Conclusion: Records, Bodies and Contested Justice

Abstract

The conclusion draws together the main themes of the book and brings the story of the miners’ class action up to date.

For most of the twentieth century, gold mining dominated South Africa’s economy. Through their extensive use of migrant labour, the industry helped shape the economies—and populations—of the southern half of the continent. The mines led the world in the use of science, provisions for compensating occupational injury and state oversight of the industry. Yet their reputation for excellence was undeserved. Rather, the collusion between the state and the industry in suppressing the knowledge of risk, the publication of misleading data and the use of publicity is best characterised as the manufacture of ignorance. In particular, the systematic failure to collect health statistics and employment records impeded the accumulation of comparable data, prevented the consolidation of epidemiological evidence and so played a significant part in hiding an epidemic of occupational lung disease.

In the first half of the twentieth century, the South African gold mining industry helped shape and consolidate apartheid. The gradual dismantling of this system in the 1990s presented both the industry and social justice advocates with far-reaching challenges. The recent settlement of the miners’ class action and establishment of the Tshiamiso Trust coincided with sharp decline of the gold mining industry and struggling ODMWA compensation system. Lack of administrative capacity, patchy employment records, difficulties in diagnosing silicosis and TB and shortages of medical staff have been exacerbated by the COVID pandemic. These and other issues have become the focus of a Justice for Miners campaign. The chapter concludes by noting that those who support miners injured in South Africa’s process of wealth accumulation—propose solutions to practical problems, conduct research into occupational diseases and mobilise local communities—make a double contribution to social justice. They assist miners and their families receive compensation, and help heal longstanding injuries to the region’s civil society.

This chapter was written four years after Jock McCulloch’s death from mesothelioma by his partner Pavla Miller. It summarises the arguments made in the previous chapters and outlines some of the challenges in implementing the class-action settlement.

Political Economy and Health

For most of the twentieth century, gold mining dominated South Africa’s economy. Unlike agricultural produce, it was impervious to bad seasons or fluctuating prices. For several decades, it accounted for more than half of the country’s exports. Between 1931 and 1961, it supplied between 12 and 42 per cent of government revenue. In 1941, the mines employed 410,000 workers; at their peak in 1986, 534,000. The mining corporations drew on international capital and advanced technologies to consolidate their size and success. The fixed price of gold enabled them to act in unison in pursuing a common political agenda. Through their extensive use of migrant labour, they helped shape the economies of the southern half of the continent.

Several factors drove recruitment to South Africa’s gold mines. Foremost among them was the Chamber’s determination to control production costs. Recruiting labour from territories to its north and paying black miners below-subsistence wages was a central part of this process. Equally important was Britain’s (and Portugal’s) desire to minimise outlays on colonial administration. The labour system constructed around these twin imperatives shifted the enormous social costs from the region’s most profitable industry onto the families and communities of migrant workers. As a critic of the WNLA concluded in 1948, ‘[t]he South African gold mining industry is permanently dependent upon being subsidised by a semi bankrupt African peasant pastoral economy in the distant reserves beyond its own national borders’.¹

The Rand mines had a distinct relationship with the state and with science. In this way, they helped shape a particular and deeply contradictory form of what Foucauldian scholars call biopolitics.² They were the first in the world to be subject to a comprehensive system of state regulation, including the mandate to compensate hard rock miners who contracted silicosis (1911). The mining houses also led the industrial world in the use of science and the collection of data. By 1916 they helped set up the South African Institute of Medical Research and the Miners’ Phthisis Medical Bureau. One of the first professional associations of occupational health specialists, the Mine Medical Officers’ Association, was founded in 1922. Those who admired the South African legislation were unaware that in 1916 the state effectively handed over the conduct of black miners’ medical examinations to employers, who thereby gained control over access to compensation. That control went unchallenged until the Leon Commission in 1994.

Under the South African Acts, a three-step occupational health regime was gradually built up for white miners, with periodic X-rays, sanatorium rehabilitation and care for those who fell ill, and education for families. The routine for dealing with black miners was considerably different. Sick and dying men whose tuberculosis was identified during entry, periodic and occasional exit medicals were repatriated to their rural homes. Early warnings about dangers of the Chamber’s approach to black miners proved to be justified. From 1920, evidence about the devastating impact of NRC and WNLA’s recruiting mounted. It came in the form of repeated warnings from District Medical Officers about men returning from the mines with tuberculosis, and it was obvious in the high rejection rates at entry medicals of men who had served multiple contracts. There were also clear warnings from medical specialists. The spread of tuberculosis from the mines, they argued, could have been reduced by the use of X-rays at exit medicals, the segregation of infectious men in mine hospitals, notifications of repatriated miners to local health authorities, and the provision of information to miners and their families about avoiding infection. Finally, the industry could have monitored miners after they returned home.

