Yanditswe na Amy Harris

Impamvu sishingiye ku muco, ubukungu n’imibereho y’abantu zigira uruhare cyane mu kugena ugerwaho n’indwara zandurira mu mibona mpuzabitsina, uhabwa serivisi zo kwipimisha no kuvurwa cyangwa se ugira amahirwe yo kwigishwa iby’imibonano mpuzabitsina itekanye.

Ingero z’izi ndwara twavuga nk’imitezi, mburugu, karamidiya, heripesi, virusi itera kanseri y’inkondo y’umura, hepatite B na C, ndetse na virusi itera SIDA. Umuntu ashobora kwandura izi ndwara ari uko akoze imibonano ikorewe mukanwa, mukibuno cyangwa mugitsina, kabone n’ubwo umuntu yaba uyikorana n’umuntu umwe. Kuba uwo mubikorana ari igitsina gabo, gore cyangwa se byombi ntacyo bihindura. Abantu mu bihe byose by’ubuzima bashobora kwandura izi ndwara, gusa kuba ufite abantu bake mukorana imibonano ni ko ugabanya ibyago byo kwandura izi ndwara.

Ntabwo indwara zose zandurira mu mibonano mpuzabitsina zigaragaza ibimenyetso bigaragarira amaso, akaba ari yo mpamvu abaganga baba bagomba guhora basuzuma abantu izi ndwara ku buryo buhoraho. Abarwayi babwiza ukuri abaganga babo ku bijyanye n’ubwoko w’imibonano bakora, ndetse n’umubare w’abantu bayikorana nibo bagira amahirwe yo gukorerwa ibipimo n’ubuvuzi bukwiye.

Abantu bakwiye kwipimisha indwara zandurira mu mibonano mpuzabitsina igihe cyose bafite umuntu mushya bayikorana cyangwa uwo bayikorana yatangiye kujya ayikorana n’undi. Kwipimisha bihoraho ndetse no kwivuza vuba birinda umuntu kugira ingaruka z’igihe kirekire, zikanongera ibyago byo kwandura virusi itera SIDA, kugira ububare bw’igihe kirekire bw’igice cy’umugongo cyo hasi, kugira ibibazo byo gusama, kugira ibibazo igihe utwite, kubyara umwana ufite ibibazo by’ubuzima ndetse no kubyara umwana upfuye.

Maine itanga ubuvuzi bwihuse kuri mugenzi wawe (EPT) ukabasha kuvuza vuba, neza kandi mu ibanga rikomeye mugenzi wawe, mu gihe hari umuntu basanganye imitezi cyangwa karamidiya. Muri EPT, muganga aha umurwayi imiti ashyira mugenzi we, atarinze aza kwa muganga ngo avurwe.  

Ikibabaje ni uko kuvuga umuntu yisanzuye kandi akavugisha ukuri ku birebana n’imibonano ndetse n’indwara zanduriramo bitoroha. Bikomerera benshi, bikarushaho gukomera iyo bari gukoresha umusemuzi cyangwa se badahuje imico. Kuri iyo mpamvu, gahunda yo kuboneza urubyaro ya Maine, imwe muri gahunda zagutse zitanga ubucuzi ku bagezweho n’izo ndwara muri Maine, bakorana n’ibigo bitandukanye nka In Her Presence na Greater Portland Health. Intego y’ubu bufatanye ni ugutanga inyigisho, gufasha abantu kugera kuri serivisi z’imyororokere n’ubuzima bigenda bikagera ku mpunzi n’abimukira muri Maine.  

Gahunda yo kuboneza urubyaro ya Maine ihabwa $160,000 atangwa na leta yo kwishyura abahuzabikorwa bazwi nka (CHOW), kubona ibikoresho byo gupima virusi itera SIDA, guhuza no kuganiriza abantu mu matsinda ndetse no guhugura abashinzwe ibi bikorwa. CHOW bigishwa uko ibyiciro by’abantu bavuga ku ndwara zandurira mu mibonano ndetse n’uko bakubaka ikizere bakabasha kurenga urukuta rwa za kirazira na ceceka byo mu mico, bakaganira kuri izi ndwara. Kumenyereza abantu gahunda yo kwipimisha no kwigishwa kuri izi ndwara n’ibimenyetso byazo ni kimwe mu bigize ubwo bukangurambaga.

Ikigaragara ni uko, uko ibintu bimeze muri Maine bidatandukanye n’uko bimeze ku rwego rw’igihugu ku birebana n’uko amoko atandukanye yitwara iyo bigeze mu kuvuga kuri izi ndwara. Ku matsinda menshi, imbogamizi zishingiye ku mico ndetse n’indimi hamwe n’ibibazo by’ubukungu bigira uruhare mu kuba abantu runaka batakwipimisha bihagije bityo bigatinza ubuvuzi. Ku rwego rw’igihugu, mu 2019, indwara zandurira mu mibonano mu birabura zari ku kigero cy’inshuro 5-8 ugereranyije na bagenzi babo b’abazungu; kikaba kuri 3-5 ku bazungu ugereranyije na bakavukire, abavuka muri Alaska na za Hawaii cyangwa abavuka ku birwa byo muri Pasifike; bikaba kandi kuri 1-2 kubavuga icyespanyoru ugereranyije n’abazungu.

Ishami rishinzwe kurwanya indwara zandurira mu mibonano ry’Urwego rushinzwe guhashya ibyorezo muri Maine (CDC) rizenguruka hirya no hino muri iyi leta rigenda ritanga umutungo wifashishwa mu gupima, kuvura no kwigisha ibirebana n’izi ndwara. Gahunda zo gupima kubuntu kandi mu ibanga zirahari ahantu hatandukanye, harimo ibigo by’ubuzima bishamikiye ku mashuri nk’ibyo muri Portland na Lewiston. Ikindi kandi gahunda ya CDC ikangurira abantu kwipimisha  ifite urutonde rw’ahantu wakwipimisha, gusa ntabwo aho bapima hose babikorera Ubuntu, ndetse ntabwo ari ko hose bapima virusi itera SIDA.  

