Ukuphindisela Kwamagciwane

EKHULWINI lama-20 kuye kwaba nentuthuko emangalisayo kuyisayensi yezokwelapha. Izinkulungwane zeminyaka, cishe abantu bebengenalusizo ekumelaneni nohlupho lwamagciwane abulalayo. Kodwa izinto zaqala ukushintsha phakathi nawo-1930 lapho ososayensi bethola i-sulfanilamide, ikhemikhali yokuqala eyayinqoba ama-bacterium ngaphandle kokulimaza isiguli.a

Eminyakeni eyalandela, ososayensi basungula imithi emisha enamandla yokulwa nezifo ezithathelwanayo—i-chloroquine yokulwa nomalaleveva nezibulala-magciwane zokuqeda i-pneumonia, ukuqubuka komzimba, nesifo sofuba. Ngo-1965 kwase kusungulwe imikhiqizo yezibulala-magciwane engaphezu kuka-25 000. Ososayensi abaningi baphetha ngokuthi izifo ezibangelwa ama-bacterium zazingaseyona inkathazo enkulu noma izinto zokucwaningwa. Kungani kwakufanele bahlole izifo ezazizophela ngokushesha?

Emazweni omhlaba athuthukile, imithi yokugoma emisha yakunciphisa ngokuphawulekayo ukuvama kwesimungumungwana, uzagiga, ne-German measles. Umkhankaso omkhulu wokugomela uvendle, owasungulwa ngo-1955, waphumelela kakhulu kangangokuthi inani labaphethwe yilesi sifo eNtshonalanga Yurophu naseNyakatho Melika lehla lisuka ku-76-000 ngalowo nyaka laya kwabangaphansi kuka-1000 ngo-1967. Ingxibongo, isifo esibulalayo esiphambili, saqedwa emhlabeni wonke.

Kuleli khulu kuye kwasungulwa nesibonakhulu, umshini onamandla kangangokuthi ososayensi babona amagciwane amancane kunozipho lomunwe ngokuphindwe izikhathi eziyizigidi. Izibonakhulu ezinjalo, kanye nezinye izinto zentuthuko yezobuchwepheshe, ziye zavula indlela yokuqonda nokulwa nezifo ezithathelwanayo kunanini ngaphambili.

Kwakubonakala Ukunqoba Kuqinisekile

Ngenxa yokutholakala kwalezi zinto, umkhakha wezokwelapha waqina idolo. Imithi yanamuhla yezokwelapha yayiwanqoba amagciwane ezifo ezithathelwanayo. Ngokuqinisekile ukunqoba kwesayensi amagciwane kwakuyoshesha, kube ujuqu! Uma lalingakatholakali ikhambi lesifo esithile, lalizotholakala ngokushesha.

Emuva ngo-1948, unobhala kahulumeni wase-United States uGeorge C. Marshall wathi ukunqotshwa kwazo zonke izifo ezithathelwanayo kwakuseduze. Eminyakeni emithathu kamuva, i-World Health Organization (WHO) yagomela ngokuthi umalaleveva wase-Asia ngokushesha wawuzoba isifo “esingelutho.” Phakathi nawo-1960, inkolelo yokuthi inkathi yobhadane nezifo eziwumshayabhuqe yayisidlulile yayisakazeke kangangokuthi udokotela omkhulu ohlinzayo wase-United States uWilliam H. Stewart watshela izikhulu zezempilo ukuthi kwase kuyisikhathi sokuyeka ukukhathazeka ngezifo ezithathelwanayo.

Ukubuya Kwezifo Ezindala

Nokho, kwakungesona neze isikhathi sokuyeka ukukhathazeka ngezifo ezithathelwanayo. Amagciwane awazange anyamalale kuleplanethi ngenxa nje yokuthi isayensi yayisungule izidakamizwa nemithi yokugoma. Kunokuba anqotshwe, amagciwane abulalayo aziwayo abuya ngezinkani! Ngaphezu kwalokho, kwavela amanye amagciwane abulalayo—amagciwane odokotela ababengawazi ngaphambili. Ngakho, amagciwane amadala namasha athe chithi sáka, asongela, ahluphe, noma abulale izigidigidi zabantu emhlabeni wonke.

