Ukumpontshelwa igazi—Umlando Omude Wempikiswano

“Ukube amangqamuzana egazi abomvu abewumuthi omusha wokwelapha namuhla, bekuyoba nzima ukuthola imvume yokuwudayisa.”—UDkt. Jeffrey McCullough.

EBUSIKA bango-1667, uhlanya olunobudlova okuthiwa u-Antoine Mauroy lwalethwa kuJean-Baptiste Denis, udokotela odumile weNkosi uLouis XIV yaseFrance. UDenis “wayenekhambi” elifanele lokwelapha ubuhlanya bukaMauroy—ukumpompela igazi lenkonyane, ayecabanga ukuthi laliyokwenza isiguli sakhe sizole. Kodwa akuzange kumhambele kahle uMauroy. Yiqiniso, ngemva kokumpontshelwa kwesibili, isimo sakhe saba ngcono. Kodwa ngokushesha ngemva kwalokho, le ndoda engumFulentshi yaphinde yahlanya, futhi ngokushesha yafa.

Nakuba kamuva kwatholakala ukuthi uMauroy wayebulawe ubuthi be-arsenic, ukuzama kukaDenis ukusebenzisa igazi lezilwane kwabangela impikiswano eshubile eFrance. Ekugcineni, ngo-1670, le nqubo yavalwa ngokomthetho. Ngokuhamba kwesikhathi, iPhalamende laseNgilandi ngisho nopapa benza okufanayo. Ukumpontshelwa igazi kwanyamalala cishe iminyaka engu-150 eyalandela.

Izingozi Zokuqala

Ekhulwini le-19, ukumpontshelwa igazi kwabuya ngezinkani. Owavuselela lo mkhuba kwakungudokotela obelethisayo waseNgilandi uJames Blundell. Esebenzisa izinqubo zakhe ezithuthukisiwe namathuluzi aphambili—futhi ephikelela ngokuthi kusetshenziswe igazi labantu kuphela—uBlundell wenza ukuba ukumpontshelwa igazi kudume futhi.

Kodwa ngo-1873, uF. Gesellius, udokotela wasePoland, wachitha ukuvuselelwa komkhuba wokumpontshelwa ngokuveza iphuzu elisabisayo: Bangaphezu kwengxenye abantu ababempontshelwe igazi ababegcine befile. Lapho bezwa lokhu, odokotela abadumile baqala ukuyilahla le nqubo. Ukwanda kokumpontshelwa igazi kwaphinde kwashabalala.

Khona-ke, ngo-1878, udokotela waseFrance uGeorges Hayem, wathaka uketshezi lwe-saline, athi lwalungase lusetshenziswe esikhundleni segazi. Ngokungefani negazi, uketshezi lwe-saline lwalungenayo imiphumela eyingozi, lwalungajiyi futhi kwakulula ukuluthutha. Ngokuqondakalayo, uketshezi lukaHayem lwe-saline lwasetshenziswa kabanzi. Nokho, okumangalisayo ukuthi abantu bakhetha igazi futhi. Ngani?

Ngo-1900, isazi sezifo sase-Austria uKarl Landsteiner sathola ukuthi kunezinhlobo ezihlukene zegazi, futhi sathola ukuthi igazi alifani ngaso sonke isikhathi. Yingakho kwakufe abantu abaningi ababempontshelwe ngaphambili! Manje lokho kwakungashintshwa, ngokuqiniseka nje ukuthi uhlobo lwegazi lomuntu othekelisayo luyafana nelomuntu ozompontshelwa. Benalolu lwazi, odokotela baqala ukuthembela ekumpontshelweni futhi—okwakufike ngesikhathi ngaphambi kweMpi Yezwe I.

Ukumpontshelwa Igazi Nempi

Phakathi neMpi Yezwe I, amasosha alimele ayempontshelwa igazi ubuthaphuthaphu. Yiqiniso, igazi lijiya ngokushesha, futhi esikhathini esidlule cishe kwakungenakwenzeka ukulithuthela enkundleni yempi. Kodwa ekuqaleni kwekhulu lama-20, uDkt. Richard Lewisohn, waseMount Sinai Hospital eNew York City, waphumelela ekuhloleni isithako esenza igazi lingajiyi okuthiwa i-sodium citrate. Abanye odokotela babheka le mpumelelo ethakazelisayo njengesimangaliso. UDkt. Bertram M. Bernheim, owayengudokotela ovelele ngosuku lwakhe, wabhala: “Kwakunjengokungathi ilanga limile.”

NgeMpi Yezwe II isidingo segazi sakhula. Kwachonywa amabhodi emphakathini ayeneziqubulo ezithi “Thekelisa Ngegazi Manje,” “Igazi Lakho Lingamsindisa,” nesithi “Udelé Igazi Lakhe. Uyolidela Yini Elakho?” Isidingo segazi sabangela ukusabela okukhulu. Phakathi neMpi Yezwe II, kwathekeliswa ngamaphayinti angaba ngu-13 000 000 e-United States. Kulinganiselwa ukuthi eLondon kwathekeliswa futhi kwasakazwa amalitha angaphezu kuka-260 000. Yiqiniso, ukumpontshelwa igazi kwakunezingozi eziningi zempilo, njengoba ngokushesha kwaba sobala.

