguva ino yaoma zvikuru, kana kuti isingabviri, kurapa nemirimo. Apo izvi zvirwere zvisinganzwi mirimo zvoutachiona zvinovhozhokera vamwe vanhu, chinetso cheutano hwavose chakakomba chinovapo somugumisiro.

Nyanzvi dziri muWHO dzakati nguva pfupi yapfuura: “Kusanzwa [mishonga nezvimwe zvinorwisa utachiona] kwakapararira munyika zhinji uye kusanzwa mirimo yakawanda kunosiya vanachiremba vachidokuva vasina mukana wokuvandudza mukurapwa kwenhamba inowedzera yehosha. Muzvipatara moga, hosha dzinoparirwa neutachiona dzinofungidzirwa kuva miriyoni imwe dziri kuitika munyika yose zuva riri rose, uye huzhinjisa hweuhu hahunzwi mirimo.”

Kuisirwa ropa, kwakashandiswa nenzira inowedzera kubvira pahondo yenyika yechipiri, kwakabetserawo kuparadzira hosha dzinopomeranwa. Pasinei zvapo nenhamburiko dzesayenzi dzokuchengeta ropa risina utachiona hunouraya, kuisirwa ropa kwakaparira zvikuru kukupararira kwehepatitis, cytomegalovirus, utachiona husinganzwi mushonga, marariya, yellow fever, hosha yeChagas, AIDS, uye dzimwe hosha zhinji dzinotyisa.

Mamiriro Ezvinhu Nhasi

Nepo sayenzi yezvokurapa yakapupurira kuwandisa kwezivo mukati mezana rino ramakore, kunoramba kune zvakavanzika zvizhinji. C. J. Peters anofunda utachiona hune ngozi paCenters for Disease Control, rabhoritari yeutano hwavose hurusa yeAmerica. Mune imwe bvunzurudzo muna May 1995, akati pamusoro peEbola: “Hatizivi kuti nei yakakomba kudaro nokuda kwevanhu, uye hatizivi zvairi kuita [kana kuti] kwainenge iri, apo inenge isiri kuparira mirakatira iyi. Hatigoni kuiwana. Hakuna imwe mhuri yevhairasi . . . iyo tine kusaziva kwakadzama kudaro pamusoro payo.”

Kunyange apo zivo yezvokurapa inobudirira, mirimo, uye nhomba zviripo kurwisa hosha, kuzvishandisa kuna avo vanozvida kunoda mari. Mamiriyoni anorarama muurombo. World Health Report 1995 yeWHO inoti: “Urombo ndicho chikonzero chikuru nei vana vasingabayiwi nhomba, nei mvura yakachena noutsanana zvisingagoverwi, nei mirimo inorapa nekumwe kurapa zvisingawaniki . . . Gore riri rose munyika ichiri kubudirira vana vane mamiriyoni 12,2 vari pasi pemakore 5 vanofa, vazhinjisa vavo nezvisakiso zvaigona kudziviswa nemasendi mashomanene chete eUS pamwana mumwe. Vanofa zvikurukuru nemhaka yokusakendenga kwenyika, chinopfuura zvose vanofa nemhaka yokuti varombo.”

Pakasvika 1995, hosha dzinopomeranwa nezvikwevaropa zvakanga zviri zvinouraya zvikurusa zvenyika, zvichitsakatisa upenyu hwevanhu vane mamiriyoni 16,4 gore rimwe nerimwe. Nenzira inosuruvarisa, mamiriyoni asingaverengeki avanhu anorarama mumamiriro ezvinhu akanakira kubuda nokupararira kwoutachiona hunouraya. Rangarira mamiriro ezvinhu anonzwisa urombo nhasi. Vanhu vanopfuura bhiriyoni varipo muurombo hwakanyanyisa. Hafu yevagari vose venyika haigoni kurapwa nguva dzose uye mirimo inokosha. Mumigwagwa yamaguta makuru akasvibiswa munodzungaira mamiriyoni evana vakaraswa, vazhinji vavo vanobaya majekiseni emirimo uye vanoita uhure. Mamiriyoni evapoteri anotambura mumisasa isina utsanana pakati pecholera, manyoka, uye dzimwe hosha.

