Ukuthi yini i-Autoimmune Hepatitis? Izimpawu, Izimbangela, & Ukwelashwa

Iyini i-Autoimmune Hepatitis?

I-Autoimmune hepatitis yisimo lapho i-immune system yakho ihlasela ngephutha amangqamuzana e-liver yakho, okubangela ukuvuvukala okuqhubekayo. Cabanga ngakho njengoba i-system yokuzikhusela yomzimba wakho idideka futhi ihlose inyama yomzimba ephilile ye-liver esikhundleni sezinto eziyingozi.

Lesi simo esingamahlalakhona sithinta abantu bazo zonke izigaba zobulili, kodwa sivame kakhulu kubantu besifazane kunabesilisa. Ukuvuvukala kuvela kancane kancane ezinyangeni noma eminyakeni eminingi, okusho ukuthi ungase ungaziboni izimpawu ngokushesha. I-liver yakho isebenza kanzima ukuhlunga izinto eziyingozi futhi ikhiqize amaprotheni abalulekile, ngakho uma ukuvuvukala kuphazamisa lezi zinqubo, kungathinta impilo yakho yonke.

Izindaba ezinhle ukuthi i-autoimmune hepatitis iphendula kahle ekwelapheni emacala amaningi. Ngokunakekelwa okufanele kwezokwelapha, abantu abaningi baphila impilo evamile, enempilo ngenkathi baphatha lesi simo. Ukutholakala kwangaphambi kwesikhathi nokuphathwa kungavimbela izinkinga ezingathi sína futhi kusize ukuvikela umsebenzi we-liver yakho isikhathi eside.

Ziyini izimpawu ze-Autoimmune Hepatitis?

Abantu abaningi abane-autoimmune hepatitis baba nomoya omubi njengesimpawu sabo sokuqala nesiphikelelayo. Ungase uzizwe ukhathele ngokungavamile ngisho noma uthole ukuphumula okwanele, futhi lo mgudu ungaphazamisa imisebenzi yakho yansuku zonke.

Izimpawu zingase zihluke kakhulu kumuntu nomuntu, futhi abanye abantu bangase bangabi nazimpawu nhlobo ezigabeni zokuqala. Nazi izibonakaliso umzimba wakho ongazibonisa uma ubhekene nokuvuvukala kwe-liver:

• Umoya omubi nobuthakathaka obuqhubekayo obungaphuli ngokuphumula
• Ubuhlungu noma ubuhlungu besisu, ikakhulukazi endaweni ephezulu ngakwesokudla
• Ukwehluleka kokudla nokwehla kobunzima obungahlosiwe
• Ukuphefumula nokuhlanza okungahle kube khona
• Ukubomvu kwesikhumba namehlo (jaundice)
• Umyisa omnyama
• Izisu ezimhlophe noma ezimhlophe njengomhlabathi
• Ubuhlungu bezingqondo nobuhlungu bemisipha
• Ukukhishwa kwesikhumba noma ukukhazimula

Ezinye izikhathi, abantu bangase babe nezimpawu ezingathi sína ezidinga ukunakekelwa ngokushesha. Lezi zingase zibe ukudinwa, ukuvuvukala okukhulu kwesisu, noma ukwanda ngokushesha kwe-jaundice. Khumbula ukuthi izimpawu zingase ziye ziye, futhi ukuba nezimpawu ezilula akusho ukuthi isimo sakho asinandaba.

Ziyini izinhlobo ze-Autoimmune Hepatitis?

Odokotela bahlukanisa i-autoimmune hepatitis zibe izinhlobo ezimbili eziyinhloko ngokusekelwe kuma-antibodies athile atholakala egazini lakho. Uhlobo 1 yiyona ndlela evamile, emelela cishe u-80% wazo zonke izimo.

Uhlobo 1 lwe-autoimmune hepatitis ngokuvamile luthinta abantu abadala futhi lungase lube khona kunoma iyiphi iminyaka. Luphawulwa ukuba khona kwama-antinuclear antibodies (ANA) noma ama-smooth muscle antibodies (SMA) egazini lakho. Lolu hlobo ngokuvamile luphendula kahle ekwelapheni okuvamile futhi ngezinye izikhathi lungase liye ekuphumuleni ngokunakekelwa okufanele.

