The dangers of TB in mining

By Sharon Kavhu recently in Totororo, Zimbabwe

In a bid to provide for his family, the late Tobias Mupeta worked tirelessly as an informal gold panner at Empress Mine and Donald Mine, Zhombe Zimbabwe.

Despite the risks of being caught on the other side of the law, his job exposed him to the jaws of respiratory infections as he worked without any protective clothing.

After being in his field of specialty for roughly nine years, the late Mupeta was diagnosed with Tuberculosis (TB) and sadly in a space of eight months, the infection stole his life.

“He was diagnosed of TB in December, 2014 at Kadoma Hospital after a persistent dry cough that ended up making him spit blood.

“At the hospital they said he was suffering from pulmonary TB so they initiated him on a TB treatment course which was expected to be complete after six months,” said Anna Sigandiwa (22), a wife to the late Mupeta.

Her husband left her alone with two children.

“He started his TB treatment sometime in January last year. However, after five months on treatment course, he was not improving and we did not have money for him to go for a review at Kadoma Hospital.

Therefore, we went with him to a local clinic but, they insisted that we go for a review at Kadoma Hospital,” continues Sigandiwa.

“During that time we had serious money crisis so we could not afford to go with him to Kadoma. Instead, we decided to go back with him to the local clinic where we pleaded with them to give us any medication just to ease his pain.  His coughs were now terrible and had severe chest pains.”

She said her late husband was given some pills to ease the pain while they were looking for enough money to go to Kadoma Hospital for a TB review.

A few weeks down the line, Mupeta got so ill that he could not eat or walk, thus he was ferried to Kadoma Hospital by some well-wishers.

The 22 year old widow continues: “Upon his arrival at the hospital, he was admitted and the doctors told me that he had developed a drug resistant TB. Unfortunately, he then died a night after his admission.”

Mapeta’s case encompasses one of the many issues adversely affecting people in mining activities across the Southern African Region.

According to International Union Against Tuberculosis and Lung Disease (The Union), miners in Southern Africa are three times more at risk of contracting TB compared to other working population.

Speaking to The Southern Times, The Union country director, Dr Christopher Zishiri urged people in mining activities to be precautious enough to wear protective clothing for their health sake.

“In Zimbabwe, we are currently working together with Ministry of Health and Child Care (MoHCC) and National TB Control Program (NTP) to ensure that people in mining activities have received health education on TB and mining,” said Dr Zishiri.

“On the other hand, we are also working hand in hand with Bio Medial Research and Training Institution of Zimbabwe in finding TB cases among mining communities including artisanal mining communities.

“So far we have covered two districts in Mashonaland Central and the programme has moved to Matabeleland South.

It is starting small then eventually it will cover a wider ground.” “However, The Union does not provide occupational health and safety measures to mine workers. It is the responsibility of the mining company.  Protective clothing is always the first line of preventing injuries and infections.”

He said miners are exposed to a lot of dust which can damage their lungs leaving them vulnerable to TB infection.

Dr Zishiri added: “We recommend the mine management to reduce the exposure levels to dust for miners and the National Social Security Authority (NSSA) is the enforcing organisation.”

In a separate interview, Zimbabwe MoHCC deputy director of HIV, TB unit Dr Charles Sandy said his ministry is a limited role to monitor mine environment activities but, the area is key in the national TB response programs.

“That role is undertaken by NSSA and the Ministry of Mines, Zimbabwe. Currently, NSSA has an occupational Health and Safety programme which includes TB and the Ministry of Mines monitors exposure to dust as well as underground ventilation,” said Dr Sandy.

“The clinical standards for prevention, care and treatment of TB are set by the MoHCC and all stakeholders including NSSA are expected to abide by those standards.

“It is important for people in mining activities in the region whether formally or informally to wear protective clothing in order to minimise exposures to various agents which may pose a health risk,” added Dr Sandy.

He said mining in dusty environment especially with prolonged exposure to silica dust increases risk for TB.

While some individuals are lacking knowledge of TB especially in remote areas, Dr Sandy told The Southern Times that it will be ideal to disseminate information on TB and mines in remote areas through radios, TV, peer educators, newspapers and pamphlets.

TB is an infection caused by a bacterium called mycobacterium tuberculosis; the bacteria usually attack the lungs causing what is known as pulmonary TB.

According to ‘Stop TB’, when the TB bacteria attack any other part of the body such as the kidney, spine and brain it causes what is known as extra-pulmonary TB.

TB is the number three cause of death among women of childbearing age and the number four cause of death among women of all ages.  Globally, more than half a million women die of TB each year.

On the other hand, it has been reported that half a million children are infected by TB on annual bases.

Zimbabwe is one of the 30 high burden countries, which collectively account for 85 to 89 percent of the TB cases globally.