There were many factors which, in theory at least, should have made recommendations such as these easy to implement. British governments, the administrations of the HCTs and the ILO all took a keen interest in the welfare of migrant labour. In principle, that interest was supported by the progressive South African legislation with its government-controlled system of medical surveillance designed to protect miners and their families. South Africa’s gold mines were also distinguished by their remarkably high levels of bio-medical knowledge. The research clusters of the Bureau and the SAIMR in Johannesburg, which did not exist elsewhere in the colonial world, were created specifically to service the gold mines. The size and profitability of the gold mining industry meant that each of the measures for controlling an emerging epidemic of tuberculosis lay well within its grasp. Instead of implementing them, the industry chose a different path: the manufacture of ignorance.

The Manufacture of Ignorance

This book has charted the making, updating, revising, challenging and transforming the complex edifice of employment and risk management in the South African gold mining industry. A core strand of the argument has been the discrepancy between the official invisibility of occupational lung disease during most of the twentieth century and its prominence since South Africa’s transition to majority rule. The best shorthand description of this discrepancy is medical involution, or more starkly the manufacture of ignorance. The histories of asbestos and tobacco litigation show that those industries have systematically suppressed evidence of hazardous work practices and the risks associated with their products. The creation of ignorance is subtler and more effective than simply hiding the evidence of risk. Suppression leaves gaps in the knowledge of risks; the fabrication of false knowledge fills such gaps with misleading information.

South African gold mining companies have long argued that the unique character of their deep mines made it inappropriate to judge working conditions there against international standards. That claim is open to question. However, another aspect of the South African gold mining industry almost certainly was unique: namely, the degree of collusion between the state and the industry in suppressing the knowledge of risk, the publication of misleading data and the use of publicity. The gold and asbestos industries in Southern Africa used different methods in dealing with the science of occupational health. Before the 1950s there was no state regulation of the asbestos industry, no medical monitoring and no data collection. The absence of engagement in public and scientific debates about asbestos contrasted with high levels of state regulation and the endless streams of data on disease rates, miners’ health and dust levels which spilled out of the Rand gold mines. South Africa’s gold industry preferred to capture the scientific debates from within and achieve state agreement with its labour practices by using massive information flows.

Several factors helped produce this outcome. The racialised labour regimes and the insidious character of pneumoconiosis were influential. So too was the nature of the research community in Johannesburg. For most of the twentieth century, there was no employment for researchers outside of the Chamber or the state, and it was the Chamber which largely set the research agenda and decided upon models of data collection. While the industry strenuously opposed gathering and sharing information on the incidence of tuberculosis, it was preoccupied with measuring dust counts. Such data was expensive to collect and to process. It also presented many technical problems, among them equipment limits and failures, the size of the particles, their silica content and vastly different dust levels at different times and places in vast mine complexes. The free silica content on the Rand, for example, varies between 35 per cent and 80 per cent of the rock. As a result, dust counts in themselves meant little; whatever readings were recorded did not constitute a definitive proof that dust levels remained at a ‘safe level’. ³ And yet, as the Johannesburg conferences of 1930, 1959 and 1969 demonstrate, questions relating to dust counts preoccupied researchers at the SAIMR and PRU for decades. In turn, the more data on silicosis released into the public domain, the less visible was the actual disease and mortality burden.

The manufacture of ignorance on South African gold mines, which arguably underpinned the industry’s profitability for most of the twentieth century, was a challenging and expensive project. The Commissions of 1902, 1912 and 1914, augmented by the 1914 Gorgas Report, provided sufficient evidence of occupational disease for the South African government to ban the recruitment of labour from the Tropical north. That decision was supported by research conducted in the 1920s and 1930s, which suggested that there were high rates of silicosis and tuberculosis, and that the mines’ policy of repatriating sick men was spreading tuberculosis to rural communities within South Africa and through the migrant labour system to adjoining states. These findings were endorsed by the Stratford and Lansdown Commissions of 1943, and again by the Oosthuizen Committee Enquiry of 1954. Despite all these warnings, the Chamber failed, over several decades, to inform the administrations of labour-sending states of the risk to public health posed by men with tuberculosis returning from the mines. By 1937, it succeeded in having the ban on the recruitment of tropical labour lifted. Until the 1990s, it also failed to carry out follow-up research into the health of ex-miners.