Uhlobo 2 lwe-autoimmune hepatitis aluvamile futhi ngokuvamile luthinta izingane nabantu abadala abasebancane. Luqondaniswa nama-liver-kidney microsomal antibodies (LKM-1) egazini. Lolu hlobo luthambekele ekubeni luqine kakhulu futhi lungase luqhubeke ngokushesha kunohlobo 1, kodwa lusaphendula ekwelapheni uma kubanjwa ngokushesha.

Womabili ama-type angabangela izimpawu ezifanayo nokulimala kwe-liver, ngakho-ke ukwahlukaniswa kusiza ikakhulukazi udokotela wakho ukukhetha indlela yokwelapha ephumelela kakhulu. Uhlobo olukhona akusho ukuthi isimo sakho sizoba sibi kangakanani noma ukuthi uzophendula kangcono kanjani ekwelapheni.

Yini ebangela i-Autoimmune Hepatitis?

Imbangela eqondile ye-autoimmune hepatitis isalungile, kodwa abacwaningi bakholelwa ukuthi ivela lapho i-immune system yakho ihluleka ngenxa yokuxubana kwezinto eziningi. Ukwakheka kwakho kwe-genetic kudlala indima ekuwenzeni ube sengozini yalesi simo.

Izinto eziningi zingase zisebenze ndawonye ukuqalisa i-autoimmune hepatitis kubantu abanesizungu se-genetic:

• Ukutheleleka kwama-viral njenge-hepatitis A, B, noma C okungase kudida i-immune system yakho
• Imithi ethile ehlanganisa amanye ama-antibiotics nama-pain relievers
• Izinto eziyingozi zemvelo noma amakhemikhali angase aqalise izimpendulo ze-immune
• Ezinye izimo ze-autoimmune ezithinta indlela i-immune system yakho esebenza ngayo
• Ukushintsha kwamahomoni, okungachaza ukuthi kungani abesifazane bethinteka kakhulu

Ezimweni ezingavamile, i-autoimmune hepatitis ingase ivela kanye nezinye izimo ze-autoimmune njenge-rheumatoid arthritis, isifo se-thyroid, noma isifo se-inflammatory bowel. Lokhu kusikisela ukuthi abanye abantu bane-immune systems ezithambekele ekuhlaseleni inyama yomzimba ephilile kulo lonke umzimba.

Kubalulekile ukuqonda ukuthi i-autoimmune hepatitis ayithatheki futhi ayikwazi ukudluliselwa kumuntu nomuntu. Awukwazi futhi ukuyivikela ngokushintsha indlela yokuphila kuphela, nakuba ukugcina impilo enhle yonke kungasiza ekuphatheni isimo uma sesitholiwe.

Nini okufanele ubheke udokotela nge-Autoimmune Hepatitis?

Kufanele uxhumane nodokotela wakho uma uhlushwa umoya omubi oqhubekayo ongaphuli ngokuphumula, ikakhulukazi uma uhlanganiswe nezinye izimpawu. Ukukhathalela kwezokwelapha kwangaphambi kwesikhathi kungenza umehluko omkhulu ekuphatheni lesi simo ngokuphumelelayo.

Hlela i-appointment nodokotela wakho uma uqaphela ukubomvu kwesikhumba noma amehlo, njengoba lokhu kubonisa ukuthi i-liver yakho idinga ukuhlolwa ngokushesha. Umyisa omnyama noma izisu ezimhlophe nazo ziyimpawu ebalulekile ezidinga ukunakekelwa kwezokwelapha, ngisho noma uzizwa kahle.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlushwa izimpawu ezingathi sína njengobuningi obukhulu besisu, ukuhlanza okuqhubekayo, ukudinwa, noma ukuvuvukala ngokushesha ezinyaweni noma esiswini. Lezi zibonakaliso zingase zibonise izinkinga ezingathi sína ezidinga ukwelashwa okusheshayo.

Ungalindi uma unemlando womndeni wezifo ze-autoimmune futhi uthola noma iyiphi i-symptom ehlobene ne-liver. Ngisho nezimpawu ezilula zifanele ukunakekelwa ngoba i-autoimmune hepatitis ingase iqhubeke ngokuthula, futhi ukwelashwa kwangaphambi kwesikhathi kuvimbela izinkinga ezingathi sína ngokuhamba kwesikhathi.