Izifo ezibulalayo okwakucatshangwa ukuthi ziphelile sezibuyile, zibulala kakhulu kunanini ngaphambili futhi kunzima ukuzelapha ngemithi. Isibonelo salokhu isifo sofuba (TB). Muva nje i-WHO ithé: “Kusukela ngo-1944, imithi ye-TB iye yasetshenziswa kabanzi eJapane, eNyakatho Melika naseYurophu ukuze kuncishiswe ngokuphawulekayo abantu abane-TB nababulawa yiyo. Nokho, iye yashaywa indiva imizamo yokulawula i-TB emazweni asathuthuka, . . . okwenze lesi sifo sabuyela emazweni anothile siyingozi kakhulu futhi simelana nemithi eminingi.” Namuhla i-TB, ngokuvamile ebangelwa ama-bacterium asemoyeni angena emaphashini, ibulala abantu abangaba izigidi ezintathu minyaka yonke—abangaphezu kuka-7000 ngosuku. Ngonyaka ka-2005, inani labafayo lingenyukela ezigidini ezine ngonyaka.

Ezinye izifo ezazibulala ziyanda nazo. Ikholera isiwumqedazwe ezingxenyeni eziningi ze-Afrika, e-Asia, naseLatin America; ihlasela futhi ibulale amanani andayo abantu. Kuqubuke uhlobo olusha ngokuphelele e-Asia.

Udenga, olusakazwa umiyane i-Aëdes aegypti, nalo lwanda ngokushesha; manje lusongela abantu abayizigidi ezingu-2500 emazweni angaphezu kwayikhulu emhlabeni wonke. Kusukela ngawo-1950, uhlobo olusha olubulalayo lokopha lwalesi sifo luye lwaqubuka futhi lwasakazeka kuwo wonke amaZwe Ashisayo. Kulinganiselwa ukuthi lubulala abantu abangaba ngu-20 000 ngonyaka. Njengezifo eziningi ezibangelwa amagciwane, awukho umuthi wokugomela lesi sifo futhi awukho owokuselapha.

Umalaleveva, isayensi eyake yaba nethemba lokuwuqeda, usubulala abantu abangaba izigidi ezimbili ngonyaka. Kokubili amagciwane kamalaleveva nomiyane abawuthwalayo sekunzima kakhulu ukubabulala.

Izifo Ezintsha Eziqothulayo

Mhlawumbe isifo esaziwa kakhulu kwezintsha ezisanda kuqubuka ezihlupha isintu ingculaza ebulalayo. Lesi sifo esingelapheki sibangelwa igciwane elalingaziwa eminyakeni engaba ngu-12 edlule. Nokho, ekupheleni kuka-1994 inani labantu emhlabeni wonke elalingenwe yileli gciwane laliphakathi kwezigidi ezingu-13 nezingu-15.

Ezinye izifo ezithathelwanayo ezazingaziwa ngaphambili zihlanganisa i-hantavirus pulmonary syndrome. Njengoba sidluliselwa amagundane, saqubuka eningizimu-ntshonalanga ye-United States futhi sabulala ngaphezu kwengxenye yabantu okwabikwa ukuthi banaso. Kuye kwaqubuka izinhlobo ezimbili zezifo zokopha—ezintsha futhi ezibulalayo—eNingizimu Melika. Kuye kwaqubuka nezinye izifo ezisabekayo—amagciwane anamagama ayinqaba nangavamile—i-Lassa, i-Rift Valley, i-Oropouche, i-Rocio, i-Q. Guanarito, i-VEE, i-monkeypox, i-Chikungunya, i-Mokola, i-Duvenhage, i-LeDantec, i-Kyasanur Forest brain virus, i-Semliki Forest agent, i-Crimean-Congo, i-O’nyongnyong, i-Sindbis, i-Marburg, i-Ebola.

Kungani Kuqubuka Izifo Ezintsha?