From the first decades of the twentieth century, the industry argued persuasively that it gradually succeeded in engineering silicosis out of the mines, and that tuberculosis was not an occupational disease, but rather was brought to the mines by infected African workers. The data presented in the annual reports of the Miners’ Phthisis Boards offered a record of ceaseless improvement in which South Africa led the world in mine safety. Between 1917 and 1935, the reported annual silicosis incidence rate among the whole workforce of white miners fell from 2.195 per cent to 0.885 per cent. For black miners the rates presented were even lower, falling to 0.122 per cent by 1934–1935. The data was accepted as authoritative by the international community and South Africa’s achievements featured prominently in science and policy debates in Australia, France, Belgium, Germany, Italy, Japan, the UK and the US.⁴

Migrant labour, the Chamber maintained, was episodic. Men would go to the mines to meet specific needs such as the purchase of cattle, and permanently left the industry once those needs were met. The Chamber also promoted the fiction that migrant labour had important health benefits. While at work, the miners were ‘gloriously well fed’. The periodic breaks from mining associated with oscillating migration reduced dust exposures and therefore silicosis rates. By preventing urbanisation, migrant labour also protected peasant communities from the tuberculosis that was rife in urban centres. Somehow, confining men in single-sex compounds for months at a time, and preventing their wives and children from joining them, at once preserved and modernised traditional societies. During the 1940s a number of Commissions, including Lansdown (1943) and Strafford (1943), subjected that orthodoxy to scrutiny. They found that migrant labour was driven by poverty and that without such income families in labour-sending areas starved. Of necessity, men continued to work on the mines as long as they could. Typically, they left the industry when their health deteriorated to such an extent that they failed the next entry medical.

The Chamber did not initially recruit miners from outside of South Africa in order to hide occupational lung disease. Over time, however, it structured the migrant labour system so it did just that. The cursory nature of mine medical examinations, the recruitment of Tropical labour, repatriation of sick miners without compensation, the failure to conduct exit medicals or notify regional authorities of tuberculosis cases, combined to obscure the extent of pneumoconiosis produced in the gold mines. Such manufactured ignorance was enhanced by the industry’s refusal to pay pensions (which would have required monitoring the men’s post-employment fate) rather than lump sum compensation, and consolidated by its failure to carry out follow-up studies of ex-miners’ health.

Lies and Statistics

Many scholars rightly point out that during the nineteenth and twentieth centuries, the collection and ever-more sophisticated manipulation of statistics went hand in hand with increasing governmentality, or the capacity of state institutions to perceive, monitor and govern populations. Such process, many imply, is a bad thing. This book makes a different point. The systematic failure to collect statistics too could become a technique of rule, not least by impeding the accumulation of comparable health data and preventing the consolidation of epidemiological evidence. In particular, the deliberate obstruction of state intelligence played a significant part in hiding an epidemic of occupational lung disease—not only from the miners themselves but from the white electorate in South Africa, the administration of adjoining states, the British government, international organisations such as the ILO and UN as well as a transnational public of social justice advocates.

The lack of meaningful statistics about miners’ health provoked a chorus of complaints from medical practitioners and local administrators. The regular reports published by mining industry bodies such as the WNLA did contain numerous statistical tables and graphs. However, valuable information presented for a short period was suddenly discontinued, key categories changed from year to year and important details were missing. There was, for example, no information about the miners’ age, work experience, years since first exposure, the kind of work they performed or the types of mines on which they were employed.⁵ For its part, during what were often protracted negotiations with the South African mining industry, the British Colonial Office never specified what it considered an acceptable annual number of deaths per thousand recruits, nor did it ask for detailed morbidity and mortality statistics.

Negotiated Diseases

The compilation (or not) of statistics overlapped with a subtler process at play, one concerned with identifying and classifying diseases, and establishing the medical and legal boundaries between health and disability. As this book has shown, these contests were not just about words; they were crafted out of a complex fabric of toil and misery, and in turn had far-reaching material consequences.

In some instances, the identification of disease involves a simple binary divide: you either have it or you do not. More frequently, it requires drawing a line at a particular point on a continuum—or indeed debates about whether there is a continuum, and what it looks like. Where the line is drawn is subject to contestation: it depends on scientific knowledge and medical technology, but always also includes a complex reconciliation of social norms, expert knowledge, local capacity and the views of powerful actors. At times, consensus is reached easily. More often, as in the story told in this book, it is subject to fierce and extensive contestation, played out in commissions of inquiry, legislation and government and industry regulations. The articulation of what does and does not constitute occupational disease is particularly fraught. By definition, occupational diseases are negotiated categories, forged in complex contests and accommodations between different powerful groups, political parties, unions and social movements, insurance companies, professionals, policy frameworks, scientific knowledges, legal systems and fractions of capital. ‘Safe level’ of silica dust, for example, was a rubbery negotiated category, far more arbitrary than the common-sense understanding of dust levels low enough not to cause injury. Rather, the thresholds represented a political compromise between medical uncertainty regarding the causes, symptoms and diagnosis of silicosis; technical problems encountered by the manufacturers of measuring equipment; companies’ preoccupation with healthy profits, and workers’ concerns with their own health.⁶

Finally, even in jurisdictions with well-funded medical facilities, there are wide disparities between different social groups in the incidence, diagnosis and access to treatment of specific diseases. In Southern Africa, gaps between the health status, diagnosis of disease and access to care between black and white populations have historically been vast, as has been their legal—and practical—access to compensation for injury.

