South Africa's gold industry was founded on the migrant labour system, a system that heavily linked to the apartheid era. Black men from poverty-stricken areas across the south of the continent were cheaper to employ than locals. Even now, more than half of the total workforce in the mining sector is recruited from neighbouring countries. Once they leave the mines, however, they disappear from the radar of the occupational health institutions and the mining houses.
In South Africa, one of the world's largest gold producers, silicosis was identified as an occupational lung disease in 1911. The implementation of the Miners' Phthisis Act of 1922 allowed white miners to receive compensation for diseases contracted in the mines. In 1930, the first conference dedicated to the illness was held in Johannesburg. The current health and safety legislation, however, excludes gold miners. For mine workers, there is a separate act, named the Occupational Diseases in Mines and Works Act (ODMWA), which for a long time "only served the white and coloured workers", explained Thuthula Balfour-Kaipa, the head of the health department at the Chamber of Mines, an institution funded by the mining companies.
The majority of the miners have been and still are black. Up until the 1990s, black men comprised some 90 percent of the mines' workforce, a statistic which has not changed significantly. The majority of those men traditionally came from countries other than South Africa.
According to Balfour-Kaipa, the compensation act has not been implemented properly, even after it was reformed following the fall of apartheid in 1994. "The men are getting less compensation than they should - if they get anything," she said. Balfour-Kaipa does not blame the mining companies, but the government. She says the lack of a functioning public health system in the provinces or countries of origin of the migrant workers is at fault. "The Eastern Cape is one of the most dysfunctional provinces in South Africa," she said. "For Lesotho and Mozambique, there isn't even legislation about occupational health."
Dr Thabiso Kolobe is a general practitioner from Maseru, Lesotho, who only learned about the disease last year. "Silicosis is not a common word here," he said. "Doctors don't think that way, they are not aware of this disease when they see an X-ray." Once a worker returns to his home, chances drop that he will ever be diagnosed with silicosis. "They just die outside in the villages," says Kolobe. "Because there is no organised service, no database of ex-miners, no screening system... Many of those men live in rural areas, so even if it's clearly indicated that they have to come for a screening every six months, they'd have to travel far."