In terms of the 5 Billion Rand out of court silicosis and TB settlement reached between lawyers of gold ex-miners and South Africa’s largest gold producers the Tshiamiso Trust is mandated to receive and process compensation claims by ex-miners who have been made chronically ill by gold mining. An important part of assessing a gold miners claim to compensation is the medical examination which serves to determine which illnesses are present and the extent of the illnesses.
In the wake of increasing reports and evidence of Claimants being misdiagnosed, incorrectly classified for compensation and rejected Justice for Miners activists
undertook an inspection of the Medical Examination facility of the Tshiamiso Trust at 15 Zomba Street, Doorn, Welkom on 22 February.
The inspection was done by Dr Rhett Kahn, Occupational Health Practitioner of 30 years’ experience and JFM Medical Advisor and Mrs Janet Kahn, JFM activist.
The JFM activists witnessed serious flaws in the standard protocols required for
assessing patients for silicosis and TB. Of these, the most alarming are:
1. Lung Function Test: this test is used to measure the level of lung function incapacitation; it is a crucial indicator of illness. The lung function was done incorrectly with the examinee breathing in with the device in his mouth, the breathing out and breathing in again instead of the standard format of breathing in, then putting the device into the mouth, breathing out and breathing in again.
2. Spirometry is a breathing test also used to establish lung function.
Spirometry is not being done according to the Global Obstructive Lung Disease Organization’s criteria. The administrator of the spirometry test has no formal training either as a nurse or in spirometry.
The Occupational Medical Practitioner is not on site to make sure that spirometry loops are acceptable.
3. Chest X-Rays provide valuable information concerning the nature of and spread of silicosis and TB and the combination of these diseases. While an experienced qualified radiographer performed digital chest x-rays the Occupational Medical Practitioner does not look at the X-Ray before the examinee leaves the site. As a result, examinee’s could leave the site without being diagnosed with silicosis, TB and/or lung cancer.
The Justice for Miners Campaign has engaged with the Tshiamiso Trust since its inception in 2019. JFM has appealed to the Tshiamiso Trust directly and in public statements amongst others that:
1. there needs to be a critical improvement of the performance of medical service providers at Benefit Medical Examination sites and TEBA officials at lodgment sites. JFM has pointed out serious problems in how claimants are treated, how they are communicated with and how their records are accessed to establish eligibility for compensation
2. given the absence of a functioning medical reviewing authority all rejects and questionable determinations should be put on hold until the reviewing authority stipulated in the Trust Deed is in place.
3. the current appeals process be extended from the current 30 days to 180 days
The JFM Campaign has submitted the details of a number of claimants’ who have received shockingly low determinations or whose claims have been rejected to the Tshiamiso Trust with corrective information and the request for remedial action. To date most of these cases remain unresolved.
Today’s findings at the Tshiamiso Trust Benefit Medical Examination Site provide further evidence that Tshiamiso Trust systems are compromised and are failing to deliver on the mandate to compensate ex-miners speedily and efficiently.
With regard to the BME sites JFM demands that Occupational Medical Practitioners rather than nurses perform clinical examinations rather than nurse practitioners. The OMP will naturally check the standard of the spirometry and chest x-ray.
JFM demands that given the high numbers of unseen claimants’ areas with large numbers of claimants should be served by at least Medical Examinations sites.
It is of great concern to JFM that the Medical Examinations (BME) site in an urban Centre such as Welkom is failing to do justice to miners who were made ill by the gold mines. If things are that bad in Welkom – how many miners are being misdiagnosed and/or rejected elsewhere in South Africa and across the region where the Tshiamiso Trust is operating?
JFM in Welkom has also in the past week recorded incidents of serious racial discrimination in the treatment of black and white claimants by Tshiamiso Trust lodgment sites. This, too, is not only alarming but also unconstitutional and merits an independent enquiry into the operations of the Tshiamiso Trust to establish if indeed the institutional and logistical arrangements that have been put into place of the last 2 years are fit for purpose.
What we are seeing is system failure and the Tshiamiso Trust’s unwillingness to honestly deal with the grave concerns that JFM has raised.
To remedy this situation the Tshiamiso Trust must open its operations, data base and claims management system to public scrutiny and open itself to honest and
effective engagement with bodies such as JFM.
Not to do this is a further betrayal of gold miners and their families whose labour and suffering have built the wealth of South Africa.
Bishop Jo Seoka
Chair of the Justice for Miners Campaign
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