Law, Politics and Health

There are narrow and broader definitions of politics. The narrow ones focus on state institutions, governments, political parties and elections. The broader ones widen the scope to encompass the deliberate input of powerful actors and effects of social structures into the negotiations, decisions and non-decisions affecting the life of the community. Using such broader definition, this book charted the negotiations, decisions and non-decisions which structured approaches to the mining of gold, the buying and selling of mine labour, the descriptions and classifications of risk and the manufacture of ignorance about occupational lung disease. In effect, while not employing the technical terms used by scholars writing on biopolitics, the book has traced a complex story of the interface between politics and population health.

In the first half of the twentieth century, the South African mining industry played an important role in the shaping and consolidation of apartheid. The gradual dismantling of this system in the 1990s, as well as the wave of anti-colonial struggles throughout the continent, presented the mining industry with far-reaching challenges. Certainly, as the Marikana story with which this book opened shows, majority rule did not result in a sudden transformation of South African politics. More broadly, as Francis Wilson concisely put it, ‘the very process that generated wealth in the economy simultaneously produced poverty and patterns of unemployment that still hobble South Africa as it struggles to democratize in the twenty-first century’.⁷ But neither is it possible to underestimate the extent and significance of the changes brought about by the transition to majority rule. The legal standing of citizens, whatever the colour of their skin, has been particularly important. Miners’ compensation for occupational injury provides a compelling picture of both sides of the coin.

As noted in previous chapters, for most of the twentieth century the mining houses succeeded in preserving a compensation system designed to minimise their liability for occupational injury. When, in 1943, the Government Actuary costed what the Stafford Commission regarded as a fair compensation system, the mines protested that they could not afford to pay. The Commission responded that if that were true the mines must be so dangerous that they should be closed.⁸ The Commission’s report was shelved, and the mining houses continued as before. Half a century later, many of the racial categories and hurdles built into the system having been removed under the new post-apartheid constitution, the extent of occupational disease became clearer—and the problems of insolvency have been amplified. As one of the medical researchers working to reform the system explained it, the Miners’ Compensation Fund is financed by levies on the mining industry, although at various points the state has had to supplement this fund from general taxation. However, the budget for the administration costs of the system, including medical staffing, comes from South African taxpayers via the Ministry of Health. This funding has failed to keep up with the needs of affected miners. In 2004, an actuarial study confirmed that the Fund was technically insolvent even on the basis of the then current claims, and that the levies paid by the mining industry needed to be raised 100-fold over a 15-year period to meet liabilities. In the same year the auditor-general referred to the financial controls of the Fund as a shambles.⁹

At their peak in 1986, the mines employed well over half a million workers, by 1999, less than half that number, and by 2022, around 95,000. In effect, a declining industry is faced with compensating ever increasing numbers of miners suffering from occupational lung disease, which often flares up a decade or more after exposure. As a result, what had already been an imperfect system all but ground to a halt. Under-resourcing of the compensation agencies responsible for certifying occupational lung disease, unwieldy panels tasked with adjudicating compensation claims and administrative failures of the Occupational Diseases in Mines and Works Act (ODMWA) system resulted in massive backlogs in payment and verification of claims.¹⁰ As before, the burden has fallen particularly heavily on black workers from Southern Africa’s labour-sending regions.¹¹ One typical study of the claims experience of 90 former gold miners diagnosed with silicosis at Groote Schuur Hospital in Cape Town between 1993 and 2005 found that only one in five received compensation, and even those had to wait between one to five years for the certification and award of their claims. In the intervening months and years, many of those entitled to compensation had simply given up.¹² Despite some progress in clearing the backlog, in 2019 an average of 12,000 claims per month, excluding those not yet entered into the new electronic database, awaited final medical adjudication, with an average delay from the initial medical examination to certification of 583 days. The claims management information system has been upgraded in recent years and peripheral examination centres were opened. At the same time, occupational health specialists and medical researchers made progress in working out how to deal more expeditiously with the backlog of claims and speed up the processing of new ones. Nevertheless, it has been difficult to find and appoint sufficient skilled medical staff to adjudicate a large volume of claims within statutory requirements.¹³

