Mtobeli Elson Vapi is only 52 and treading lightly is about as much activity as his body can handle.
Mtobeli Elson Vapi shelters himself from the misty rain with a blue floral umbrella as he walks through the long, wet grass on the way to his rural home in Ngqeleni in the Eastern Cape.
Dressed in a white and blue chequered cardigan and brown slacks, he has big, round eyes and an even bigger smile. He paints a picture of peaceful retirement – a quiet, contented elderly man in a picturesque setting of undulating green hills and fresh air.
But Vapi is only 52 and treading lightly is about as much activity as his body can handle. His idyllic home is pretty, but also pretty far from everything, including hospitals, lawyers and the resources he needs to help him solve his huge problems.
Vapi is one of 3 500 former migrant gold miners who are suffering the ravages of silicosis after working in mines largely owned by Anglo American South Africa. The mineworkers hope to claim billions of rands in damages from the mines and are in the midst of a lawsuit against the multinational.
Representing the miners is Leigh Day and Co, a British law firm offering worldwide representation to people who sustain workplace injuries because their employers are negligent.
Vapi worked at the Vaal Reefs Mine near Klerksdorp from 1985 until he was retrenched in 1997. When he left the job, he was having difficulty breathing. Back in 1989, he said, mine doctors examined him, but he was never informed of any results.
He experienced breathing problems throughout his time at the mine, but every time he went for a medical examination, he was given pills and declared fit for work, said Vapi.
In 1997, he was told by the mine that a problem had, in fact, been detected in his lungs in 1989, but that the spots that were now seen on his lungs would eventually disappear after he left the mine. His condition worsened, however.
Government disability grant
He contracted tuberculosis twice and in 2008, he was finally diagnosed with silicosis at the Canzibe state hospital near Mthatha.
It was a dark day, recalled Vapi: "The doctor explained it was a lung problem and they told me if your lungs have died, you cannot be cured. I was not well. I asked them how long it would be until I passed. They said they did not know, that it was up to God."
When he was retrenched in 1997, he was advised to obtain a medical certificate from the Medical Bureau for Occupational Diseases and he received compensation from the mine to the tune of R57 000. He used it to build a house for his wife and three young boys. Now the family survives on his government disability grant of R1200 a month and a R280 child grant for each son.
Vapi is disappointed in himself. As a father, he would like to play soccer with his kids and send them to university. As a husband, he would like to buy his wife all she desires. If he had known then what he knows now, he said, he would never have become a miner.
"I pray we can win this case before I die," he said.
A deadly triple-shot cocktail
Perhaps the most reliable indicator of silicosis rates among local gold miners is the annual surveillance report on occupational lung diseases in South African mining that is released by the National Institute for Occupational Health.
The report is recognised internationally.
Since 1975, the institute has performed more than 105 000 autopsies on miners and its surveillance reports are based on these and on the clinical case files and employment histories of dead miners.
Ticking time bomb
The surveillance reports show an increase in silicosis prevalence among gold miners from about 17% in 1975 to 33.5% in 2011. Taking into account that the number of gold miners in South Africa peaked at about 500 000 in 1983 and stood at roughly 134 000 in 2011, the number of miners with silicosis could run into hundreds of thousands.
Tuberculosis, HIV/Aids and silicosis add up to a deadly mix for mineworkers. According to Statistics South Africa's 2011 midyear population estimates, about 16.6% of the general adult population aged 15 to 49 years was HIV-positive by mid-2011.
By contrast, said the World Bank, up to 30% of the country's gold miners are HIV-positive.
Miners more at risk
The national department of health said the incidence of tuberculosis in miners had increased exponentially every year with that of HIV.
It names silicosis, dusty environments and an HIV-positive status as the major risk factors for tuberculosis in the mining industry.
According to the World Bank, in 2011 South Africa's incidence of tuberculosis was 993 people in every 100 000 of the population. For gold miners, the health department said, this figure was between 3000 and 7000 for every 100 000 prior to 2007.
The consequence is that gold miners return to rural areas and put their families and friends at risk – not just of tuberculosis, but multidrug-resistant tuberculosis.