Strides made to contain TB, silicosis

Continental body call on governments to prioritize efforts

MATHATISI SEBUSI

MASERU – The East, Central and Southern African Health Community (ECSA-HC) has taken a hands-on approach to advocating for elimination of tuberculosis (TB) in the mining sector and encourages governments to prioritise the subject and put it on top of national agendas. In an effort to broaden the advocacy, ECSA-HC has for the past two consecutive years been capacitating journalists from 13 SADC countries on sustainable, responsible and informed reporting on TB in the mining sector to ensure that TB in the mines remains high on the national and regional agenda. The second capacitation workshop, which was held between April 27 and April 28, brought together 39 journalists from countries including Lesotho, Angola, Botswana, DRC, eSwatini, Madagascar, Namibia, South Africa, Zambia, Tanzania, Malawi, Zimbabwe and Mozambique.

The diverse advocacy follows findings by ECSA-HC revealing that the mining industry is a key driver of TB in the SADC region with at least seven percent of miners contracting TB each year. Lesotho is among 16 SADC member countries which are burdened by TB. ECSA-HC’s findings further state that exposure to silica dust, poor working and living conditions and migration across borders are among the risk factors for miners to be prone to TB. ECSA-HC’s communications and advocacy officer, Justin Mahimbo, noted that another key driver in TB infection in the region is HIV/Aids. To address the burden of TB in the region, especially TB in the mines, Mahimbo said the Southern African Regional Coordinating Mechanism (RCM), with support from the Global Fund (GF), launched the TB in the Mining Sector in Southern Africa (TIMS) programme in 2012 that is being implemented by ECSA.

He said the programme is a multi-faceted collaboration involving various sectors such as the Ministry of Health, the Ministry of Labour and Mining, the private sector (mining companies) and mineworkers’ associations with a goal to identify the link missing TB cases and create a more effective response to the TB problem in the region. He further stated that the programme is guided by the declaration on TB in the mining sector and SADC TB Strategic Plan 2020-2024. On the other hand, with regard to addressing TB in the mining sector, SADC heads of state signed a declaration on TB in 2012, indicating five priority areas on TB, HIV, silicosis, and other occupational respiratory diseases. The priority areas include elimination of conditions leading to high TB rates in mines, actively looking for people with TB and treat them promptly, improving TB treatment, actively seeking former mine workers who could have TB and creating a legal and regulatory framework that provides compensation for occupational diseases among mine workers and ex-miners.

As of March 2023, 40 909 Basotho miners and ex-miners who contracted silicosis while working in the South African mines and are eligible for compensation. Out of these people, 5 128 received compensation worth M440 558 145 from Tshiamiso Trust – a South African institution managing thousands of claims for mineworkers eligible for compensation due to contracting TB or silicosis from working in certain gold mines during specific periods between March 12, 1965, and December 10, 2019. In an interview with Public Eye, Acting CEO at Tshiamiso Trust, Lusanda Jiya, said the Trust has received 40 909 claims from Lesotho, and together with TEBA, they have been helping and ensuring that beneficiaries get their dues.

She noted that the Tshiamiso Trust does lodgements, through TEBA, as well as Benefit Medical Examinations (BMEs), through their medical service providers in Maseru, Leribe, Mafeteng, Botha-Bothe, Mohale’s Hoek, Mokhotlong, Qacha’s Nek, Quthing and Teyateyaneng. From May 4 to May 19, Tsiamiso will be doing outreaches across Lesotho helping new claimants to lodge their claims and offering medical examinations for eligible claimants. Tshiamiso’s mandate is to pay compensation to an estimated 500 000 ex-gold miners across Southern Africa including Lesotho, eSwatini, Botswana and Mozambique, which served as pools of labour for the South African gold mines.

The settlement reached in the Johannesburg High Court (South Africa) in 2016 covers employees who worked on the cited mines for two years or more between March 12, 1965, and December 10, 2019, and who contracted silicosis or TB due to their work. World Health Organisation (WHO) data on Lesotho’s TB profile (2021) states that in 2021 Lesotho recorded 14 000 TB cases with an incidence rate of 614 per 100 000 population. Out of the cases, 8 700 cases were reported to be of people living with HIV recorded at an incidence rate of 383 per 100 000 population. The data further reports that in the same year, the country recorded 620 cases of drug resistant TB at an incidence rate of 27 per 100 000 population.

Ministry of Health TB and Leprosy Manager, Dr Llang Maama, said a number of corrective measures are being implemented at the mines to curb the scourge of TB at the mines. “Mines have improved housing conditions for the miners who can now have proper houses and not living in dormitories. There are now strong HIV and TB programmes to support miners within the mines or linkage with nearby health services. “Some mines have coordinators who help link patients even across the borders. “We have through the global fund regional grant known as TB in the Mining Sector (TIMS), Lesotho now has two occupational health services centres aimed at providing Benefits Medical Examinations and link them up to compensation in South Africa,” she said.

Ministry of health director Dr Nyane Letsie expressed concern over the burden TB contracted in SA mines poses for Lesotho’s health sector.

“Miners face high burden of TB due conditions such as silicosis as an occupational lung disease as well as HIV for different reasons such as being away from home from their families. Their burden is estimated to more than 1000 cases per 100,000 population,” Dr Letsie said yesterday. “TB in the mines affects Lesotho and as a country we have to manage all the TB patients which attracts more costs to care. “The country has capacity to treat all the TB patients. Actually the Ministry is in active search for missing TB patients in order to reduce the current prevalence incidence. Every year a budget is set aside to procure TB testing reagents and anti TB medicines and others such as nutritional supplements,” she added.