Assessment of artisanal gold mining-induced public health risks in Sudan | |
| Author | Fadlallah, Mahmoud Ali |
| Call Number | AIT Diss. no.DM-21- |
| Subject(s) | Health risk assessment--Sudan Public Health--Sudan Gold mines and mining--Sudan--Health aspects |
| Note | A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Disaster Preparedness, Mitigation and Management |
| Publisher | Asian Institute of Technology |
| Abstract | Artisanal gold mining is still common in developing countries, including Sudan. In these mines, the occurrence and severity of health hazards are tremendous and unbearable. This includes occupational and environmental hazards. Artisanal gold mining, which accommodates more than one million miners who support more than 4 million people, imposes significant health threats to workers due to harsh working conditions and unsafe work practices. Miners are exposed to a wide range of health hazards such as dust, noise, dangerous substances, gases, pit collapses, rockfalls, and asphyxia. These hazards cause significant mortality and morbidity among the miners and the communities in the neighbourhood. Miners do not adhere to health and safety measures,. Frequently reported casualties lead to mortality, permanent disability, or reduced quality of life and the overall health status. Besides work-related issues, these miners also live in poor environmental health conditions, which expose miners and communities to risks of diarrhoea, typhoid, jaundice, and epidemic diseases. The mines are also located in natural hazard-prone areas where common floods, heatwaves, dust storms and extremely cold conditions. Apart from direct human health risks, miners are exposed to the additional burden of healthcare costs, and the majority of them lack access to social security. Because of the higher revenues generated in the artisanal gold mining sector, miners and their families depend on long-term mining work, which makes it difficult to control the mining activity and the associated health risks and environmental degradation. There is a dire need to evaluate the health hazards and vulnerabilities for artisanal gold miners due to the absence of baseline and evidence-based informationin the local context. There is a gap in knowledge regarding integrated risk assessment in artisanal gold mining using comparative assessment and analysis among the miners themselves. Perception of risk, which is context-specific and employs a bottom-up approach for assessment, planning and policymaking, has a significant gap in global literature related to artisanal gold mining. Therefore, the overall objective is to comparatively assess the occupational health hazards and vulnerabilities for artisanal gold miners and to shed light on the perception of risk and level of impacts to establish effective strategies for risk prevention and mitigation and for the overall miners' preparedness to improve safety practices and behaviours and reduce the gross health risks at various stages. This research adopted the model of disaster risk to estimate the actual physical risk using hazard, vulnerability, and adaptive capacity parameters. The study used both quantitative and qualitative approaches. Quota sampling technique was applied to select the miners based on two locations where the gold extraction processes are carried out in the Abideya area in Berber locality of the River Nile state of Sudan. Abideya, the main study area, hosts major gold mining operations and the largest gold market in the country. The target miners were approached based on their accessibility and consent during fieldwork. The inclusion criteria were artisanal gold miners aged 18 years or older who had worked for at least one year in the area of Abideya. A total of 211 respondents (45.5% from processing centres and 54.5% from digging sites) were included in the interviews. Key informant interviews were used as a supplementary tools to get insights on perceptions of health and environmental risks, expected benefits, governance issues, and possible mitigation measures. Checklists were prepared to conduct the interviews with relevant stakeholders involved in the artisanal gold mining industry, both at national and local levels. The averaging method was employed to compute a composite index for expected risk using hazard, vulnerability, and capacity components and for perceived risk using specific sets of defined indicators. At each calculation, the assessment indicator was considered as having an equal contribution towards the component. Using comparative analysis, the study found a significant difference in hazard and vulnerability but not in actual risk among the groups of miners. Despite the fact that miners from mining sites (digging sites) showed a relatively higher average score of actual risk, this was not statistically significant, indicating that people from both sites are almost experiencing a similar level of exposure to physical consequences (risk). This may confirm that all miners are at high risk of getting accident-related injuries and/or mining-related diseases, including cancers. Regarding perceived risk, the minimum perceived risk score was 0.46, and the highest was 0.84. Comparatively, no statistically significant difference was observed between digging sites and processing centres, indicating that miners from both sites share and express almost similar beliefs and attitudes towards mining risks. The factors determining the perceived risk included education, unemployment, years of work, income, personal experience of natural hazards, distance to the health facility, access to water and sanitation, experience of social communication, and hazard characteristics. Moreover, age, limited alternative livelihoods, household size, and self-rated health status were not statistically significant. Although miners' perception of risk was significantly high, there was always a shortcoming to transform it into safe behaviour. Miners employed rudimentary and substandard locally-devised personal protective equipment (PPEs) at every level of the gold mining process, whose protection level is far below the prescribed standard. On top of that, the majority of miners reported having no health insurance indicating poor access to social security. Thus, miners have to pay out-of-pocket to receive healthcare services for themselves and their families. Hence they are exposed to financial hardship and even impoverishment. In this regard, the research found that, on average, miners spend about 11% of their monthly income on healthcare services. Furthermore, about 7.4% spent >30% of their monthly income on healthcare services considered relatively high. This concludes that miners are exposed to mining-related health hazards, that miners are exposed to mining-related health hazards and the financial risk that leads to impoverishment and the vicious circle of poverty. This study could be beneficial for those who work in disaster science by applying similar comparative analysis within the same study community. A little advanced statistical modelling (hierarchical regression) can also be utilized for analysis by different researchers. This study contributes to public health by employing assessment tools (indexing methods) for multiple public health risks at the workplace and the development of assessment indicators relevant to the local and global contexts. |
| Year | 2021 |
| Type | Dissertation |
| School | School of Environment, Resources, and Development + School of Engineering and Technology |
| Department | Department of Development and Sustainability (DDS) |
| Academic Program/FoS | Disaster Preparedness, Mitigation and Management (DM) |
| Chairperson(s) | Pal, Indrajit; |
| Examination Committee(s) | Shipin, Oleg V.;Chatterjee, Joyee S.; |
| Scholarship Donor(s) | Ministry of Health, Sudan;AIT Fellowship; |
| Degree | Thesis (Ph.D.) - Asian Insitute of Technology, 2021 |