Izinhlelo Nezifo Eziwumshayabhuqe: Impumelelo Yokukhumbula Nokukhuthaza

Ingane egulayo ithola ukufakelwa isibindi okunqoba izithiyo eziningi ngezikhathi ze-covid ezivelayo

Ungasifaka ngokushesha kangakanani ngemuva kokudlulisa isibindi? Ngakho-ke, kwavela umbuzo ovela kudokotela we-hepatologist owelaphayo wengane N waseMalaysia. Phakathi namahora angu-24 esimweni esiphuthumayo, mhlawumbe isikhathi eside ezigulini zamazwe ngamazwe kuye ngamaphepha nezimvume ezivela ehhovisi lenxusa, kwaba isiqinisekiso sethu esisheshayo.

U-Baby N ubenejaundice kusukela esikhathini sakhe sokuzalwa esanda kuzalwa futhi lapho kungaxazululeki emasontweni ambalwa alandelayo, ukuhlolwa okuningiliziwe kwaholela ekuxilongweni kwe-biliary atresia. Wayenefomu elinzima kakhulu le-syndromic ene-dextrocardia, i-heterotaxy enesibindi esimaphakathi, ukonakala kanye ne-polysplenia. I-Kasai portoenterostomy yenziwa ngosuku lwama-55 lokuphila kanye nokuhlinzwa kokulungisa ukonakala. Naphezu kwenqubo ye-Kasai efika ngesikhathi ehlanganisa i-hepaticojejunostomy ngenhloso yokusungula ukuphuma kwe-biliary, isifo sakhe saqhubeka nokuthuthuka ngokushesha futhi wayesesehlile isifo sesibindi ngesikhathi esenezinyanga eziyisi-6 futhi waba nesiqephu sokuphuma kwegazi eliphezulu ngenxa ye-portal ethuthukisiwe. nomfutho wegazi ophezulu. Wayedinga a ukufakelwa kwesibindi, okuwukuphela kwendlela yokwelapha eqinisekile yokwelapha isimo sakhe osekuyinkomba ehamba phambili yokufakelwa isibindi sezingane ezingxenyeni eziningi zomhlaba.

Sathunyelelwa imininingwane yomtholampilo kanye nomnikeli ohlonziwe, ekupheleni kukaFebhuwari wonke amalungiselelo okuya kithi bese enziwe umndeni. Amathikithi abhukhiwe futhi alungele ukundiza kodwa umzila ka-baby N wawukwehlukile. Wakhula kanzima inyumoniya kanye ne-encephalopathy emfaka endaweni yokunakekelwa okukhulu. USir Henri Bismuth, omunye wabasunguli bokufakelwa kwesibindi washo ngokudabukisayo nangokunembile ukuthi “Inkinga embi kakhulu yokufakelwa kwesibindi ukufa ngaphandle kokuthola ukufakelwa isibindi”. Yonke impilo ifanelwe yithuba izingane ezingenakubalwa ezishona ezimeni ezifanayo ezingalitholi. Njengokungathi uyenqaba indiza eya eZulwini, u-baby N waba ngcono futhi lapho esezinzile wafakwa endizeni eya e-India kuphela ngemva kokuba umbandela wangaphambili wokufakelwa okuphuthumayo wamukelwe ithimba elamukelayo.

Ubhubhane lwe-covid lwaluqubuke futhi lwanda umhlaba wonke lapho umntwana uN efika eNdiya ngesonto lesibili likaMashi. Imikhawulo yokuhamba ibingakasebenzi kodwa izidingo zokuvalelwa bodwa kubantu abakhethiwe beziyimpoqo. IMalaysia yayingekho phakathi kwabo. Ukuntwela kokusa ngemva kobusuku abafika kuzo bekuwukuphonsa wonke amasu ngeseluleko esivela kuHulumeni waseNdiya sokuvalela yedwa amasonto ama-2 bonke abahambi abavela eMalaysia, njengoba kubikwe amacala ambalwa e-coronavirus ezweni.    

