1
|
Moyo D, Kavenga F, Moyo F, Muzvidziwa O, Madziva G, Chigaraza B, Ncube M, Madadangoma P, Masvingo H, Muperi TC, Mando TC, Ncube RT. Health Screening Strategies for Artisanal and Small-Scale Miners for Tuberculosis, Human Immunodeficiency Virus and Silicosis: A Case of the USAID-Supported Kunda Nqob'iTB Project in Zimbabwe. Int J Environ Res Public Health 2024; 21:70. [PMID: 38248534 PMCID: PMC10815506 DOI: 10.3390/ijerph21010070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Artisanal and small-scale mining is characterized by excessive exposure to physical, chemical, ergonomic, psychosocial and biological hazards. There is a high burden of tuberculosis (TB), human immunodeficiency virus (HIV) infections and silicosis among artisanal and small-scale miners (ASMs). The aim of this project report is to describe lessons learned from strategies implemented to reach ASMs with screening services for TB, HIV and silicosis in Zimbabwe through the Kunda-Nqob'i TB (KNTB) project supported by the United States Agency for International Development (USAID). The intervention package for screening ASMs for TB, HIV and silicosis included service provision through two occupational health clinics at two provincial hospitals and a mobile workplace-based screening (WBS) facility at the mining sites. From 1 October 2020 to 30 September 2023, 10,668 ASMs were screened, with a high number of cases of silicosis (21%) and TB (7.4%). There was a high burden of HIV (30%) in ASMs attending the occupational health clinics. The two occupational health clinics screened 3453 ASMs, while the mobile WBS activities screened 7215 ASMs during the period. A total of 370 healthcare workers (doctors/clinical officers, nurses, environmental health technicians and district tuberculosis and Leprosy control officers) were trained on TB and the fundamental diagnostic principles of silicosis. The KNTB project has been successful in reaching out to many ASMs operating in remote and hard-to-reach mining areas. The KNTB project has brought to light the positive health-seeking behavior of ASMs operating in remote areas. The project has brought to the fore the effectiveness of multi-stakeholder engagement and collaboration in reaching out to ASMs in remote areas with health screening services. There is a high burden of TB, HIV and silicosis in ASMs. Screening for TB, HIV and silicosis using workplace-based screening and occupational health clinics is an effective strategy and should be rolled out to all areas with high artisanal and small-scale mining activity.
Collapse
Affiliation(s)
- Dingani Moyo
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
- Department of Community Medicine, Faculty of Medicine, National University of Science and Technology, Bulawayo 029, Zimbabwe
- School of Public Health, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Fungai Kavenga
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (F.K.); (T.C.M.)
| | - Florence Moyo
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
- Department of Health Sciences, Faculty of Health, Zimbabwe Open University, Gweru 054, Zimbabwe
| | - Orippa Muzvidziwa
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
| | - Godknows Madziva
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
| | - Blessings Chigaraza
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
| | - Mpokiseng Ncube
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
| | - Precious Madadangoma
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
| | - Hellen Masvingo
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
| | - Tafadzwa Charity Muperi
- Baines Occupational Health Services, Harare 024, Zimbabwe; (F.M.); (O.M.); (G.M.); (B.C.); (M.N.); (P.M.); (H.M.); (T.C.M.)
| | | | | |
Collapse
|
2
|
Singo J, Moyo D, Isunju JB, Bose-O’Reilly S, Steckling-Muschack N, Becker J, Mamuse A. Health and Safety Risk Mitigation among Artisanal and Small-Scale Gold Miners in Zimbabwe. Int J Environ Res Public Health 2022; 19:14352. [PMID: 36361232 PMCID: PMC9659187 DOI: 10.3390/ijerph192114352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Artisanal and small-scale gold mining (ASGM) is often associated with no or compromised attention to health and safety. Although headlines of fatal accidents in Zimbabwe characterise ASGM, little attention is paid to prevention strategies. This study, therefore, explores health and safety risk mitigation in ASGM in Zimbabwe to inform prevention strategies. A qualitative design was used with focus group discussions and in-depth interviews. Data were analysed using thematic analysis, coding, and descriptive statistics. Reported factors contributing to compromised health and safety included immediate causes, workplace factors, ASM related factors, and contextual factors, with interconnectedness between the causal factors. In addition, factors related to ASGM were significant. For risk mitigation, formalisation, organisation of risk reduction, behaviour change, and enforcement of prevention strategies is proposed. A multi-causal analysis is recommended for risk assessment and accident investigation. A multi-stakeholder approach could be considered for risk mitigation including community and public health interventions. However, risk mitigation has been characterised by gaps and weaknesses such as lacking ASM policy, lack of capital, poor enforcement, negative perceptions, and non-compliance. Therefore, we recommend addressing the threats associated with health and safety mitigation to ensure health and safety protection in ASGM.
