Many researchers in the Artisanal and Small-Scale Mining (ASM) sector have concluded that informal mining in Ghana is beleaguered with environmental and occupational health problems and that addressing them would help promote the sector as a socially and economically viable activity in the country. For many people in ASM communities, mining is an important source of income, particularly for the rural poor and the unemployed.
Why Healthcare Is a Major Issue in the ASM Sector
The development aspirations of the world depend largely on having a thriving and healthy human population. However, a cursory glance at figures pertaining to human health reveals massive disparities when it comes to access to basic healthcare. The progress report on the Sustainable Development Goals (SDGs) identified over 400 million people as those who do not have basic healthcare and 40% of them lack social protection. In addition, 7 million people die every year from exposure to fine particles in polluted air. (UN, 2018). More than 1.6 billion people live in fragile settings where protracted crises, combined with weak national capacity to deliver basic health services, present a significant challenge to global health (UN, 2018). The SDG 3 goal which is to ensure healthy lives and promote well-being for all at all ages is in agreement with the work of the Ghana Health Service. The Ghana Health Service (GHS) is mandated by Ghanaian constitution under Act 525 of 1996 to provide and prudently manage comprehensive and accessibility health service with special emphasis on primary healthcare at the regional, district and sub-district levels in accordance with approved national policies (GHS, 2011). Ghana’s healthcare delivery system is decentrilsed from the national, regional, district, sub district level and community-based health planning and services (CHPS) zones. Meanwhile evidence has shown that the large number of people involved in ASM globally face significant health and safety issues that have an impact beyond the miners and their communities. Most mining community members are impoverished and live in rural areas that normally lack basic resources such as health care services, clean potable water and quality education. It is difficult to assess the human health impacts of Artisanal miners in Ghana because they often occur on the periphery of the Ghanaian health care system. (Yakovleva, 2017). Due to distance to health facilities, lack of familiarity with health care availability, or in some cases the illegal status tag, ASM participants are less likely to participate in the regular government health system. As a result, they are less often treated and missed in disease surveillance (Basu, Niladri, Clarke & et.al 2015). Despite the effort of GHS, ASM communities continue to be vulnerable to HIV/AIDS and other sexually transmitted infections (STIs) (Banchirigah, 2008). For instance, local health authorities in the Birim North District in the Eastern Region of Ghana reported an increase in teen pregnancy and STIs in the District as informal mining activities gained grounds in the area (Yakovleva, 2008). The seasonal and migratory nature of ASM leads to high-risk behaviour that can facilitate the spread of sexually transmitted infections (STIs), HIV and AIDS (Centre for Development Studies: University of Wales, 2004).
What is the way forward?
It is important to identify the gaps that exist between ASM operators and the healthcare services provided by the Ghana Health Service especially the Public Health unit so as to inform the development of health sector response to the needs of ASM communities. This is because the ASM sector in Ghana creates employment and contributes massively to local economic development. The sector is seen as an important livelihood activity especially in rural areas. Despite the moratorium and the effort to stop the operators by several governments, ASM directly employs an estimated one million people and provides support to approximately 4.5 million people who are mostly women and youth. The sector also contributed 35 percent of Ghana’s total gold production in 2014 with almost 1.5 million ounces of gold. In the spirit of leaving no one behind, there is the need to pay attention to the health needs of the sector. Efforts geared towards improving the health seeking behaviour of ASM actors will result in better utilisation of health facilities leading to good health outcomes.
Ali Tanti Robert
The writer is the Executive Director of Youth Alliance for Development, a youth development-oriented NGO based in Obuasi and New Edubiase. He is also an Emerging Public Health Practitioner who has interest in the health seeking behaviour of Artisanal and Small-Scale Miners.