Umndeni wawukhungathekile, iqembu lezokwelapha lisenkingeni enkulu. U-Baby N wayezinzile okwamanje kodwa angawohloka noma nini uma kubhekwa isigaba sakhe sokuphela ukwehluleka kwesibindi. Ukwenqaba ukuhlinzwa okusindisa ukuphila ngenxa yokwesaba ukutheleleka okungenzeka ukuthi akakaze akuthwale kwasekuqaleni, kwakuwukuziphatha kangakanani lokho? Noma kunjalo, angaba sesikhathini sokufukamela futhi yimuphi umphumela ongalindeleka uma ethola ukufakelwa bese ebonakalisa isifo se-covid? Kungenzeka kanjani ukuthi umnikezeli wakhe, unina, intokazi enhle enempilo, ahlinzwe okwakungambeka engozini enkulu uma enegciwane? Izisebenzi zezokwelapha zingachayeka kanjani engozini? Ukuhlolwa kwe-Covid bekungaphansi komthetho kahulumeni futhi bekungakatholakali ezibhedlela ezizimele. Inikezwe kuphela abantu abanezimpawu ezibhedlela zikahulumeni ezikhethiwe njengoba izinsiza zokuhlola bezilinganiselwe. Isicelo sokuhlolwa kwe-covid yengane engu-N nabazali bayo sinqatshelwe yiziphathimandla ezidingekayo njengoba ukuhlinzwa okuningi bekumisiwe. Futhi, ukuhlolwa okungalungile bekungeke kusale ukuvalelwa okugunyaziwe. Lesi sifo sasisisha kakhulu eNdiya, kuncane kakhulu okwakwaziwa ngegciwane futhi nokwelashwa kwakusacwaningwa. Uvalo lwaluphezulu, umugqa omncane phakathi kokuba nesibindi nokuba budedengu wawungacacile. Ukufakelwa kuzomele kulinde. Ngabe umntwana u-N angaba ngumuntu oshonile ngenxa ye-covid noma ngabe ukusiphi isimo se-covid? 

Isikhathi esithengiwe sasetshenziswa njengethuba lokwakha isimo sakhe somsoco futhi wasondela ekuphileni kwakhe okusha njengoba eqhubeka ezinzile futhi ekhuluphala usuku ngalunye oludlulayo naphezu kwamazinga akhe aphezulu e-bilirubin acishe abe ngu-45 mg/dl. Njengoba esondela ekupheleni kwamaviki ama-2, ukuhlolwa kwe-covid nakho kwatholakala kithi futhi bobabili umama nendodakazi batholakala bengenayo. Ukufakelwa kwakhe ekugcineni kwakuhlelelwe ukuthi kwenzeke, noma akunjalo?

 Ngemva kwezinsuku eziyi-14 efikile, umphumela wamazinga e-bilirubin aphezulu ngokuyingozi endaweni eyi-SA yenhliziyo eyi-dextrocardiac wamholela ekuthuthukiseni i-heart block. Njengoba izinga lokushaya kwenhliziyo liphakathi kuka-40-45/ngomzuzu, wayesekunakekelweni okujulile ngemithi yokwelapha esungulwe ukuvimba inhliziyo. Imithamo inyuswe futhi yabhalwa ngaphandle kwempendulo. Ingabe i-plasmapheresis yokunciphisa i-bilirubin ingasiza? Ngezingozi zayo zomsizi kulesi simo, inketho ayizange ikhethwe. Uzodinga i-pacemaker. Ukuhamba kwesikhashana kwaqalwa ngaphambi kokuba ayiswe ukuyohlinzwa okufakelwa kabusha uma kubhekwa isimo sakhe somzimba esingavamile. Mhlawumbe njengemvume yazo zonke izivivinyo nezinsizi zakhe, ukuhlinzwa kokufakelwa kwafezwa ngaphandle kwezinkinga ezinkulu zokuhlinza kanye nangemuva kokuhlinzwa. Empeleni ukufa kwakukhethe ukuzihlukanisa nengane engu-N futhi imvumele ukuba aqhakaze abe intombazanyana ekhazimulayo, isimangaliso sokuqina komuntu, imithi yesimanje nomusa waphezulu.