By Zina Shanahan
There is little doubt that mining has an adverse affect on the health and well being of people living and working in mining regions. Health is impacted by factors including air pollution, noise pollution, water contamination and migrant labour. In some cases the effects are noticeable immediately, but for many mining related illnesses, symptoms take some time to manifest. These long term effects are particularly serious as they are preventable, but may not be identified until it is too late.
Air contamination by dust particles is one of the biggest causes of illness in mining related communities, and has serious impacts in both the short and long term. In 2006 The Energy and Research Institute (TERI) produced a report on health and human well-being in mining affected
Pneumoconiosis is an occupational lung disease caused by long-term exposure to dust. In the context of coal mining it is popularly known as the black lung disease. In asbestos mining it is known as asbestosis. If the dust is of iron origin, such as in
Another serious illness associated with various mining industries - including iron - is silicosis. This disease is caused by the inhalation of crystalline silica dust - which is odorless and non-irritable, thus easily confused with regular dust. Several months of exposure to this contaminant can lead to complete loss of lung function as well as increased susceptibility to tuberculosis, bronchitis and lung cancer.
Tuberculosis (TB) is a widespread preventable illness in
Equally as serious as dust pollution, but less visible to the naked eye, is the threat of water contamination. Like dust pollution, water contamination has immediate effects as well as others that may take several years, or even decades to manifest. People in
Existing data on the effects of ingesting excess amounts of manganese are scarce; however symptoms that have been associated with ingestion include poor memory, lethargy, tremors and mental disturbances. More comprehensive studies which have examined the long-term effects of manganese dust inhalation observe weakness, anorexia, muscle pain, apathy, slow speech, monotonous tone of voice, emotionless facial expression, and slow clumsy movement. In general, these effects are irreversible.
Furthermore, there is the possibility of iron contamination. This is a threat both to water supplies and also in the potential presence of metals in crops grown on mining reject dumps. TERI’s report briefly addresses the latter threat, however the results are largely inconclusive – indicating that further research into this issue is crucial. What is apparent from this report is that an excess of metals in mining dumps can accumulate in plants which can affect humans both through direct consumption and through the food chain. There are serious risks involved in re-vegetating mining dumps for local consumption and export, risks which need to be explored with closer attention in
According to the Iron Disorders Institute in the United States, iron overload can lead to chronic fatigue, joint pain, infertility, premature cessation of menstrual cycle, changes in skin colour, jaundice, abdominal pain, depression, high blood sugar, weight-loss, shortness of breath, chest pain, heart arrhythmia, depression, enlargement of spleen and elevated liver enzymes. Even mild cases of iron overload increase the risk for liver disease (cirrhosis, cancer), heart attack or heart failure, diabetes mellitus, osteoarthritis, osteoporosis, metabolic syndrome, hypothyroidism, hypogonadism, and in some cases premature death. Iron overload can also accelerate such neurodegenerative diseases as Alzheimer’s, early-onset Parkinson’s, Huntington’s, epilepsy and multiple sclerosis, while acute iron poisoning can lead to organ damage and death.
A third potential threat to the safety of water is arsenic poisoning. As per the 2008 report, ‘
The most important remedial action to prevent chronic arsenic poisoning is the provision of safe drinking-water. The cost and difficulty of reducing arsenic in drinking-water increases as the targeted concentration lowers, and the technology for measurement of arsenic in drinking-water at levels relevant to health, as well as the removal of arsenic from the water supply is costly and requires technical expertise.
In addition to air and water contamination, the mining industry threatens local health through the emergence of migrant labour. In July of this year, Dr Prabhudessai was visited by his first patient suffering from chikungunya. The young man was suffering from a high fever, and the doctor gave him symptomatic treatment, not immediately recognizing the disease as it was until then unknown in this area. On the third day the man returned, still suffering from fever. On examination it was revealed that the man was also suffering from joint pain and a rash. Soon after this, patients began coming more and more frequently, until the doctor’s average of 20 patients per day had increased to 80, all complaining of the same symptoms. In total, the Doctor attended to between seven and eight hundred chikungunya patients, believing that around seventy percent of the community was afflicted. With so many people coming down with this illness, the doctor explained that people were becoming anxious. “Suddenly a young fellow is not able to do anything. Suddenly he can’t move. He becomes so incapacitated and depends on his other fellows to help him. He is not able to walk.” In this case individuals suffered relapses for an average of 2-3 months. Dr Prabhudessai has no doubt that the chikungunya epidemic was related to the mining industry, specifically as a result of migrant labour. “It was brought by a person, he was suffering from chikungunya. He was bitten by a mosquito, which got infected, so the locals got infected.” Unfortunately there is little research done into chikungunya in
In addition to the chikungunya epidemic, there are other diseases popping up in the community including HIV and Hepatitis B. These diseases were until recently unheard of, but with the increase in migrant labour, foreign diseases are beginning to infiltrate mining regions. Such communicable diseases are not only damaging in and of themselves, but they pose the additional threat of increased susceptibility to further illnesses prevalent in these communities.