The interface between impoverished former miners and an imperfect administrative system requiring precise information compounded the problems. Among the hurdles identified by Trapido in her 1990s research on former gold mineworkers in the Eastern Cape were incorrect transcription of addresses at the MBOD or CCOD, poor postal services in rural areas, low literacy among miners and their families and limited banking services.¹⁴ Rodney Ehrlich, writing in 2007, painted a similar picture. Even should a former mineworker find his way into the system, he noted, a further hurdle awaited—to prove his goldmining service. Some record of mine service had always been required, but until recent years the miner’s own recall, together with a fingerprint record, was accepted. In response to some incidents of fraud, the Compensation authority began insisting on some original record of service. In the experience of his team, only one in two and perhaps as little as one in three mineworkers could produce such evidence. A few, particularly those with more recent service and longer contracts, retained their personnel card and may have an extant record at the mine. Frequently, however, service was long past and consisted of a number of contracts at different mines. A surprising number of mineworkers lost the remaining scraps of documents tying them to their past in the fires which frequently ravage informal settlements. As far as the system was concerned, their mine service had been expunged from the record.¹⁵ In order to address issues such as these, the Minerals Council undertook a massive process of digitising data relevant to compensation for occupational lung disease—a project hampered by the historic reluctance of mining houses to generate and to keep employment records.¹⁶ It is in the context of challenges facing ODMWA system that the settlement of the miners’ class action needs to be seen.

The Miners’ Class Action

Prior to majority rule, the concept of an individual miner suing an employer for occupational lung disease was foreign to South African law. The system established from 1911 under the various Miners Compensation Acts was always assumed to preclude workers’ capacity to sue employers, and there is no evidence of a black miner bringing a case to court. The law also made no provision for class actions. This has now changed. In 1994, the ODMWA was amended to remove overt racial discrimination for compensation.¹⁷ More broadly, the respective legal standing of employers and workers was transformed. Under Section 34 of the Constitution, every South African has the right of access to justice while Section 38 opens South African courts to class actions. Those clauses have altered the types of claims which can be brought before a court and the kinds of people who can seek legal redress.

The improbable legal victories by asbestos miners over the British company Cape Plc and the South African conglomerate Gencor in 2003 have pioneered such claims. The plaintiffs were impoverished communities in the Northern Cape who on appeal to the Law Lords in London successfully pursued an extra-territorial claim against a multi-national corporation. Those victories led immediately to the recent class actions by Southern African gold miners against 32 mining companies, representing virtually the entire gold mining industry in South Africa. The settlement of the consolidated class action, reached in May 2018, was approved by the South African High Court in July 2019 and became effective in December 2019.

The miners’ class action opened a new chapter in South African history. It expanded eligibility for compensation for miners or their surviving dependants across the Southern African region. On paper at least, it relaxed the burden of proof for occupational injury and set aside funds for the tracking and tracing of potentially eligible claimants, assistance with the claims process, the processing of claims, claimants’ travel expenses and the facilitation of benefit medical examinations. The court’s sympathy with the mineworkers’ plight and its reworking of legal precedents and regulatory frameworks to accord with the human rights principles enshrined in the South African constitution entrench this judgement as a landmark in the South African jurisprudential landscape.¹⁸

The Tshiamiso Trust

The Tshiamiso Trust was formally set up to implement and fulfil the terms of the class-action settlement.¹⁹ As with previous path-breaking South African interventions into miners’ occupational health, the terms under which the Trust was set up and operates represent a process of contestation and compromise. The Trust needs to conform to a long and complex court-approved trust deed and adhere to eight steps involved in processing each claim. While these requirements have delayed the compensation process, there is no formal limit to the number of people the Trust can deal with, with estimates ranging from seventeen thousand to half a million of potential claimants.²⁰ No one is in a position to provide more precise figures. The Trust does not have funds for research into the matter, and previous studies only looked at small sub-sections of the mining workforce. Miners suffering from occupational lung disease can get compensation from both the ODMWA and the Tshiamiso Trust. The Trust began functioning in February 2020 and is expected to operate for 12 years after that date. It processed the first few pilot payments in December 2020.²¹ In January the following year, claimants were able to begin booking appointments at 50 lodgement offices in mining centres and areas from which labour has historically been drawn in South Africa, Lesotho, Mozambique, eSwatini and Botswana. The offices began opening a month later, and sites for the Benefit Medical Examinations were established in South Africa and Lesotho. The first batch of more than 100 compensation payments was processed in August 2021. A year later, by the end of August 2022, 7418 claims were paid. At that date, 13,018 claimants were deemed medically eligible; 6753 claims were ‘Medically Deferred’ for reasons such as missing documentation and need for additional medical examinations, and more than half, or 25,626, were deemed Medically Ineligible.²² Those rejected for compensation had a month in which to appeal, something which is difficult to organise for people who find bureaucracies hard to navigate.

