In many countries, health and safety legislation is either nonexistent or not effectively enforced and, therefore, greatly influences the number of mining- related work opportunities available for healthcare service providers, such as International SOS, in Midrand, South Africa.
International SOS medical services director Dr Philip Nganwa says some countries – such as the Democratic Republic of Congo – do not have or are unable to effectively enforce the legislation in place, owing to inadequate infrastructure and policies.
“South Africa, however, has and is able to implement its legislation – which empowers officials to perform inspections of mines and enforce Section 54 stoppages, shutting down mines that do not comply with legislative requirements,” he says.
South Africa regulates health and safety in the mining industry through the Mine Health and Safety Act (MHSA), which is enforced by the Department of Mineral Resources, and the Occupational Health and Safety Act (OHSA) – which is enforced by the Department of Labour.
“The difficulty is that the Acts are for two different working environments and, as a result, some mines follow clauses in the OHSA which are contradictory to clauses in the MHSA, most notably where a healthcare professional is legally allowed to carry out the service,” he adds, explaining further, that neither Act overrides the other.
Nganwa further explains that the main difference between the Acts, is that the MHSA refers to occupational medical practitioners, which are doctors only, whereas OHSA refers to occupational health practitioners, which can be both doctors and nurses.
This, he notes, means professionals who can legally work under the OHSA and the MHSA differ, as specified by the Health Professions Council of South Africa, which implies that there could be a difference in the level of service offered, because of the differences in training between doctors and nurses.
Notwithstanding this confusion, South Africa has legislation in place to ensure that mining companies comply with health and safety regulations, Nganwa assures.
However, other African countries lack the resources to hold companies to account and, therefore, are not diligent in upholding such legislation.
“You’ll find that many mining companies that work in countries with no or unenforced legislation get away with murder – literally – because they don’t have medical services in place.”
Medical services are not the core business of mining companies and, subsequently, they often do not have medical divisions in place to look after the medical needs of employees, Nganwa suggests.
“As a result of this, mining employees may be exposed to unidentified health risks resulting in poor health, which can be to the detriment of mining operations, leading to unforeseen delays and costs.”
Subsequently, a company without an internal medical department needs to decide on the level of health risk it is willing to take regarding its projects by deciding whether to engage a healthcare service provider – like International SOS – to conduct a health risk assessment with recommendations, Nganwa explains
“It speaks to ‘duty of care’ – as an employer, you have an obligation to the people that you employ,” he notes, adding that employees cannot be placed in a dangerous environment where they do not have access to the level of healthcare they are accustomed to,” says Nganwa.
Owing to this obligation, International SOS offers clients from all industries on-site health reviews, as well as workplace health risk assessments, to ensure that they are adequately attending to the healthcare needs of their employees.
Site health reviews provide detailed insights into a mining project’s medical hazards and the availability or limitations of healthcare resources around the project area. This enables clients to plan for the provision of proper medical care and undertake preventive measures to avoid illness and injuries.
“Our on-site clinics are not fully [equipped] hospitals, so typically we try to work in conjunction with local facilities in close proximity to mining projects to supplement our resources to help diagnose patients,” Nganwa explains.
International SOS’s workplace health risk assessment is aimed at helping clients to identify and understand how to control exposure to hazards, integrate solutions to mitigate risks and develop or enhance their surveillance programmes.
The company’s Medfit division also offers clients ‘fitness to work’ certificates for their employees who are being deployed to remote sites with inadequate healthcare resources.
This, Nganwa explains, allows clients to identify employees who might be at increased risk of health problems and allows them to proactively put cost-effective measures in place to mitigate these health risks.
“We advise clients accordingly and provide reasonable justifications. The choice to take our advice or ignore it, is up to them – but we provide them with all the information to make an informed decision,” he adds.