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Burden Shifting: Creating Equitable Outcomes in South Africa’s Mining Industry
Team #7 Alexandra Adams, Sarah Grusin, Erik Heinonen, Eugene Lee, Brittany Ngo, James Ting
• • •
Nov. 10, 2012
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South African Mining Industry
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Annual Contribution to GDP 8.6 percent – 525 billion USD
Mining employment 498,141
Value of reserves of gold, platinum, chromium
$2.5 trillion
BUT • Increasing costs of doing business for mining companies • Loss of market share since 2005
Bottom Line
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• Losing current and future foreign direct investment
• Lost tax revenues
• Rising unemployment (currently: 24.9 percent)
• Decreased citizen support for government
• Increased burden on public health system
If disputes between miners and mining companies persist, South Africa risks:
Root Causes
Labor dispute
Migrant laborers
Working conditions
Low wages Disease/injury compensation
Poor living conditions
Root Causes
Labor dispute
Migrant laborers
Working conditions
Low wages Disease/injury compensation
Poor living conditions
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Working Conditions
Poor Disease/Injury Compensation
Low wages
Second Order Causes
Lack of input from miners
Mines not held accountable
Mines don’t bear cost of occupational
disease and injury
Lack of input from miners
Mines not held accountable
Mines don’t bear cost of income inequality
Lack of input from miners
Mines not held accountable
Mines don’t bear cost of occupational
disease and injury
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Working Conditions
Poor Disease/Injury Compensation
Low wages
Second Order Causes
Lack of input from miners
Mines not held accountable
Mines don’t bear cost of occupational
disease and injury
Lack of input from miners
Mines not held accountable
Mines don’t bear cost of income inequality
Lack of input from miners
Mines not held accountable
Mines don’t bear cost of occupational
disease and injury
Recommendations
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Mining Welfare Administration (MWA)
• Input
Burden Shifting
Mining Welfare Commission (MWC)
• Accountability
Public Health Strategies
• Burden Shifting
Education Campaign
• Input
• Set mine safety standards focusing on prevention and occupational health
• Set fair wage standards
• Align payments to worker compensation fund with mine conditions
• Collect and publicize annual claims data
• Collect fines for violation of standards
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Burden Shifting
Mining Welfare Administration
• Membership includes representatives from: - Department of Finance - Department of Mines - Department of Health - Mineworkers - Mine owners • Equal voting power for mine workers and mine owners
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Input
Mining Welfare Administration
Mining Welfare Commission
• Independent forum for workers to lodge complaints about violations of MWA standards and abusive mining practices
• Commissioners investigate, evaluate and adjudicate complaints
• All investigations and findings will be published in public reports
• Commissioners will be appointed by the MWA, assuring mineworkers have a voice in selecting arbiters
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Accountability
• Ensure equal access to care throughout country with emphasis on Community Health Planning
• Build 100 Community Healthcare Clinics in migrant labor sending areas (e.g. Northern Cape, Northern province of Eastern Cape, and Mozambique)
• Mining Companies and Stakeholder Engagement/Partnership
• Collaboration with Community Health Committees, local NGOs, MSF, and hospital network 13
Burden Shifting
Public Health Strategies
Public Health Strategies
• Extension workers provide free prevention services
• Clinic employee education and training program
• Establish treatment reimbursement system for migrant workers in SADC from Mines and Works Compensation Fund
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Burden Shifting
Education Campaign
• Knowledge of rights to compensation and process for applying for benefits is limited among: - Miners and their families - Doctors and nurses
• South Africa should create an education campaign targeted at mineworkers upon entry and departure from a mine and targeted at health clinics and hospitals throughout the country
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Input
Budget for Recommendations
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1 2 3 4 5 6 7 8 9 10
MWA 50 50 50 50 50 50 50 50 50 50
MWC 40 40 40 40 40 40 40 40 40 40
Education 10 10 10 10 10 10 10 10 10 10
Health 100 90 80 80 75 75 75 75 75 75
Total (1.8B)
200 190 180 180 175 175 175 175 175 175
All figures are in millions USD
Remaining funding that is made available (up to $18B) should be reserved for funding an increase in ODMWA payments in the event of legislative reform
Challenges and Limitations
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Persistent lack of knowledge of rights
Resistance from mining companies
ODMWA compensation statutorily limited
Conclusion
By generating input from miners, creating accountability for mining corporations, and shifting cost burdens to those who can most afford it, we can create an equitable, safe, and sustainable mining industry in South Africa.