In considering the miners’ claims for compensation, the South African High Court acknowledged the overwhelming problems faced by those who became ill after working in the mines. Logistically, these problems include the remoteness of labour-sending areas with poor and expensive transport and communication systems, language and literacy barriers, particularly for those in distant labour-sending regions, and the poor state of medical and diagnostic services in rural areas. Senior citizens located in remote villages, with patchy phone coverage, few mobile phones and no access to the internet, face particular problems. The class-action settlement and the Tshiamiso Trust did make some provisions for overcoming these obstacles. Although the Trust does not have funding for the setting up of new clinics, some of its offices are located outside of South Africa, and basic information on the Trust website is available in seven languages other than English. Despite efforts to engage with communities in the old labour-sending regions, however, progress is slow. Although mine workers from Mozambique formed between tenth and a quarter of the mine workforce between 1971 and 1999, for example, as of August 2022 none so far reached the sixth part of the 8-step compensation process, the Medical Certification Panel, or received compensation. None of the claimants from Botswana, eSwatini or Malawi have reached that stage either.²³

Many of the challenges facing the Tshiamiso Trust are similar to those confronting the ODMWA system. All have been exacerbated by the COVID pandemic and the problems it poses to administration, staffing and travel. COVID-19 also presents a serious threat to gold miners whose health is already compromised by TB and silicosis. With increased chances of dying as a result of the potential combination of COVID-19 and occupational lung diseases, claimants need to be diagnosed and compensated as soon as possible. That is not always easy.

Diagnosis

While the Trust operates with a more generous definition of eligibility than much of the previous legislation, the diagnosis of complex occupational diseases remains difficult. Few doctors are qualified to diagnose silicosis. Even before the pandemic, many African countries faced critical shortages of medical staff. This shortage is particularly acute in Mozambique and Malawi, and severe in Zimbabwe and Zambia.²⁴ Everywhere, it has been aggravated by the COVID epidemic. Combined with lack of appropriate training of many of those conducting the qualifying medical examinations, this has meant that many sick miners—even those found eligible for compensation under the ODMWA—have been diagnosed as healthy.²⁵ As in the past, some X-rays are not of sufficient quality to determine the extent of injury, and so miners have to travel back for re-examination. The length of mining service presents other difficulties. The Benefit Medical Examinations run by the Trust are free of charge if the ex-mineworker worked for five or more years at qualifying mines during qualifying periods. Claimants with less than five years of service at qualifying mines have to bear the cost of the examination. Although this cost will be reimbursed should they be found to be eligible for compensation, raising money for transport and examination is difficult for men no longer able to work. Yet other problems confront those who lived for years in apparent good health after leaving the mines, only to discover they have silicosis after a long period of latency.

Mining Service Records

To be eligible for compensation, applicants or their surviving family members have to prove they worked at particular mines, sometimes many decades earlier. As noted above, while some miners have retained scraps of the required documentation, many others have not. In theory, such service records should also be available from the mine recruiting agency and individual mines.²⁶ For a number of reasons, these records are incomplete. And while the Medical Bureau for Occupational Diseases (MBOD) should have a complete record of all risk shifts worked by gold mineworkers, a substantial breakdown of its system after 1994 resulted in records either lost, destroyed or simply not kept. In cases such as these, the recent digitisation of miners’ records is of limited use. As Booi Mohapi, chapter leader of Justice for Miners Campaign in Lesotho noted, most of the ex-miners and their dependants asking for assistance at their offices complain of a lot of paperwork that is involved and hard to obtain from the relevant mines. ‘Some complain that even when they believe that the paperwork is complete, the Trust officers will demand the most insignificant document which they would not be aware of. They are then turned away. Some of those needed documents can be availed by the mines themselves. It is the duty of each mine to facilitate attempts to obtain the required documents’, Mohapi explained with much indignation. ‘How can Tshiamiso demand mine documents from a woman whose husband died in the 1980s which the trust itself cannot find from the mine even though they have access to the mines?’²⁷ In a recent media release, Daniel Kotton, CEO of Tshiamiso Trust, explained some of the delays:

Claims related to deceased mineworkers are especially difficult to process as death certificates often state that the claimant died from natural causes, making no reference to silicosis or TB … we have partnered with various government bodies and provincial health departments to access historical health data, unabridged death certificates, post-mortem reports, and medical records from clinics and hospitals. This is a mammoth task in itself, since some archives dating back to 1965 have not been digitized.²⁸

