South Africa’s gold mines became renowned for mine safety in the 1900s while the mounting rate of silicosis among black mineworkers lay hidden.

In his book, South Africa’s Gold Mines and the Politics of Silicosis, Professor Jock McCulloch, of Australia’s RMIT University, investigates how South Africa managed to hide disease among its workers for more than a century.

“The key to the discrepancy is the way in which data was collected,” McCulloch tells Mining Weekly.

In 1916, the Miners Phthisis Medical Bureau was founded to assist mineworkers with compensation claims. The bureau was also tasked with collecting data and publishing the yearly disease rates for miners phthisis (silicosis) and tuberculosis (TB), which were compensatable diseases.

However, while the bureau examined white miners itself, it outsourced the examination of black miners to mine medical officers, who could then report cases of silicosis or TB to the bureau, McCulloch explains.

“The problem was that, in outsourcing the examination of black miners to mine medical officers, it was being assumed that those officers would act against the best interest of their employers and report all cases of occupational disease, which they did not,” he says.

Also, while the Miners Phthisis Medical Bureau had a supervisory role over the medical examinations of black miners, the supervision was not carried out effectively.

Therefore, when the bureau published its results, the data showed that there was little disease among white miners and virtually no disease among black mineworkers, he adds.

“As a result of this data, when the world looked at South Arica’s gold mines, it saw that the silicosis rate among black mineworkers was only 0.2%, and came to the conclusion that the mines had to be safe.

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McCulloch states that the small number of silicosis cases reported was not a result of a lack of medical knowledge.

“Silicosis and TB are difficult to diagnose, but it can be done if the required amount of time and resources are spent on each patient. To successfully diagnose these diseases, X-rays have to be taken, the person has to be examined and a work and medical history should be taken.”

However, there were too many miners in the system for this to be done. By 1930, there were more than 100 000 black mineworkers, most of whom were serving 12-month contracts.

In around 1920, one of the larger mines may have had one medical officer for every 12 000 black mineworkers, which made it impossible for the mine medical officer, no matter how diligent, to pick up much of the disease, says McCulloch.

“To implement an effective system would have been expensive and the mining companies were not willing to carry the cost, and the State was not willing, or able, to pressure the mining companies to do so, thus leading to ineffective data on the rates of disease,” he says.

To realise the full effect of what was hidden, one could compare the reported silicosis rate of 0.2% to the current silicosis rate, as determined by research, which is more than 20%.

McCulloch states that he interviewed a former consulting doctor of the Miners Phthisis Medical Bureau, GWH Schepers, who worked at the bureau from 1944 to 1952.

“Schepers was a whistle-blower who believed that the mines were exporting the disease by sending sick mineworkers back to the areas from where they came, and that it was policy not to make compensation awards to diseased miners.

“These statements cost Schepers his career in South Africa; however, he stated that his claims were not of a political nature but rather that he was simply trying to practise medicine.”

Schepers told McCulloch that it was extremely difficult for a white worker to get compensation for occupational disease during the 1940s and 1950s, and that it was virtually impossible for a black miner to get compensation during this period.

“The policy was to work white mineworkers until they were too sick to work, while sending black mineworkers with TB back to the rural areas from which they came.

“Schepers told me that this was common knowledge in the mine medical community in Johannesburg and that he also believed that this was common knowledge within the major mining companies,” McCulloch says.

Change
After 1994, this started to change as a massive shift took place, coinciding with majority rule.

“New techniques of diagnosis were not used but researchers went into labour-sending areas, carried out autopsies to determine the true effect of the disease, and found it to be a hundredfold higher than was previously reported.

“If you look at the figures in a naïve way, you could say that South African mines were safe before 1994 as the disease rates were so low; however, after 1994, a dreadful coincidence took place. The mines go from being the safest in the world to being dangerous, and, of course, the explanation for this is the political setting, emphasising that the situation was created by politics,” McCulloch says.
“While the goal was not to have a fraudulent system, through the legislation, the lack of State control over the process and the outsourcing of the medical examinations of black miners, what we now in retrospect view as close to a fraudulent system of reporting and compensation was created,” he says.

Disturbingly, however, is that in a study done by Rhodes University’s Dr Jane Roberts about five years ago, during which she interviewed a cohort of former mineworkers in the Eastern Cape, she found that 85% of the workers had not had an exit medical examination aimed at picking up compen- satable disease.

“This is disturbing because it seems that the policy not to give workers medical exams for fear of picking up diseases, that Schepers spoke about as being prevalent in the 1940s and 1950s, is in fact still alive and well, although we do not know how widespread this phenomenon is,” he concludes.