A scathing ‘All Risk and No Reward’ report on conditions of service for miners in Botswana has detailed how Debswana Diamond Company (the world’s leading producer of diamonds by value), and other local mining companies connive with mine doctors to downplay workers’ occupational injuries.
The report indicates how the companies would pull all stops to avoid paying overtime for other workers to fill an injured worker’s job role, cover training costs for a replacement worker, or divert administrative resources in the wake of an injury.
It carries detailed accounts of many harrowing experiences of mine workers at the hands of their employers who are hell bent on maximizing profits and ignoring safety protocols.
The study is a joint project by Botswana Labour Migrants Association (BoLAMA), Center for Economic and Social Rights (CES), and Northwestern Pritzker School of Law Center for International Human Rights (NPSLCIHR).
The Deputy Branch Chairperson of the Botswana Mine Workers Union, the reports states, corroborated miners’ experiences. According to the report, the unionist said it was common for miners to be sick or injured only to receive a “fit for duty” designation in the mine hospital and to be sent back to work without a diagnosis or treatment.
“Two doctors with decades of combined experience working in several different mine hospitals and extensive experience providing care to miners and ex-miners in the private sector described in detail the methods and consequences of mine companies’ interference in miners’ health care,” reads the 90 page report.
“Dr. Arnold Oneetswe Motsamai stated that he first observed the results of this corporate pressure working in the Debswana mine hospital in Jwaneng. He described the consequences as a downgrading of the severity of workers’ injuries and illnesses so they could continue working.”
The doctor, according to the report, said the mine tends to keep the injured workers, even with a diagnosis, because they want people in the mine.
Dr. Motsamai reportedly described instances during which mine managers and contractors applied direct pressure on him as Chief Medical Officer to change his diagnosis of specific miners so they could be sent back to work.
“There is an element of a compromise of ethics. For doctors, normally, ethics is our backbone. We shouldn’t depart from ethics. That’s what protects us. But there is a challenge, in terms of the mines and medical ethics, where you have a company policy, or in order to keep your job, you have to bend your patient care to accommodate the system. There’s a lot of that,” the Doctor was quoted in the report.
The Doctor sees miners at his private practice on a monthly basis who have been injured or fallen ill in the mines but who have not been properly diagnosed, despite repeated visits over months or even years to the mine hospital.
The report details how corporate management at mine companies exerts pressure on doctors to declare sick or injured miners “fit for duty” when they are not and to downgrade the severity of miners’ injuries.
“Our research indicates that the purpose of this interference is to ensure a sufficient labor force in the mines, to avoid having to report incidents and injuries to the Department of Mines and to reduce potential worker’s compensation liability.”
The ‘All Risk and No Reward’ report points to direct interference which includes corporate communication with doctors that actively influences or seeks to influence the doctors’ decisions about particular patients. It also talks about Indirect interference that includes implicit pressure—such as threats against career advancement—that mine doctors feel in an environment in which corporate officials expect mine doctors to prioritize production demands over their patients’ health.
“Mine companies’ interference with health care in mine hospitals leads to lower quality care and worse health outcomes for miners and ex-miners. Miners, ex-miners, doctors who worked in mine hospitals and a representative of the Botswana Mine Workers Union all reported that mine companies exert pressure on doctors in mine hospitals to designate miners “fit for duty” when they are not.”
The report, on How the Government and Mine Companies Fail to Protect the Right to Health of Miners and Ex-Miners in Botswana, was released earlier this past week.