Administration

In order to expedite the processing of claims, the Tshiamiso Trust negotiated a partnership agreement with TEBA Ltd. to record applicants’ details and facilitate payments of compensation awards. As a result, the Trust lodgement sites are situated in existing TEBA offices. According to the communications manager of the Trust, while in the future lodgement centres will not be only limited to this organisation, ‘Engaging with TEBA, which has a single management structure, is for Tshiamiso far more efficient than would be the case dealing with multiple organisations which may lack the infrastructure TEBA has’. The problem is that many former miners view TEBA with deep distrusts. As noted in Chap. 2, the Rand Native Labour Association, subsequently the Witwatersrand Native Labour Association, was formed in 1886 to eliminate competition between the mining houses and centralise the supply of migrant labour.²⁹ The Native Recruiting Corporation was formed in 1912 by the Chamber of Mines to carry out the same function within South Africa and the High Commission Territories. For decades, the two recruitment agencies supplied workers to the mines. In 1997, they were amalgamated to form The Employment Bureau of Africa (TEBA). Several years later, the agency diversified to assist mineworkers with programmes that included screening for TB and silicosis and processing their labour and medical claims with the authorities. In 2005 the founding president of the National Union of Mineworkers, Dr James Motlatsi, bought 75 per cent of TEBA, with 25 per cent of shares given to its employees.³⁰ Despite the change in name, function and ownership, many mineworkers strongly oppose the partnership between the Tshiamiso Trust and TEBA Ltd. The recruiting agency, they argue, has not served them well in the decades since it was set up. They accuse the company of many cases of fraud and see it as part of the mining companies they are fighting against. Rather than rely on its partnership with TEBA, they argue, the Trust should work with the network of community-based organisations, including paralegals and medical staff, that helped sign up miners to the class-action litigation. This is particularly important in the current social context.³¹

In a society still struggling with the legacies of apartheid, miners seeking compensation face many difficulties in organising themselves and working out who to trust. Ex-miner organisations are weak, and there is an endemic culture of non-caring. At the same time, many people are trying to defraud claimants. As the Tshiamiso Trust website explains:

There are many people out there who are making promises to people that they can get them compensation from the Trust and taking money from them, when they have no way to make that happen. … Only the Trust’s officials are authorised by the settlement agreement to help process claims and determine if a claim meets the criteria for compensation. The authorised officials will not expect any payment from you for their involvement and/or assistance. Those who dishonestly make promises of payment from the settlement fund in order to persuade people to pay them money are not authorised to do so by the settlement agreement and are not officials of the Trust.³²

The modern and efficient methods for making appointments too present problems. Using mobile phones to send and receive text messages and download documents saves time and money—but not for those whose only access to a smart phone are neighbours’ children working in a regional town. By the same token, requesting banking details from claimants via SMS is problematic as this platform is frequently used for phishing for banking details.

Justice for Miners Campaign

Many of the activists and groups who supported the miners in their long struggle for compensation have come together in an organisation called the Justice for Miners Campaign (JFM). With the assistance of funding partners such as The Open Society Institute of Southern Africa, The Ford Foundation, The Heinrich Boll Foundation, Open Society Foundation and Oxfam South Africa, the JFM has been building up a civil society interface between mining communities and the Tshiamiso Trust. The JFM organisational units, or Chapters, work on the ground within mineworker communities severely affected by TB and Silicosis. Chapters are composed of community members and groupings, such as local ex-miner organisations, church groups, women’s groups and student and university collectives. Each Chapter is independent and draws upon its localised needs in contributing to the transnational JFM campaign. Currently there are JFM Chapters in Lesotho, Eastern Cape and Free State in South Africa, and in Botswana.

Looking towards mining communities, JFM activists undertake extensive training, capacity building, induction and orientation to new team members and JFM Chapters. This covers sound knowledge of what the JFM does, skills necessary for building effective campaigns and up-to-date information about the Tshiamiso Trust Deed and Legal Reform. Looking towards the wider society, the JFM is trying to build a movement that will influence and lobby government institutions, mining houses, Tshiamiso Trust, TEBA and the Minerals Council to do the work required to ensure fast and just compensation is paid to gold miners and their dependants affected by TB and silicosis. Media campaigning, often using the award-winning documentary Dying for Gold, is an important part of JFM work.³³ In order to guide and strengthen the JFM campaign and link it to broader civil society, in November 2019 a group of civil society organisations and ex-miners’ associations met in Johannesburg to set up a regionally representative forum.³⁴