Ziyini izinto ezingozi ze-Autoimmune Hepatitis?

Ukuba owesifazane kukwandisa kakhulu ingozi yakho yokuthuthukisa i-autoimmune hepatitis, njengoba abesifazane banethuba elingaphezu kwesine lokukhula lesi simo kunabesilisa. Umehluko wesondo usikisela ukuthi ama-hormones angase adlale indima ekuqaliseni ukusebenza okungalungile kwe-immune system.

Izinto eziningi zingakwenza ube sengozini yokuqala i-autoimmune hepatitis:

• Umlando womndeni wezifo ze-autoimmune njenge-lupus, i-rheumatoid arthritis, noma izifo ze-thyroid
• Ukutheleleka kwe-viral hepatitis okungase kube yikho okwenze i-immune system yakho ibe novalo
• Ukuthatha imithi ethile, ikakhulukazi amanye ama-antibiotics noma ama-anti-seizure drugs
• Ukuba nezinye izimo ze-autoimmune ezivele zikhona emzimbeni wakho
• Izici zobulili - Uhlobo 1 ngokuvamile luthinta abantu abaneminyaka engama-15-40
• Ukushintshashintsha kwe-genetic okwenza i-immune system yakho ibe nomphumela omkhulu

Ezimweni ezingavamile, ukubonisana nezinto eziyingozi zemvelo noma amakhemikhali kungase kukwandisa ingozi yakho, nakuba lo xhumano aluqondakali ngokuphelele. Abanye abantu bathuthukisa i-autoimmune hepatitis ngemuva kokubhekana nokucindezeleka okukhulu komzimba noma okwengqondo, kodwa abacwaningi basafunda lo mqalisi ongaqondakali.

Ukuba nezinto ezingozi akusho ukuthi uzokuthuthukisa ngokuqinisekile i-autoimmune hepatitis, futhi abantu abaningi abanazo izinto eziningi ezingozi abazithuthukisi lesi simo. Ukuqonda ingozi yakho kukusiza uhlale ulungile ezimpawini futhi ufunani ukunakekelwa kwezokwelapha ngokushesha uma kudingeka.

Ziyini izinkinga ezingase zenzeke nge-Autoimmune Hepatitis?

Ngaphandle kokwelashwa okufanele, i-autoimmune hepatitis ingabangela ukubola kwenyama yomzimba ye-liver, okuyaziwa ngokuthi i-cirrhosis. Lokhu kubola kuphazamisa ikhono le-liver yakho lokusebenza kahle futhi kungase kuqhubeke kancane kancane eminyakeni eminingi.

Ukuvuvukala okuqhubekayo kungabangela izinkinga eziningana ezingathi sína ezithinta impilo yakho yonke kanye nekhwalithi yokuphila:

• I-Liver cirrhosis, lapho inyama yomzimba ephilile ithathelwa indawo yinyama yomzimba ebolile
• I-Portal hypertension, ebangela ukwanda kokucindezela emithanjeni yegazi ye-liver
• I-Spleen enkulu engase ithinte inani lamaseli egazi akho
• Ukuqoqwa kwezinto ezingamafutha esiswini sakho (ascites)
• Ukuvuvukala ezinyaweni nasezinyaweni zakho ngenxa yokugcinwa kwamafutha
• Ukungena engozini enkulu yomdlavuza we-liver emacaleni athuthukile
• Ukuphuma kwegazi emithanjeni yegazi enkulu esifundeni sakho

Ezimweni ezingavamile, i-autoimmune hepatitis ingase iqhubekele ekwehlulekeni kwe-liver okuqine kakhulu, okuyisimo esiphuthumayo sezokwelapha esidinga ukwelashwa okusheshayo. Le nkinga inamathuba amaningi uma isimo singatholakali isikhathi eside noma uma ukwelashwa kungalandelwa kahle.

Izindaba ezimnandi ukuthi ngokuxilongwa kwangaphambi kwesikhathi nokuphathwa okufanele, izinkinga eziningi zingavikeleka noma zilimele kakhulu. Ukulandelela njalo neqembu lakho lokunakekelwa kwezempilo kusiza ukuthola noma yikuphi ukushintsha kwangaphambi kwesikhathi futhi kulungise ukwelashwa njengoba kudingeka.

