Thandile Qwalela died in the tuberculosis (TB) ward of his Eastern Cape district hospital at the age of 48. He was an underground miner from age 20 who served 17 years as a stoper and winch driver on the gold mines.
Qwalela was diagnosed with TB while in mine service in 1997 and was dispatched to his home in the Eastern Cape. There he started wasting away, while remaining convinced that he would recover.
His modest expectation was that his community could be helped with agricultural development. ”We want to do ploughing as a project,” he said. ”After I’ve recovered I’ll be able.”
He knew nothing of the Occupational Diseases in Mines and Works Act 78 of 1973 — or that he was entitled, until the amendment of 2002, to annual ”benefit medical examinations”, free of charge, and thereafter to free examinations every second year.
In the more than 10 years since leaving mine employment he never received medical checks for dust-related respiratory disease. While employed, he was not told about the legislation or informed of his statutory rights by his local health services.
When the legislation was explained to him, he thought it was new. In fact it embodies an occupational disease compensation system that is almost a century old. It guarantees miners not just medical examinations for life, but also compensation for an occupationally related lung disease. It also requires that when they die, the bodies of all former miners must be autopsied.
Did Qwalela have silicosis, a disease that predisposes a person to TB? No one will ever know, because he was buried before the possibility of an autopsy could be raised with his widow. He died and was buried without undergoing an X-ray while he was alive to test for the presence of silicosis and without a post-mortem examination.
He left a widow who now survives and feeds three schoolgoing children by collecting and selling bundles of wood.
Former miner Machule Mapasa also died in the rural Eastern Cape this year while undergoing TB treatment, at the age of 46. Beginning work on the gold mines in 1981, he was employed for more than 23 years, first as a ”timber boy” and then as a machine operator.
When Mapasa was retrenched in 2004, he was given an exit X-ray, but was told nothing about the results of the examination or his rights under occupational disease legislation.
In 2006 he was admitted to his local district hospital for TB treatment and in 2007 was readmitted to the ward. He died on January 24 this year.
He told this researcher: ”They just say I have TB. Nothing can help me. But I agree with autopsy. I have no objection to that. I want this autopsy.”
Mapasa’s clinical signs — relentless coughing, severe pain in his left arm and legs, extreme breathlessness on exertion and pitting oedema — all pointed to chronic lung disease.
Local health workers did not know of the autopsy requirement for all ex-miners. He received this right as a result of external intervention, discussions with his family and the hiring of a private doctor to remove his heart and lungs. The organs were collected by the National Institute for Occupational Health.
Mapasa’s autopsy report, in May this year, found that ”there is silicosis” as well as dust deposition in regional glands. The report has now been forwarded to the certification committee of the Medical Bureau for Occupational Disease. His destitute widow and five schoolgoing children await the certification and compensation outcome.
Thousands of former miners like Mapasa and Qwalela live in South Africa’s labour-providing rural areas. Will they continue to die and be buried as TB or pneumonia victims without any possibility of being diagnosed with mining-related respiratory disease? What is happening is a travesty of their rights under occupational disease legislation.
Jaine Roberts is deputy director of research at the Health Systems Trust