Digging Deeper: National Consultation on Tuberculosis

By Nomagugu Ncube

In August 2012, the Heads of State of the 15 Southern African Development Community (SADC) countries united through the adoption of the Declaration on Tuberculosis in the Mining Sector, in response to the TB crisis in the mining sector in the region.

The Declaration recognizes that mineworkers and ex-mineworkers are at increased risk of occupational diseases such as TB and Silicosis resulting from long term exposure to silica dust in the mines. Traditionally, mines are a major pull factor for labour migration, drawing people from different parts of the country and beyond. In Zambia, the mines draw most of their labour internally from various provinces in the country with a faction coming from neighbouring countries such as Tanzania and DR Congo. These workers, and their families and host communities, are excessively affected by TB due to a combination of challenges, including:

  • Poor or no access to basic health care and social services;
  • Absence of effective cross-border medical referral systems;
  • Non-harmonized treatment regimes
  • Inadequate or no legal framework to protect the rights of ex-mineworkers;
  • Inadequate or no mechanisms for financial compensation for (ex-)mineworkers with TB, Silicosis or other occupational respiratory diseases;
  • Inadequate or no medical surveillance programmes and systems for post-employment follow-up and
  • Lack of information among (ex-) mineworkers, employers, trade unions, and government about their roles, rights and responsibilities in relation to mining, tuberculosis and other occupational conditions.

The Ministry of Mines and Energy, in collaboration with the International Organization for Migration (IOM) spearheaded and supported a national level consultative process to unpack and review the provisions of the Declaration with a view of moving towards implementation in Zambia and to ensure full ownership and domestication of the document. The national consultative process brought together over fifty key stakeholders from various sectors including government (Ministries of Mines and Energy, Health, Labour, Community Development Mother and Child Health and Finance), United Nations (World Food Programme), Center For Disease Control (CDC), Civil Society Organisations, mining houses, mine workers representatives (mine workers unions, ex-mine workers associations); donor agencies (World Bank, USAID), and media houses. The event was also attended by the Permanent Secretaries for Ministry of Mines and Energy and Ministry of Health who provided the much needed government buy-in to the consultative process.

The meeting called for continued stakeholder collaboration and communication on TB in the mining sector. The meeting further noted that the current disjointed approach to programming among stakeholders was a major challenge. The meeting culminated in the development of a plan of action, which IOM Zambia intends to explore for future programme development.  This was aptly put by the IOM Zambia Chief of Mission, Dr. Andrew Choga, who reiterated the organization's “commitment to supporting government efforts to continue to deal with TB in the mining sector”.