I-Autoimmune Hepatitis ixilongwa kanjani?

Ukuxilonga i-autoimmune hepatitis kudinga ukuhlolwa okuningi ngoba akukho ukuhlolwa olulodwa oluqinisekisa isimo. Udokotela wakho uzoqala ngokuhlunga igazi ukuhlola umsebenzi we-liver yakho futhi afune ama-antibodies athile abonisa umsebenzi we-immune system.

Inqubo yokuxilonga ngokuvamile ihlanganisa ukuhlola ama-enzymes e-liver yakho, aqandana uma i-liver yakho ivuvukile. Udokotela wakho uzobuye ahlole ama-autoantibodies athile afana ne-ANA, i-SMA, noma i-LKM-1 esiza ekuqondeni uhlobo lwe-autoimmune hepatitis onayo.

I-Liver biopsy ivame ukudingeka ukuqinisekisa ukuxilongwa nokulinganisa ubukhulu bokulimala kwe-liver. Ngalesi senzo, isampula encane yenyama yomzimba ye-liver isuswa futhi ihlolwe ngaphansi komkhiqizo. Nakuba lokhu kungase kuzwakale kukhathaza, ngokuvamile kwenziwa njengesenzo sokuphuma ngaphandle kokukhathazeka okuncane.

Udokotela wakho uzobuye akhiphe ezinye izimbangela zesifo se-liver njenge-viral hepatitis, ukulimala okuhlobene notshwala, noma imiphumela yemithi. Le nqubo iqinisekisa ukuthi uthola ukwelashwa okufanele kakhulu isimo sakho esithile. Ngezinye izikhathi ukuhlolwa kwezithombe ezengeziwe njenge-ultrasound noma i-CT scans kusiza ekuhlaleni ubukhulu nokwakheka kwe-liver yakho.

Ukuphathwa kwe-Autoimmune Hepatitis yini?

Ukuphathwa okuyinhloko kwe-autoimmune hepatitis kuhlanganisa imithi ecindezela i-immune system yakho esebenza kakhulu. Ama-corticosteroids afana ne-prednisone ngokuvamile iyona ndlela yokuqala yokwelapha futhi anganciphisa ukuvuvukala kwe-liver kubantu abaningi.

Uhlelo lwakho lokwelapha luzohlanganisa enye noma ngaphezulu yalezi zindlela:

• Ama-corticosteroids (prednisone) ukunciphisa ukuvuvukala ngokushesha
• Imithi yokucindezela i-immune njenge-azathioprine yokuphathwa isikhathi eside
• Ukuphathwa okuhlanganisiwe kokusebenzisa womabili ama-type wemithi ndawonye
• Ama-immunosuppressives ahlukile uma ukwelashwa okuvamile kungasebenzi
• Ukulandelela njalo ukulungisa imithi njengoba kudingeka

Abantu abaningi baqala ukubona ukuthuthuka ezimpawini zabo nasekuhlolweni kwegazi ezinyangeni ezimbalwa ngemuva kokuqala ukwelashwa. Noma kunjalo, ukufinyelela ekuphumuleni okuphelele kungathatha izinyanga eziningi kuya eminyakeni embalwa yokusebenzisa imithi ngokuqhubekayo.

Ezimweni ezingavamile lapho i-liver ilimele kakhulu, ukutshalwa kwe-liver kungase kudingeke. Lokhu ngokuvamile kubhekwa kuphela lapho ezinye izindlela zingaphumelelanga futhi umsebenzi we-liver ulimazeke kakhulu. Izindaba ezinhle ukuthi i-autoimmune hepatitis ayibuyi ngokuvamile ema-livers atshalwe.

Udokotela wakho uzosebenza eduze nawe ukuthola ibhalansi efanele yemithi elawula isimo sakho ngenkathi unciphise imiphumela emibi. Ama-appointment okuphindaphinda njalo abalulekile ekuqondeni intuthuko yakho nokwenza noma yikuphi ukulungiswa okudingekayo ohlelweni lwakho lokwelapha.

Indlela yokuphatha i-Autoimmune Hepatitis ekhaya?

