By Sukuoluhle Ndlovu
Masvingo – ‘People think we have less knowledge when it comes to Tuberculosis, but we have a lot of knowledge about the disease and that is why we have taken it upon ourselves to make sure that we are safe always and undergo regular medical check-ups. People think that because we are miners we do not have full information about TB, but we do.’ Tawanda Kashiri.
Mining activities, especially artisanal mining with its lack of protective clothing, expose one to a lot of diseases, and Tuberculosis (TB) is one ailment that is prevalent in this sector.
It is therefore of vital importance that miners have the correct information about TB so that they know how to fully protect themselves against infection or contracting TB from an infected colleague.
Norman Maroveke, an artisan miner who works for Ethel 8 Gold mine said that he is fully aware of the dangers that surround him and the other miners working in different places in the country.
“The shafts we get into have timber supported pillars and at certain temperatures, that timber produces both carbon monoxide and carbon dioxide, gases which have dangerous properties on humans,” Maroveke said.
“The explosives we use in the mining process leave us vulnerable as we might inhale dangerous fumes. Mining is also associated with a lot of dust emissions so we have to make sure there is a lot of ventilation to avoid infections.
“So we do not just go down the shaft blindly but we do take precautions to protect ourselves,” he said.
Maroveke, who has been a miner since 1992, said he holds regular engagements with the health people who visit their workplace, in addition to going for examinations.
“People from the health fraternity visit us regularly and carry out tests for TB and HIV. They advise us on how we should carry out our work to avoid getting infected. I also go regularly to get examined and so far all is well for me, I am safe,” he said.
Another miner, Simpson Dondo, said that below the shafts there is water that provides them with oxygen hence good circulation of oxygen.
“The water found below the shaft also helps with oxygen so that we do not suffocate from inhaling carbon dioxide,” Dondo said.
Said Gregory Simbi, “The water again is regularly tested at laboratories to check whether it is safe or not; if it is safe they then know it is not toxic for our health. We also use a compressor to blow the gases that are toxic out of the mine shafts.”
The Country Director for The Union, Christopher Zishiri gave advice to miners who are highly at risk of getting infected.
“Advice that can be given to miners include ensuring immediate treatment of active tuberculosis, treatment of latent tuberculosis disease to reduce the burden of active cases, and appropriate management of patients infected with HIV.
“Miners often have multiple treatment episodes with inappropriate therapy and high default rates, which can lead to the acquisition of drug-resistant TB.
Although miner’s at large sites in some countries have access to extensive tertiary-care health facilities during their periods of employment, primary-care facilities are often sparse near mines and in the rural areas to which miners return after seasonal work, and many care facilities are inaccessible to contract workers, who sometimes constitute the majority of the mining population” he said.
In some countries, mining companies report regular TB screening, but independent verification was lacking and there was some evidence that TB was undetected.
Dr Zishiri said one study of miners that was based on autopsies revealed that a significant fraction had active disease undetected during their lives.
He however, said there were solutions that could reduce high mortality rate due to TB.
“The solution to the high mortality due to TB is simple: improve workers’ living conditions, improve their diet, and expand medical services so that those who are sick receive timely, appropriate care.”
Dr Zishiri said that all these reasons make miners more susceptible to TB deaths.
The National Tuberculosis Programme in partnership with the International Union Against Tuberculosis and Lung Disease (The Union) with support from Global Fund and USAID’s Challenge TB has been implementing different strategies to improve case detection. Mining areas are sometimes hard to reach and accessibility to quality health services can be challenging. Therefore, mobile teams are conducting active case finding activities for TB in mines among other high risk communities.
“Working conditions inside mines create a high-risk environment for TB transmission, resulting in part from silica dust exposure – which increases the risk of pulmonary TB, particularly in gold mines – as well as confined and poorly ventilated environments conducive to transmission.
“Outside the mines, circular migration continues to be the norm. Sex work remains common around all-male hostels at the mines, increasing the risk of HIV transmission which in turn increases the risk of active,” he said.
Recent estimates indicated that miners were three to four times more likely to be infected with HIV than non-miners; partners of migrant miners have also been found to have significantly greater prevalence of HIV than prevalence among the general populations, Dr Zishiri said.