Njengoba kunolwazi nezinzuzo ezingaka zesayensi yanamuhla yezokwelapha, kungani kubonakala kunzima kangaka ukunqoba amagciwane abulalayo? Esinye isizathu ukuhamba kakhulu komphakathi wanamuhla. Izinto zokuhamba zanamuhla ngokushesha zingasakaza umqedazwe wendawo embulungeni yonke. Ukuhamba ngezindiza kwenza kube lula ukusakazeka kwesifo esibulalayo, esikumuntu onegciwane, kusuka engxenyeni eyodwa yomhlaba kuya kunoma iyiphi enye ingxenye yomhlaba ngamahora ambalwa.

Isizathu sesibili, esikhuthaza ukusakazeka kwamagciwane, ukukhula okusheshayo kwenani labantu emhlabeni—ikakhulukazi emadolobheni. Yiqiniso, imfucumfucu ivela emadolobheni. Imfucumfucu iqukethe izitsha zepulasitiki namathayi agcwele amanzi emvula ahlanzekile. EmaZweni Ashisayo, lokho kubangela ukwanda komiyane abathwala izifo ezibulalayo njengomalaleveva, i-yellow fever, nodenga. Ngaphezu kwalokho, njengoba nje ihlathi eliminyene lingavuthela umlilo, nokuminyana kwabantu kuveza izimo ezinhle zokusakazeka okusheshayo kwesifo sofuba, imfuluwenza, nezinye izifo ezithwalwa umoya.

Isizathu sesithathu esibangela ukuqubuka kabusha kwamagciwane ukushintsha kokuziphatha kwabantu. Amagciwane athathelwana ngobulili aye anda futhi asakazeka ngenxa yokwanda okukhulu kokuba nobuhlobo bobulili nabantu abahlukahlukene, okuye kwaba isici esiphawulekayo kulengxenye yokugcina yekhulu lama-20. Ukusakazeka kwengculaza kungesinye nje isibonelo.b

Isizathu sesine esenza kube nzima ukunqoba amagciwane abulalayo siwukuthi umuntu uye wahlasela amahlathi amakhulu namahlathi emvula. Encwadini yakhe ethi The Hot Zone umlobi uRichard Preston uthi: “Ukuqubuka kwengculaza, i-Ebola, namanye amagciwane amaningi asemahlathini emvula kubonakala kuwumphumela ongokwemvelo wokonakalisa izindawo ezishisayo. Amagciwane aqubukayo avela ezingxenyeni zomhlaba ezinendawo ezungezile eyonakalisiwe. Amaningi avela emingceleni ecekelwe phansi yamahlathi emvula asezindaweni ezishisayo . . . Amahlathi emvula asezindaweni ezishisayo ayimithombo ejulile yokuphila kuleplanethi, aqukethe iningi lezitshalo nezilwane emhlabeni. Amahlathi emvula futhi ayimithombo emikhulu yamagciwane, njengoba zonke izinto eziphilayo zinamagciwane.”

Ngakho abantu baye bathintana nezinambuzane nezilwane ezinegazi elishisayo lapho amagciwane ehlala khona, ezalela khona, futhi afele khona ngaphandle kokubangela ingozi. Kodwa lapho igciwane “leqa” esilwaneni liya kumuntu, lingase libe ingozi.

Ukulinganiselwa Kwesayensi Yezokwelapha

Ezinye izizathu ezenza ukuba izifo ezithathelwanayo zibuye zihlobene nesayensi yezokwelapha ngokwayo. Ama-bacterium amaningi asemelana nezibulala-magciwane ezake zawabulala. Ngokuhlekisayo, izibulala-magciwane ngokwazo ziye zabangela lesi simo. Ngokwesibonelo, uma isibulala-magciwane sibulala amaphesenti angu-99 kuphela ama-bacterium ayingozi kumuntu ogulayo, iphesenti elilodwa eliye lamelana nesibulala-magciwane lingakhula futhi lande njengokhula olunamandla ensimini esanda kulinywa.

Iziguli zandisa lenkinga lapho zingayiqedi imithi yokwelashwa egunyazwe udokotela. Iziguli zingase ziyeke ukuphuza amaphilisi lapho sezizizwa zingcono. Nakuba kungenzeka ukuthi kuye kwafa amagciwane abuthakathaka, lawo anamandla ayasinda futhi akhule buthule. Emasontweni ambalwa, lesi sifo siyaqubuka futhi, kodwa kulokhu kunzima kakhulu, noma akunakwenzeka, ukuselapha ngemithi. Lapho lamagciwane amelana nemithi ehlasela abanye abantu, kuvela inkinga yezokwelapha engathi sína emphakathini.