  Kwigisha abana imibonano itekanye ni ikintu gikomeye gifasha mu kugabanya izi ndwara muri U.S. Abarenga icyakabiri cy’abandura izi ndwara bagaragara mu rubyiruko ruri hagati y’imyaka 15 na 24. Mu miryango myinshi y’abimukira ifite urubyiruko rukurira mu muco wa Amerika, biragora cyane kuganira ku bitsina n’indwara zandurira mu mibonano. Imwe mu miryango itinya ko kuvuga ku bitsina byashumurira abana muri iyo mico.

Murseal Nabi, Umuslamukazi wavukiye muri Amerika akabyarwa n’ababyeyi bakomoka muri Pakisitani no muri Afuganisitani, afitanye amaserano y’imikoranire y’umwaka umwe n’ikigo Greater Portland Health, mu mushinga wo gukusanya amakuru ku bikenerwa n’abimukira baturuka muri Afurika ndetse n’uburasirazuba bwo hagati ndetse na Asias yo hagati batuye muri Lewiston Auburn ndetse no mu gace k’umujyi ka Portland. Afite ubuhamya bwe bwite ku birebana n’akato kajyana no kuvuga ku bitsina. Urebye yahisemo uyu mwuka kuko abona ko ‘hari ihezwa rikabije. Nta muntu ukwiye gucirwa urubanza kuko ashaka kugira ubuzima buzira umuze, n’ubwo byaba biganisha ku gitsina… ndetse n’ubu, ku myaka 24 nanakora aka kazi, mama nanjye ntabwo dushobora kuganira ku bitsina’.

Fowsia Musse, umubyeyi w’umuslam ukomoka muri Somalia akaba nyina w’abana batanu bose bavukiye muri U.S, akanaba umuyobozi mukuru w’umuryango Maine Community Integration, avuga ko mu mashuri yo muri Lewiston-Auburn icyo yita ‘itsimbarara rishingiye ku bwoba’ ritera imiryango myinshi gukura abana babo mu nyigisho zitangwa na’amashuri zigisha ibijyanye n’ibitsina.

Niyo mpamvu, Musse, yigisha buri cyumweru abagore gusa amasomo agenewe abakomoka ku bimukira, ariko kandi bakanigisha n’ababyeyi babo. Mu masomo atanga, afasha abantu kuzamura ubumenyi, abagore ukwabo, akabigisha indwara zandurira mu mibonano mpuzabitsina, ubumenyi ku bitsina, uburinganire, ubuzima bwo mumutwe, ibyo gukeba abagore ndetse n’ingaruka cyangwa indwara zikomoka ku gukoresha ibiyobyabwenge. Nyuma, abagore n’abakobwa babo barahura bakagirana ikiganiro bisanzuye, kandi bakabona ibisubizo ku bibazo bishingiye ku mico baba bibaza. Abakomoka mihanda yose ku isi bitabiriye amahugurwa ye aheruka harimo n’impunzi zikomoka muri Afghanistan ziherutse gutuzwa.

Mareisa Weil, ni umuyobozi wungirije w’ikigo Maine Family Planning Community Development and Engagement. Kimwe n’abandi benshi bigisha ku birebana n’ibitsina muri iyi leta, yifuza ko ababyeyi bamenya ko amasomo ku birebana n’ibitsina atavuga gusa ku bitsina, ahubwo ko avuga ku bijyanye no kwemera, gushyiramo intera ndetse n’uburyo bwo kuganira bukenewe kugirango habeho umubano utekanye kandi urinzwe indwara. Abashinzwe kuganiriza abantu batirengagiza imico nka Nabi ni ab’ingenzi cyane mu kuganiriza ababyeyi bitewe n’uko bakoresha indimi nyinshi kandi bakaba bahuje amateka hamwe n’abakiriya babo. Bashobora kubafasha kurenga imbibi kandi bagatsinda ubwoba, kutagira amakuru, za kirazira cyangwa ibyizerwa bitari byo bivuzwe ku kuboneza urubyaro ndetse n’indwara mu muryango w’impunzi ndetse n’abimukira.

Umubare w’abandura indwara zandurira mu mibonano mpuzabitsinda ukomeje kuzamuka muri U.S. Imibare yashyizwe ahagaragara umwaka ushize yerekana ko 2019 yarushije umwaka wabanje mu kugira umubare munini w’abafite izo ndwara, ibi bikaba ari ko byagenze mu myaka 6 ishize. Igiteye impungenge byihariye ni izamuka cyane ry’umubare w’abafite imitezi ndetse n’abana bavukana imitezi, ibintu bishobora guteza ibibazo bikomeye ndetse n’urupfu.

Ubusanzwe, gupima izi ndwara ndetse no gushaka inzira zo kuziganira kumugaragaro no ku mibonano itekanye mu mico itandukanye birakenewe cyane kugirango umuryango wose wa Maine ube ufite ubuzima buzira umuze. Bitewe n’uko icyorezo cya COVID-19 cyakomye munkokora gahunda yo gupima izi ndwara no kuzivura, ubu ahantu henshi bari inyuma kurusha uko byari bimeze. Bitewe n’uko nyinshi muri izi ndwara zizwi cyane zitagira ibimenyetso, abantu bose bakora imibonano mpuzabitsina bakwiye gupimwa ku buryo buhoraho kugirango birinde kandi barinde bagenzi babo ahubwo bagire ubuzima bwiza.