Justice for Miners Campaign activists believe that the current compensation system is broken, failing to process and deliver payments to miners whose health and lives deteriorate further as justice is delayed. From their perspective, sick miners struggle to navigate two complex and onerous systems: statutory compensation under the ODMWA and the Tshiamiso Trust. Their three key demands emphasise speed: in achieving just compensation, improved administration and legal reform. The first demand entails rapid and equitable compensation for all affected mineworkers. The second has to do with quick reform of institutions tasked with paying compensation. Simple claims and payments processes, JFM notes, must be accompanied by sufficient staffing capacity to follow through on claims within a reasonable time period. At the same time, administrative and diagnostic services must be decentralised and established in all present and former labour-sending areas. Accountability and transparency in executing these reforms must be reflected in quarterly reports to Parliament and civil society. The final demand calls for speedy legal reform to enable just compensation for all affected mineworkers. Elected representatives of the people, the Justice for Miners Campaign insist, must take up this issue and push for legal reform as a matter of the highest urgency.³⁵

Bodies, Records and Contested Justice

For the best part of the twentieth century, South Africa held a reputation as a world leader in researching and compensating miners’ occupational lung disease. During that period, the centrepiece of the mines’ management of tuberculosis was repatriation of sick workers, without notification of local authorities, isolation of those with infective disease or education of family members on how to avoid infection. This approach to TB enhanced the gold mines’ profitability but confounded every principle of public health policy. As previous chapters have shown, the system persisted despite detailed and repeated criticisms from community leaders, medical practitioners, local government officials, researchers and members of parliamentary commissions and committees of enquiry. At the same time, delays in the onset and difficulties in the diagnosis of silicosis helped obscure the public visibility of the disease—but did not stop retired miners from getting sick. In practice, the requirements for diagnosis and compensation for the majority of miners were such that few of those with occupational lung disease were able to prove they were ill, and fewer surmounted the hurdles in submitting claims and receiving compensation. Instead, impoverished labour-sending communities shouldered the extra burden of caring for men whom mining made ill.

Making sense of his career in treating miners for occupational lung disease, Rodney Ehrlich called his 2007 Inaugural Professorial Lecture ‘The body as history’.³⁶ Whatever the state of politics, scientific knowledge or administration, he pointed out, the bodies of miners were indelibly marked with traces of their past employment. The vast extent of these bodily records stands in stark contrast with many decades of manufactured official ignorance regarding the extent of miners’ occupational injuries. And while the individual bodies of workers carry indelible signs of past mining employment, the paucity of paper-based employment records obstructs the process of compensation. Just as the diligent collection of some statistics and studious efforts to avoid collecting others contributed to the manufacture of ignorance, so too did systematic non-compliance with repeated requests to keep records of miners’ employment and medical histories.³⁷ At the same time, while the mines were subject to remarkably high levels of government surveillance and produced copious records, today the archive holdings are patchy, with what must have been voluminous correspondence files of key players missing.

This book has paid tribute to some of those who warned against looming health crises, advocated for miners and attempted to stem the tide of occupational lung disease. The Justice for Miners Campaign is among those who continue this tradition today. In assisting miners injured in South Africa’s process of wealth accumulation, proposing alternative solutions to practical problems and mobilising local communities, JFM also helps heal injuries to the region’s civil society.

Advocacy and practical support for miners overlap with contesting and dismantling manufactured ignorance regarding occupational lung disease. Previous chapters noted some of the work of those who contributed to this process. Jock McCulloch, who researched and wrote the bulk of this book, is among them. A prominent historian of colonialism and occupational health, Jock died from mesothelioma in 2018. His fatal exposure to asbestos (the only known cause of mesothelioma) almost certainly occurred in the 1990s, while researching the history of asbestos mining in Southern Africa. To see the mines first hand and interview mine owners and former workers, he toured Zimbabwe and the Northern Cape, where the landscape was littered with tailing dumps of fibre from abandoned workings, and where even today asbestos contaminates the environment. It was a bitter irony that he died trying to save others from being exposed to the same lethal asbestos fibres that tragically claimed his own life.

Confronted with the paucity of records which commonly accompanies company behaviour contrary to that publicly espoused, Jock believed that conventional archival research needed to be augmented by what he called ‘forensic history’. This approach, which he used successfully on previous projects, involves reviewing a large volume of archival material to find the fragments of a story, drawing on secondary literature and field visits to identify relevant clues and triangulating accounts of one event from a number of different actors and sources. Like Jock’s previous books, Mining gold and manufacturing ignorance is distinctive in bringing together and juxtaposing a vast range of sometimes ephemeral evidence to document what happened behind the scenes. Jock passed his enormous collection of materials on silicosis and asbestosis in Southern Africa and Australia to colleagues at Columbia University and City University of New York to form part of Project Toxicdocs.³⁸ Hopefully, this book will inspire others to chart the evolving story of money, mining, politics and health. The evidence presented in Mining gold and manufacturing ignorance, together with the materials in Project Toxicdocs, should make such contributions to social justice more manageable.