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Routine care (vaccinations and regular checkups)
Health Clinic's “One-Stop" Services - Quick referrals and careful monitoring of both TB and HIV patients
Directly Observed Treatment (DOT) - Standardized treatment regimen for MDR-TB and HIV/AIDS integration
Prevention arm: - HIV Counseling and Testing (HCT) - TB screening (skin and blood tests (IGRAs)) and questionnaire, TB Bacille Calmette-Guérin (BCG) vaccination
Treatment arm: - Isoniazid preventive therapy (IPT) and antiretroviral therapy (ART) combination. - HIV first-line regimens (zidovudine or tenofovir) - Generic fixed-dose combination of zidovudine, lamivudine and nevirapine - TB diagnostic testing (e.g. sputum smear for acid fast bacilli, chest radiograph, and sputum culture), and short course chemotherapy
Appendix A: Medical services covered
Appendix B: Comparison of ODMWA and COIDA
ODMWA COIDA What is the clinical threshold to qualify for compensation?
• ODMWA recognises only two degrees of clinical lung disease: o First Degree (10-40% impairment) o Second Degree (40%-100% impairment, or a
combination of 2 compensatable diseases) • Percentage of impairment is of either lung functioning
or ability to perform work • A 100% impairment of lung functioning would mean
death
• COIDA provides payment for any permanent disablement above 20% impairment
• Above 20% payments increase with percentage of impairment o For example, if based on earnings a worker
would earn R100 for a 100% impairment, then a 20% impairment would entitle the worker to R20 and a 60% impairment would entitle the worker to R60
Is Temporary Incapacity recognised for lung disease? What will you get?
• Only temporary incapacity for TB (not any other lung disease) is recognised
• 75% of earnings (wages), limited to 6 months only
• Any temporary incapacity is recognised • 75% of earnings, provided for up to 2 years
What about Permanent Incapacity as a result of an injury or lung disease?
• Lump sum payment for all permanent disability capped at: o R31 440 for First Degree o R70 008 for Second Degree
• Not adjusted to increase with inflation • No monthly pension provided The real value of ODMWA payments continues to decline over time as inflation continues. Inadequate payments force many ex-miners and their families to rely on state and community support as well as social grants to survive
• For disablement less than or equal to 30%, workers get a lump sum payment equal to 15 times their monthly salary with: o Minimum lump sum of R45 800 o Maximum lump sum of R183 400
• For disablement greater than 30%, workers get lifetime monthly pension increasing with their percentage of disability. o Minimum monthly pension ranges between
R700 and R2 300 o Maximum monthly pension ranges between R5
000 and R 16 400 • Updated to increase with inflation
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ODMWA COIDA Is on-going medical care provided for miners and ex miners with lung disease ?
• The employer pays for on-going medical care only if the mine worker is able to continue working. However, the miner has no choice in which doctor to see
• If the miner has stopped working because of the severity of the injury or retrenched, either the state must pay or the miner must pay out of his own pocket (uses his own money)
• Occupational health facilities for mine workers are located in some urban areas. Ex miners living in rural areas or who have returned to their home countries within the SADC, have no access to the urban medical centers and have to rely on private GPs or the state health sector/s
• The compensation fund covers 2 years of medical care at “reasonable cost”
• The commissioner may pay for further care if he determines that the care will result in a reduction of disablement
Is there an autopsy requirement for widows of deceased mine workers in SA and SADC countries to claim compensation? • Yes. The heart and lungs of a deceased mine worker
must be sent to Johannesburg for inspection by state officials
• This is a requirement even if the family of the deceased worker lives far away or in another country
• Sending human organs of a deceased worker into SA requires special permission from the NDoH, that is often difficult to obtain
• Compensation is only provided if the state inspector / examiner finds evidence of a compensatable disease.
• No. • A medical report is sufficient
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Eugene Lee