Muhondo iri pakati pemunhu noutachiona, mamiriro ezvinhu akatsigira zvikuru utachiona.

[Mashoko Omuzasi]

[Mashoko okukwezva vaverengi ari papeji 24]

“Muzvipatara moga, hosha dzoutachiona dzinofungidzirwa kuva miriyoni imwe kuri kuitika munyika yose zuva riri rose, uye zhinjisa dzaidzodzi hadzinzwi mirimo.” World Health Organisation

[Bhokisi riri papeji 25]

Apo Utachiona Hunodzorera

Utachiona huduku hunozivikanwa sebucterium “hunorema zvishomanene segiramu 0.00000000001. Blue whale inorema anenge magiramu 100 000 000. Bva bucterium rinogona kuuraya whale.”—Bernard Dixon, 1994.

Pakati peutachiona hunotyiwa zvikurusa hunowanwa muzvipatara kune marudzi asinganzwi murimo eStaphylococcus aureus. Marudzi aya anotambudza vanorwara nevasina simba, achiparira hosha dzeropa dzinouraya, mabayo, uye toxic shock. Maererano nokumwe kuverenga, staph inouraya vanhu vanenge 60 000 muUnited States gore rimwe nerimwe—vanopfuura avo vanofa mutsaona dzemotokari. Kwemakore, aya marudzi eutachiona akava asinganzwi mishonga kwazvo zvokuti pakasvika 1988 kwakanga kuchingova nomushonga mumwe bedzi waibudirira kuarwisa, murimo unonzi vancomycin. Nokukurumidza, zvisinei, mishumo yemarudzi asinganzwi vancomycin yakavamba kuoneka munyika yose.

Bva, kunyange apo mishonga inoita basa rainofanira kuita, zvimwe zvinetso zvingamuka. Pakati pa1993, Joan Ray akaenda kune chimwe chipatara muUnited States nokuda kwokuvhiyiwawo zvako kwomuitiro. Aikarira kuva kumusha mumazuva mashomanene chete. Panzvimbo pezvo, aifanira kuramba ari muchipatara kwemazuva 322, zvikurukuru nemhaka yokutapurwa kwakavamba pashure pokuvhiyiwa. Vanachiremba vakarwisa kutapurwa kwacho nezvitsama zvine simba zvemishonga, kubatanidza vancomycin, asi utachiona hwacho hwakadzorera. Joan anoti: “Ndaisagona kushandisa maoko angu. Ndaisagona kushandisa tsoka dzangu. . . . Ndaisagona kunyange kunonga bhuku kuti ndirirave.”

Vanachiremba vakaparapatika kuti vawane kuti chikonzero nei Joan akanga achiri kurwara pashure pemwedzi yokurapwa nemirimo. Basa romurabhoritari rakaratidza kuti mukuwedzera kukutapurwa nestaph, Joan akanga ane rumwe rudzi rweutachiona mumuviri make—enterococcus isinganzwi vancomycin. Seizvo zita racho rinokarakadza, utachiona uhu hauna kukuvadzwa nevancomycin; hwairatidzikawo kuva husingafi nomumwe mushonga uri wose.

Ipapo vanachiremba vakadzidza chimwe chinhu chakavakatyamadza. Utachiona hwacho hauna bedzi kusanzwa mirimo yaifanira kuva yakahuuraya asi, mukupesana nezvavaikarira, chaizvoizvo hwakashandisa vancomycin kuti hurarame! Chiremba waJoan, nyanzvi yezvirwere zvinopomeranwa, akati: “[Utachiona hwacho] hunoda vancomycin iyoyo kuitira kuti huwanziridze, uye kana husina iyoyo hahukuri. Naizvozvo, mupfungwa yakati, huri kushandisa vancomycin sechokudya.”

Apo vanachiremba vakamira kupa Joan vancomycin, utachiona hwacho hwakafa, uye Joan akava nani.

[Mufananidzo uri papeji 26]

Utachiona hunokura zvakanaka apo varwere vanoshandisa mirimo zvisina kufanira

[Mufananidzo uri papeji 27]

Kuisirwa ropa kunoparadzira utachiona hunouraya