Muva nje ochwepheshe be-WHO bathé: “Ukumelana [nezibulala-magciwane nezinye izinto zokuwanqanda] kuwubhadane emazweni amaningi futhi ukumelana nemithi eminingi kushiya odokotela cishe bengenandlela yokwelapha inani elandayo lezifo. Ezibhedlela kuphela, kunabantu abangaba isigidi emhlabeni wonke abangenwa izifo ezibangelwa amagciwane nsuku zonke, futhi eziningi zalezi azilapheki ngemithi.”

Ukumpompela igazi, okuye kwasetshenziswa kakhulu kusukela ngempi yezwe yesibili, nakho kuye kwasakaza izifo ezithathelwanayo. Naphezu kwemizamo yesayensi yokugcina igazi lingenawo amagciwane abulalayo, ukumpompela igazi kuye kwanezela ngokuphawulekayo ekusakazekeni kwesifo sokusha kwesibindi, i-cytomegalovirus, ama-bacterium amelana nezibulala-magciwane, umalaleveva, i-yellow fever, i-Chagas’ disease, ingculaza, nezinye izifo eziningi ezisabekayo.

Isimo Sezinto Namuhla

Nakuba isayensi yezokwelapha iye yabona ukwanda okukhulu kolwazi phakathi naleli khulu leminyaka, kusenezimfihlakalo eziningi. UC. J. Peters ucwaninga ngamagciwane ayingozi e-Centers for Disease Control, isikhungo sokucwaninga sezempilo yomphakathi esiphambili eMelika. Lapho kuxoxwa naye ngo-May 1995, wathi ngokuphathelene ne-Ebola: “Asazi ukuthi kungani ibawohloza kangaka abantu, futhi asazi ukuthi yenzani, [noma] ukuthi ikuphi, lapho ingawubangeli lomqedazwe. Asiyitholi. Alukho olunye uhlobo lwamagciwane . . . esingenalwazi kangaka ngalo.”

Ngisho nalapho kukhona ulwazi lwezokwelapha oluphumelelayo, izidakamizwa, nemithi yokugoma ukuze kulwiwe nezifo, kudingeka imali ukuze kunikezwe labo abakudingayo. Izigidi ziphila ngobumpofu. I-World Health Report 1995 ye-WHO ithi: “Ubumpofu buyisizathu esiyinhloko sokuthi kungani izinsana zingagonyiwe, kungani amanzi ahlanzekile nokukhucululwa kwendle kungekho, kungani imithi yokwelapha nokunye ukwelapha kungatholakali . . . Minyaka yonke emazweni asathuthuka kufa abantwana abayizigidi ezingu-12,2 abaneminyaka engaphansi kwemihlanu, iningi ngenxa yezimbangela ebezingavinjelwa ngamasenti ambalwa nje ase-United States umntwana ngamunye. Ngokuyinhloko bafa ngenxa yokunganaki komhlaba, kodwa ngaphezu kwalokho bafa ngenxa yokuthi bampofu.”

Ngo-1995, izifo ezithathelwanayo namagciwane zazingababulali abakhulu emhlabeni, zibulala abantu abayizigidi ezingu-16,4 ngonyaka. Ngokudabukisayo, izigidi zabantu ezingenakubalwa ziphila ezimweni ezilungele ukuqubuka nokusakazeka kwamagciwane abulalayo. Cabangela lesi simo esidabukisayo namuhla. Abantu abangaphezu kwezigidi eziyinkulungwane baphila ngobubha. Ingxenye yabantu emhlabeni ayikutholi njalo ukwelashwa nemithi edingekile. Emigwaqweni yamadolobha amakhulu angcolile kunezigidi zabantwana abalahliwe, iningi labo elidla izidakamizwa futhi lifebe. Izigidi zababaleki ziphila emakamu angahlanzekile anekholera, isifo sohudo, nezinye izifo.

Kulempi phakathi komuntu namagciwane, izimo ziye zavuna amagciwane.