Collapse
Affiliation(s)
- Josephine Singo
- Centre for International Health, University Hospital, LMU Munich, Ziemssenstr. 5, 80336 Munich, Germany
- Devsol Consulting, Clock Tower, Kampala P.O. Box 73201, Uganda
- Exceed Institute of Safety Management and Technology, Kampala P.O. Box 72212, Uganda
| | - Dingani Moyo
- School of Public Health, University of the Witwatersrand, Private Bag 3, WITS, Johannesburg 2050, South Africa
- Faculty of Medicine, National University of Science and Technology, Ascot, Bulawayo P.O. Box AC 939, Zimbabwe
- Faculty of Medicine, Midlands State University, Private Bag 9055, 263, Senga Road, Gweru P.O. Box 9055, Zimbabwe
| | - John Bosco Isunju
- Disease Control and Environmental Health Department, School of Public Health, Makerere University, Kampala P.O. Box 7072, Uganda
| | - Stephan Bose-O’Reilly
- Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336 Munich, Germany
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, 6060 Hall in Tirol, Austria
| | - Nadine Steckling-Muschack
- Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336 Munich, Germany
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, 6060 Hall in Tirol, Austria
- Klinikum Osnabrueck GmbH, Am Finkenhuegel 1, 49076 Osnabrueck, Germany
| | - Jana Becker
- Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336 Munich, Germany
- German Professional Association of Private Practitioners in Hematology and Medical Oncology, Sachsenring 57, 50677 Cologne, Germany
| | - Antony Mamuse
- Department of Geosciences, Midlands State University, Private Bag 9055, Senga Road, Gweru, Zimbabwe
| |
Collapse
|
3
|
Singo J, Isunju JB, Moyo D, Bose-O’Reilly S, Steckling-Muschack N, Mamuse A. Accidents, Injuries, and Safety among Artisanal and Small-Scale Gold Miners in Zimbabwe. Int J Environ Res Public Health 2022; 19:ijerph19148663. [PMID: 35886514 PMCID: PMC9324458 DOI: 10.3390/ijerph19148663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/07/2022] [Accepted: 07/10/2022] [Indexed: 01/08/2023]
Abstract
Artisanal and small-scale gold mining (ASGM) employs 14–19 million people globally. There is limited research on accidents, injuries, and safety in Zimbabwe’s ASGM. This study investigates the prevalence of accidents and injuries, as well as the associated risks and existing safety practices. A cross-sectional survey was conducted among artisanal and small-scale gold miners. Data from 401 participants were analyzed using descriptive statistics and regression analysis. The prevalence of accidents and injuries was 35.0% and 25.7%. Accidents associated with experiencing injuries included mine collapses and underground trappings. The major injury risk factors were digging, blasting, being male, being 18–35 years old, crushing, and the underground transportation of workers and materials. Injuries were reported highest among the miners working 16 to 24 h per day. Participants had heard about personal protective equipment (PPE). There was training and routine inspections mainly on PPE use. Mine owners and supervisors were reported as responsible for OSH, which was mainly PPE use. Practices including the use of wire winch ropes and escape routes were rare. There was ignorance on underground mine shaft support. The mining regulations that had the potential to introduce comprehensive safety controls were not adaptable. We recommend applicable health and safety regulations for Zimbabwe’s ASGM.
Collapse
Affiliation(s)
- Josephine Singo
- Centre for International Health, University Hospital, LMU Munich, Leopoldstrasse 5, D-80802 Munich, Germany
- Devsol Consulting, Clock Tower, Kampala P.O. Box 73201, Uganda
- Exceed Institute of Safety Management and Technology, Kampala P.O. Box 72212, Uganda
- Correspondence: or
| | - John Bosco Isunju
- Disease Control and Environmental Health Department, Makerere University School of Public Health, Kampala P.O. Box 7072, Uganda;
| | - Dingani Moyo
- School of Public Health, University of the Witwatersrand, Private Bag 3, WITS, Johannesburg 2050, South Africa;
- Faculty of Medicine, National University of Science and Technology, Ascot, Bulawayo P.O. Box AC 939, Zimbabwe
- Faculty of Medicine, Midlands State University, Private Bag 9055, 263, Senga Road, Gweru P.O. Box 9055, Zimbabwe
| | - Stephan Bose-O’Reilly
- Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, D-80336 Munich, Germany; (S.B.-O.); (N.S.-M.)
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria
| | - Nadine Steckling-Muschack
- Institute and Clinic for Occupational, Social, and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, D-80336 Munich, Germany; (S.B.-O.); (N.S.-M.)