Izifo Ezisegazini

Ngemva kweMpi Yezwe II, intuthuko enkulu kwezokwelapha yavula amathuba okuhlinza okwakungenakwenziwa ngaphambili. Ngenxa yalokho, kwavela imboni engenisa izigidigidi zamaRandi ngonyaka eyayizonikela ngegazi lokumpontshelwa, odokotela abase beqala ukulibheka njengenqubo evamile ekuhlinzeni.

Nokho, ngokushesha kwavela ukukhathazeka ngezifo ezibangelwa ukumpontshelwa. Ngokwesibonelo, phakathi neMpi YaseKorea, amaphesenti abalelwa kwangu-22 alabo abampontshelwa i-plasma angenwa yisifo sokusha kwesibindi—isibalo esicishe sisiphinde kathathu esangeMpi Yezwe II. Ngawo-1970, i-U.S. Centers for Disease Control yalinganisela ukuthi abantu ababulawa isifo sokusha kwesibindi ngenxa yokumpontshelwa igazi babengu-3 500 ngonyaka. Abanye babethi leso sibalo sasiphindwe kayishumi kunalokho.

Ngenxa yenqubo engcono yokuhlola igazi nokukhethwa ngokucophelela kwabantu abathekelisa ngalo, abantu abanesifo sokusha kwesibindi sohlobo B bancipha. Kodwa-ke kwaqubuka igciwane elisha neliyingozi ngezinye izikhathi—isifo sokusha kwesibindi sohlobo C. AmaMelika abalelwa ezigidini ezine athola leli gciwane, amakhulu ezinkulungwane zawo ngenxa yokumpontshelwa igazi. Kuyiqiniso ukuthi ekugcineni ukuhlolisisa kwanciphisa ukusakazeka kwesifo sokusha kwesibindi sohlobo C. Noma kunjalo, abanye banovalo lokuthi kunezingozi ezintsha ezisazovela futhi ziyotholakala sekwephuzile.

Elinye Ihlazo: Igazi Elinegciwane I-HIV

Ngawo-1980, kwatholakala ukuthi igazi lingaba ne-HIV, igciwane elibangela ingculaza. Ekuqaleni, abagcini begazi babengafuni nokuyizwa eyokuthi igazi abaligcinile lingase libe negciwane. Ekuqaleni abaningi babo babengabaza ukuthi lukhona usongo lwe-HIV. NgokukaDkt. Bruce Evatt, “kwakunjengokungathi kwakufiké othile ovela ogwadule wayesethi, ‘Ngibone umuntu ohlala emkhathini.’ Balalela, kodwa babengakukholelwa.”

Nokho, emazweni amaningi kuye kwavela amahlazo embula ukuthi igazi linegciwane le-HIV. Kulinganiselwa ukuthi eFrance, abantu abaphakathi kuka-6 000 no-8 000 bathola i-HIV ngokumpontshelwa igazi phakathi kuka-1982 no-1985. Kuthiwa ukumpontshelwa igazi kuye kwabangela i-HIV kubantu abangamaphesenti ayishumi kulo lonke elase-Afrika kanye nengculaza kwabangamaphesenti angu-40 ePakistan. Namuhla, ngenxa yezinqubo ezithuthukile zokuhlola igazi, ukusakazeka kwe-HIV ngokumpontshelwa igazi kuyivelakancane emazweni athuthukile. Nokho, ukusakazeka kwayo kuseyinkinga emazweni asathuthuka angenazo lezi zinqubo zokuhlola igazi.

Kuyaqondakala ukuthi kungani eminyakeni yamuva nje kuye kwaba nesithakazelo esikhulayo ekwelapheni nasekuhlinzeni ngaphandle kwegazi. Kodwa ingabe iphephile leyo ndlela?

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Ukumpontshelwa Igazi—Akubekelwé Ndinganiso Kwezokwelapha

Unyaka ngamunye e-United States kuphela, iziguli ezingu-3 000 000 zimpontshelwa amaphayinti angaphezu kuka-11 000 000 amangqamuzana abomvu egazi. Ngenxa yaleso sibalo esiphakeme sokumpontshelwa, umuntu ubengacabanga ukuthi kunendinganiso ephakeme odokotela abayilandelayo uma kuziwa ekumpompeleni igazi. Nokho, i-New England Journal of Medicine iphawula ukuthi kunokwaziswa okuncane kakhulu “okulawula izinqumo eziphathelene nokumpontshelwa.” Yebo, kunezinqubo ezihlukene kakhulu, hhayi ngokuphathelene nokuthi yini ngempela empontshelwayo futhi kangakanani, kodwa futhi ngokuphathelene nokuthi kuyadingeka yini ukumpompela. Iphephabhuku lezokwelapha i-Acta Anæsthesiologica Belgica lithi: “Ukumpompela kuxhomeke kudokotela, hhayi esigulini.” Uma kucatshangelwa okungenhla, akumangalisi ukuthi ucwaningo olwanyatheliswa kuyi-New England Journal of Medicine lwaveza ukuthi “ukumpontshelwa okulinganiselwa kumaphesenti angu-66 kwenziwa ngokungafanele.”

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NgeMpi Yezwe II isidingo segazi sakhula

[Imithombo]

Imperial War Museum, London

U.S. National Archives photos