[Imibhalo yaphansi]

[Amazwi acashunwe esihlokweni ekhasini 6]

“Ezibhedlela kuphela, kunabantu abangaba isigidi emhlabeni wonke abangenwa izifo ezibangelwa amagciwane nsuku zonke, futhi eziningi zalezi azilapheki ngemithi.” I-World Health Organization

[Ibhokisi ekhasini 7]

Lapho Amagciwane Ephindisela

Igciwane elincane elaziwa ngokuthi i-bacterium “linesisindo esiyigremu elingu-0,00000000001. Umkhomo oluhlaza unesisindo esingaba amagremu angu-100 000 000. Kodwa i-bacterium ingawubulala umkhomo.”—UBernard Dixon, ngo-1994.

Phakathi kwama-bacterium asatshwa kakhulu atholakala ezibhedlela kunezinhlobo ezimelana nemithi ze-Staphylococcus aureus. Lezi zinhlobo zihlasela abagulayo nababuthakathaka, zibangele izifo ezibulalayo zegazi, i-pneumonia, nokucindezeleka kwesimiso sokuzivikela. Ngokokunye ukulinganisa, i-staph ibulala abantu abangaba ngu-60 000 e-United States unyaka ngamunye—abangaphezu kwalabo abafa ezingozini zezimoto. Kuleminyaka edlule, lezi zinhlobo zama-bacterium ziye zamelana nezibulala-magciwane kangangokuthi ngo-1988 kwakunesibulala-magciwane esisodwa kuphela esimelana nazo, isidakamizwa i-vancomycin. Nokho, ngokushesha kwezwakala imibiko evela emhlabeni wonke yezinhlobo ezimelana ne-vancomycin.

Nakuba-ke izibulala-magciwane ziwenza umsebenzi okulindeleke ukuba ziwenze, kungase kuphakame ezinye izinkinga. Maphakathi no-1993, uJoan Ray waya esibhedlela esithile e-United States ukuze ayohlinzwa. Wayelindele ukubuyela ekhaya ngemva nje kwezinsuku ezimbalwa. Kunalokho, kwadingeka ukuba alale esibhedlela izinsuku ezingu-322, ngokuyinhloko ngenxa yokugula ngemva kokuhlinzwa. Odokotela balwa nalokhu kugula besebenzisa inkindlane yezibulala-magciwane, kuhlanganise ne-vancomycin, kodwa amagciwane amelana nazo. UJoan uthi: “Izandla zami zazingasebenzi. Izinyawo zami zazingasebenzi. . . . Ngangingakwazi ngisho nokuthatha incwadi ngifunde.”

Kwakunzima ukuba odokotela bathole ukuthi kungani uJoan ayesagula ngemva kokwelashwa ngezibulala-magciwane izinyanga eziningi. Ukucwaninga kwabonisa ukuthi ngaphezu kokungenwa i-staph, uJoan wayenolunye uhlobo lwama-bacterium emzimbeni wakhe—ama-enterococcus amelana ne-vancomycin. Njengoba igama libonisa, i-vancomycin ayizange iwenze lutho lama-bacterium; futhi kwabonakala emelana nazo zonke ezinye izibulala-magciwane.

Khona-ke odokotela bafunda okuthile okwabamangalisa. Lama-bacterium awazange nje amelane nezidakamizwa okwakufanele ziwabulale kodwa, ngokuphambene nalokho ababekulindele, empeleni ayesebenzisa i-vancomycin ukuze aphile! Udokotela kaJoan, uchwepheshe wezifo ezithathelwanayo, wathi: “[Lama-bacterium] adinga i-vancomycin ukuze ande, futhi uma engayitholi ngeke akhule. Ngakho, ngandlela-thile, asebenzisa i-vancomycin njengokudla.”

Lapho odokotela beyeka ukunikeza uJoan i-vancomycin, lama-bacterium afa, futhi uJoan waba ngcono.

[Isithombe ekhasini 8]

Amagciwane ayachuma lapho iziguli zingazisebenzisi ngendlela efanele izibulala-magciwane

[Isithombe ekhasini 9]

Ukumpompela igazi kusakaza amagciwane abulalayo