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnoefer-Zentrum 1, A-6060 Hall in Tirol, Austria
- Klinikum Osnabrueck GmbH, Am Finkenhuegel 1, D-49076 Osnabrueck, Germany
| | - Antony Mamuse
- Department of Geosciences, Midlands State University, Private Bag 9055, 263 Senga Road, Gweru P.O. Box 9055, Zimbabwe;
| |
Collapse
|
4
|
Rasmussen J, Eriksson M, Martinsson J. Citizens’ Communication Needs and Attitudes to Risk in a Nuclear Accident Scenario: A Mixed Methods Study. IJERPH 2022; 19:ijerph19137709. [PMID: 35805364 PMCID: PMC9265994 DOI: 10.3390/ijerph19137709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 12/10/2022]
Abstract
The potential devastation that a nuclear accident can cause to public health and the surrounding environment demands robust emergency preparedness. This includes gaining a greater knowledge of citizens’ needs in situations involving radiation risk. The present study examines citizens’ attitudes to a remediation scenario and their information and communication needs, using focus group data (n = 39) and survey data (n = 2291) from Sweden. The focus groups uniquely showed that adults of all ages express health concerns regarding young children, and many also do so regarding domestic animals. Said protective sentiments stem from a worry that even low-dose radiation is a transboundary, lingering health risk. It leads to doubts about living in a decontaminated area, and high demands on fast, continuous communication that in key phases of decontamination affords dialogue. Additionally, the survey results show that less favorable attitudes to the remediation scenario—worry over risk, doubt about decontamination effectiveness, and preferences to move away from a remediation area—are associated with the need for in-person meetings and dialogue. Risk managers should thus prepare for the need for both in-person meetings and frequent information provision tasks, but also that in-person, citizen meetings are likely to feature an over-representation of critical voices, forming very challenging communication tasks.
Collapse
Affiliation(s)
- Joel Rasmussen
- Crisis Communication Centre, School of Humanities, Education and Social Sciences, Örebro University, 701 82 Örebro, Sweden;
- Correspondence:
| | - Mats Eriksson
- Crisis Communication Centre, School of Humanities, Education and Social Sciences, Örebro University, 701 82 Örebro, Sweden;
| | - Johan Martinsson
- Medical Radiation Physics, Lund University, 205 02 Malmö, Sweden;
| |
Collapse
|
5
|
Moyo D, Zishiri C, Ncube R, Madziva G, Sandy C, Mhene R, Siziba N, Kavenga F, Moyo F, Muzvidziwa O, Ncube P, Chigaraza B, Nyambo A, Timire C. Tuberculosis and Silicosis Burden in Artisanal and Small-Scale Gold Miners in a Large Occupational Health Outreach Programme in Zimbabwe. Int J Environ Res Public Health 2021; 18:ijerph182111031. [PMID: 34769551 PMCID: PMC8583466 DOI: 10.3390/ijerph182111031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/04/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022]
Abstract
Artisanal and small-scale miners (ASMs) labour under archaic working conditions and are exposed to high levels of silica dust. Exposure to silica dust has been associated with an increased risk of tuberculosis and silicosis. ASMs are highly mobile and operate in remote areas with near absent access to health services. The main purpose of this study was to evaluate the prevalence of tuberculosis, silicosis and silico-tuberculosis among ASMs in Zimbabwe. A cross-sectional study was conducted from 1 October to 31 January 2021 on a convenient sample of 514 self-selected ASMs. We report the results from among those ASMs who attended an outreach medical facility and an occupational health clinic. Data were collected from clinical records using a precoded data proforma. Data variables included demographic (age, sex), clinical details (HIV status, GeneXpert results, outcomes of chest radiographs, history of tuberculosis) and perceived exposure to mine dust. Of the 464 miners screened for silicosis, 52 (11.2%) were diagnosed with silicosis, while 17 (4.0%) of 422 ASMs were diagnosed with tuberculosis (TB). Of the 373 ASMs tested for HIV, 90 (23.5%) were sero-positive. An HIV infection was associated with a diagnosis of silicosis. There is need for a comprehensive occupational health service package, including TB and silicosis surveillance, for ASMs in Zimbabwe. These are preliminary and limited findings, needing confirmation by more comprehensive studies.
Collapse
Affiliation(s)
- Dingani Moyo
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
- Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg 2193, South Africa
- Department of Community Medicine, Faculty of Medicine, Midlands State University, Gweru 054, Zimbabwe
- Department of Community Medicine, Faculty of Medicine, National University of Science and Technology, Bulawayo 029, Zimbabwe
- Correspondence: ; Tel.: +26-(37)-7215-0115
| | | | | | - Godknows Madziva
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Charles Sandy
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Reginald Mhene
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Nicholas Siziba
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Fungai Kavenga
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Florence Moyo
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Orippa Muzvidziwa
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Petronella Ncube
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Blessings Chigaraza
- Baines Occupational Health Services, Harare 024, Zimbabwe; (G.M.); (F.M.); (O.M.); (P.N.); (B.C.)
| | - Andrew Nyambo
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| | - Collins Timire
- Ministry of Health and Child Care, Harare 024, Zimbabwe; (C.S.); (R.M.); (N.S.); (F.K.); (A.N.); (C.T.)
| |
Collapse
|