Ukuthatha imithi yakho ngokuqondile njengoba kulotshiwe yiyona nto ebaluleke kakhulu ongayenza ukuphatha i-autoimmune hepatitis ekhaya. Ungalokothi uyeke noma ushintshe imithi yakho ngaphandle kokubonisana nodokotela wakho, ngisho noma uzizwa kahle.

Ukusekela impilo yakho ye-liver ngokukhetha indlela yokuphila kungase kuhambisane nokuphathwa kwakho kwezokwelapha ngokuphumelelayo. Ukugwema utshwala ngokuphelele kubalulekile ngoba kungenza ukuvuvukala kwe-liver kube sibi futhi kuphazamise imithi yakho. Ngisho namanani amancane utshwala angaba yingozi uma une-liver disease.

Ukudla ukudla okuqondile, okunomsoco kusiza umsebenzi we-liver yakho ukusebenza kahle ngenkathi uphulukana. Gxila ezithelo ezintsha, imifino, amaprotheni ahlanzekile, nama-grains aphelele ngenkathi ugcina ukudla okucutshunguliwe nosawoti olukhulu. Uma uthuthukisa ukugcinwa kwamafutha, udokotela wakho angase akukhuthaze ukunciphisa ukudla kwesosawoti.

Hlala ubuyekeza ngokujova, ikakhulukazi nge-hepatitis A ne-B, njengoba imithi yakho ye-immune system ikwenza ube sengozini yokutheleleka. Xoxa nodokotela wakho ukuthi yimaphi ama-vaccines aphephile kuwe ngenkathi uthatha imithi yokucindezela i-immune.

Ukuzivocavoca okuthambile njalo kungasiza ekuqedeni umoya omubi nokugcina impilo yakho yonke, kodwa lalela umzimba wakho uphumule uma kudingeka. Ukuphathwa kokucindezeleka ngezindlela zokuphumula, ukulala okwanele, nokwesekwa ngokomzwelo kungazuza kahle impilo yakho yonke.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ngaphambi kwe-appointment yakho, bhala zonke izimpawu zakho, kuhlanganise nokuthi zaqala nini nokuthi zikuthinta kanjani impilo yakho yansuku zonke. Faka imininingwane mayelana namazinga omoya omubi, ubuhlungu, nanoma yikuphi ukushintsha ekudleni noma ebunzimeni bakho.

Letha uhlu oluphelele lwazo zonke imithi, izithasiselo, nezinye izinto zokwelapha eziluhlaza okwesibhakabhaka ozithathayo, kuhlanganise nezinga. Faka noma iyiphi imithi ye-over-the-counter oyisebenzisayo njalo, njengoba ezinye zingase zithinte umsebenzi we-liver noma zihlangane nokuphathwa kwakho.

Lungisa umlando womndeni wezokwelapha, ikakhulukazi uqaphele noma yiziphi izifo ze-autoimmune, izinkinga ze-liver, noma ezinye izimo ezingamahlalakhona ezihlobene zakho. Lolu lwazi lusiza udokotela wakho ukuqonda izinto ezingozi zakho noxhumano olukhona lwe-genetic.

Bhala imibuzo ofuna ukuyibuza udokotela wakho, njengokwelashwa, isikhathi esilindelekile sokuthuthuka, ukushintsha indlela yokuphila, nemiphumela emibi yemithi. Unganqikazi ukubuza nganoma yini ekukhathazayo noma okungakuqondi.

Uma kungenzeka, letha umngane othembekile noma ilungu lomndeni e-appointment yakho. Bangakusiza ukukhumbula ulwazi olubalulekile futhi banikeze ukwesekwa ngokomzwelo ngesikhathi soxoxa mayelana nokuxilongwa kwakho nohlelo lwakho lokwelapha.

Iyini into ebalulekile mayelana ne-Autoimmune Hepatitis?

I-Autoimmune hepatitis yisimo esilawuleka uma sixilongwa ngokushesha futhi siphathwa kahle. Nakuba idinga ukunakekelwa kwezokwelapha okuqhubekayo nokushintsha indlela yokuphila, abantu abaningi abanesimo esinjalo bangaphila impilo egcwele, esebenzayo ngokwelashwa okufanele.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi lesi simo siphendula kahle ekwelapheni emacala amaningi. Ngokusebenzisa imithi ngokuqhubekayo nokulandelela njalo kwezokwelapha, ungavimbela izinkinga ezingathi sína futhi ugcine umsebenzi we-liver omuhle iminyaka eminingi ezayo.

