The last week has been one which has delivered some very good, and some very bad news in the fight against the TB epidemic in Southern Africa’s gold mines. It seems natural that this would be the case, so widespread and diffuse is the problem. Just as a solution seems to be appearing, a new problem arises.
Let’s start with the good news.
On Wednesday last week, South African Minister in the Presidency, Jeff Radebe announced new plans for a partnership between mines and the municipal governments that they operate under to convert single-sex hostel style housing into family units. The move forms part of the objectives set out in the amendments to the Broad-Based Socio-Economic Empowerment Charter for the South African Mining and Minerals Industry (known as the mining charter) which seeks to address systemic problems within the mining industry.
One of the objectives of the Charter focuses on Housing and Living conditions and sets out an objective to ‘convert or upgrade hostels into family units by 2014’. While the main objective of the upgrade is stated as ‘bringing dignity to privacy to mineworkers’, and will no doubt do so, the move will also be seen as a win in the fight against TB.
Cramped, poorly ventilated hostels have long been a breeding ground for TB and other infectious diseases, as well as often acting as venues for the transmission of HIV through sex worker activity, ever-present in mining communities in which miners are separated from their families.
So, this is a welcome move , and one which RESULTS and our partners in Southern Africa have long been calling for in relation to the response to tackling tuberculosis. We shall wait patiently to see how quickly and widely these plans are implemented.
On a less positive note, new evidence has come to light that rates of TB are rising in miners working in South Africa’s platinum mines. Despite the absence of some of the more direct risk factors of gold mines, such as exposure to silica dust and very deep, unventilated working conditions, levels of TB are begining to rise among this group.
The new evidence some from forensic autopsy reports on 34 mine workers who were killed by police during a strike at the Marikana Platinum mine, in Rustenburg in 2012. Under the Occupational Diseases in Mines Act on 1973, the family of any person who has worked on a mine and died from ‘unnatural’ causes can send their organs for examination for compensable diseases.
The reports identified that two of the mine workers had inactive TB at the time of death, while a further seven had silicosis. So, nine of the 34 mine workers had a serious respiratory condition.
The levels of silicosis can be traced back to gold mining – all of those with the condition at autopsy had previously been employed as gold miners, where exposure to silica dust is common place. The worrying trend is that of men moving from gold to platinum mining, as gold mining work continues to decline, are silicotic or pre-silicotic, and thus at greater risk of contracting TB and silicosis.