Despite the increasing ill health of people in mining areas, medical services remain limited. The number of doctor’s posts sanctioned to serve the mining areas is low in comparison to government norms. Additionally, TERI’s research suggests that sanctioned positioned often remain unfilled. For example, in Sanguem Health Centre there were seven doctors in 2006, and now there are only five. Primary Health Centres, the main medical facilities serving mining affected communities, are not required to have specialists. The Bicholim and Saquelim health centres have x-ray facilities, but these are not always available and there are no on-site radiologists. The x-rays must be sent to Mapusa for analysis. At the Sanguem centre, there is no x-ray facility at all. There are no facilities for pulmonary function tests in any of the health centres contacted. In communities suffering from extremely high levels of respiratory illness, including tuberculosis, the basic facilities provided by the health centres are certainly inadequate. For further facilities patients must access the private health sector (which is usually more expensive and likely to be located in urban areas) or district centres (which are usually further away). What with the traffic congestion created by mining trucks paired with the demands of work and family life, it is difficult for many people to access distant medical facilities and receive proper treatment.
As per the Mines Safety Act of 1952, mining companies are expected to provide emergency facilities, regular health checkups for workers and free consultation facilities at mining dispensaries. TERI’s report suggest that only some companies are providing these services, and further research suggests that where these services are provided, they are inadequate. The report also states that the Mineral Foundation of Goa ‘provides some community health facilities from time to time.’ The details of these remain unspecified.
Locals in mining affected areas are generally dissatisfied with the available medical services. Complaints include long waiting times, ineffective treatment, difficulty in accessing services, not enough centres, unavailability of medicines, lack of equipment and doctors, and lack of ambulance services.
When I asked Dr Prabhudessai about the services provided by the mining companies in his area, it became clear that without his private practice, the community would not be adequately served. One doctor is sanctioned by the mining company to provide services in the community, however he is appointed to five or six places. His schedule is not dependable, and he may attend the community for only an hour or two, for a few days each week. He is not available at many times, and does not stay in the community overnight. And as the Doctor put it, “If you create a disease and then you say, ‘I am giving you somebody to cure the disease’, it is not the right philosophy.” For this reason, many community members will refuse to see the company doctor, preferring to visit Dr Prabhudessai’s private practice – a place where the doctor will not only treat them, but stand beside them and fight against a major source of their ailments: the mining companies.
The illnesses and diseases discussed here are only the tip of the dry and dusty iceberg of health concerns that these communities are facing. Further health impacts to consider include the effects of air pollutants on the eyes and skin, stresses on the body of mine workers, such as hearing impairment, lower back and sciatic pain and lumbar inter-vertebral disorders. Cancers of the lung, bronchus, and trachea have also been associated with iron mining elsewhere.
Additionally, the psychological impact of mining on local communities must be devastating. In Colomba, Dr Prabhudessai, his wife and many other community members were arrested for protesting against a mine situated on community land. The matter of ownership of this land has been in court for two years, and while it remains undecided, mining is allowed to continue. In order to gain control of land for mining, companies are well known to employ the tried and tested technique of divide and conquer and in some cases have successfully destroyed community relations based on differences of religious belief, caste or other distinctions. The pressure to succumb to the demands of the companies is heavy. People in Dr Prabhudessai’s community are suffering high levels of anxiety, and the use of anti-anxiety medication is on the rise. He has found that sleeping troubles, mental agitation and high blood pressure are also prevalent; symptoms that you would not usually expect in such a small, remote community.
Alcoholism is also a serious problem, and not only because it increases the individuals susceptibility to various diseases. Alcoholism is well documented as a common problem in mines across the globe. Dr Phabhudessai described how there are now many young women in local villages, widowed because of alcoholism. “If you sit with me in my consulting room, you will find widows coming, young widows. These mines are creating alcoholism, thereby creating more widows.” Liver failures, peptic ulcers and traffic accidents are just some of the ways that alcohol is killing young men who should be in their physical prime.
The economic impact of poor health in mining regions is also substantial. According to TERI's report, the economic cost of ill-health due to exposure to air pollution alone in
Mining is considered by many to be the backbone of