Ungavumeli ukwesaba noma ukungabaza kukuvimbele ekuthola usizo uma uhlushwa izimpawu. Ukungenelela kwangaphambi kwesikhathi kwenza umehluko omkhulu emiphumeleni, futhi iqembu lakho lokunakekelwa kwezempilo likhona ukukusekela kuzo zonke izinyathelo zokuxilonga nokuphathwa.

Khumbula ukuthi ukuba ne-autoimmune hepatitis akuchazi wena noma akulingani amandla akho okuphila impilo enempilo, egcwele. Ngokunakekelwa okufanele, abantu abaningi bathola ukuthi izimpawu zabo ziyalawulwa kahle, kubavumela ukuthi bagxile ezintweni abazithandayo kakhulu.

Imibuzo evame ukubuzwa mayelana ne-Autoimmune Hepatitis

Ingase iphiliswe ngokuphelele i-autoimmune hepatitis?

Nakuba kungekho ukwelashwa okuhlala njalo kwe-autoimmune hepatitis, abantu abaningi bafinyelela ekuphumuleni isikhathi eside ngokwelashwa okufanele. Ukuphumula kusho ukuthi izimpawu zakho ziyaphela futhi ukuhlolwa kwegazi kubuyela ekujwayelekile, nakuba cishe uzodinga ukuqhubeka nokuthatha imithi ukuze ugcine lo mthuthuko. Abanye abantu ekugcineni banganciphisa imithi yabo noma bathathe ama-breaks ekwelapheni ngaphansi kokunakekelwa okufanele kwezokwelapha.

Ingabe i-autoimmune hepatitis iyefa?

I-Autoimmune hepatitis ayithathwa ngokuqondile njengezinye izifo ze-genetic, kodwa ukuba namalungu omndeni ane-autoimmune conditions kukwandisa ingozi yakho. Izici ze-genetic ezenza umuntu abe sengozini yezifo ze-autoimmune zingase ziqhubeke emindenini. Noma kunjalo, abantu abaningi abanemlando womndeni wezimo ze-autoimmune abazithuthukisi i-autoimmune hepatitis.

Ngingaba nezingane uma ngine-autoimmune hepatitis?

Abesifazane abaningi abane-autoimmune hepatitis bangaba nokukhulelwa okunempilo, kodwa kudinga ukuhlela ngokucophelela nokulandelela neqembu lakho lokunakekelwa kwezempilo. Imithi ethile esetshenziswa ekwelapheni i-autoimmune hepatitis ingase idingeke ukulungiswa ngaphambi nangesikhathi sokukhulelwa. Odokotela bakho bazosebenza nawe ukuphatha isimo sakho ngokuphepha ngenkathi uvikela impilo yakho kanye nempilo yengane yakho.

Ingabe ngizodinga ukuthatha imithi impilo yonke?

Abantu abaningi abane-autoimmune hepatitis badinga imithi yesikhathi eside ukuze bagcine isimo sabo lilawulwa, kodwa lokhu akusho ukuthi ukwelashwa impilo yonke kubo bonke. Abanye abantu banganciphisa imithi yabo kancane kancane noma bathathe ama-breaks ekwelapheni ngemuva kokufinyelela ekuphumuleni okuqhubekayo. Udokotela wakho uzolandelela isimo sakho eduze futhi alungise uhlelo lwakho lokwelapha ngokusekelwe ekuphenduleni kwakho ngokuhamba kwesikhathi.

Ingabe ukucindezeleka kwenza i-autoimmune hepatitis ibe sibi?

Nakuba ukucindezeleka kungabangeli i-autoimmune hepatitis ngokuqondile, kungase kuqalise ukwanda kwabanye abantu noma kwenze izimpawu zizwe zibi. Ukuphathwa kokucindezeleka ngezindlela zokuphumula, ukulala okujwayelekile, ukuzivocavoca okuthambile, nokwesekwa ngokomzwelo kungaba usizo empilweni yakho yonke futhi kungasiza ekuphatheni izimpawu. Noma kunjalo, ukuphathwa kokucindezeleka kufanele kuhambisane, kungabi yisikhombisi, sokwelashwa kwakho okunqunywe.