Fuelled by a desire to avoid having to report incidents and injuries to the Department of Mines, as well as to reduce liability for workers’ compensation, health and safety personnel at mines across Botswana routinely exert pressure on mine doctors to declare mine workers in need of care and time off work as fit for duty. According to a joint report compiled by Botswana Labour Migrants Association, threats against career advancement are used to encourage doctors to violate their ethics in this manner. Staff Writer SESUPO RANTSIMAKO reports
FRANCISTOWN: Mine doctors in Botswana violate their ethical standards by declaring injured workers fit for duty because of pressure exerted on them by mine companies, a scathing re-port on the rights of miners and ex-miners to health has revealed.
According to the report, the interference is aimed at ensuring sufficient labour force at the mines at all times. The report was compiled by Botswana Labour Migrants Association (BOLAMA) in collaboration with the Centre for Economic and Social Rights and Northwestern Pritzker Schools of Law’s Centre for International Human Rights. It states that there is either direct or indirect interference from the mine companies in this pressure on doctors to violate their own oath.
“The direct interference includes corporate communication with the doctors that actively influences or seeks to influence the latter’s decision about a particular patient, while indirect interference includes implicit pressure such as threats against career advancement,” the report asserts. “Corporate officials expect mine doctors to prioritize production demands over their patients’ health.”
It warns that a consequence of this interference with healthcare in mine hospitals lowers quality care and worsens health outcomes for miners and exminers.
The reports cites incidents in mines at Jwaneng and Selibe-Phikwe where doctors at the mine hospitals failed to properly diagnose the miners and instead sent them back as fit for duty. Doctors have confirmed and corroborated such interference. “Dr Khumoetsile Mapitse, a former mine doctor at Debswana and BCL confirmed that at times mine company safety and health officers pressure doctors at mine hospitals to downgrade the severity of mine injuries,” the report says.
“Mine doctors feel pressure from corporate management to grade injuries lower than the doctors would otherwise grade them. Corporate pressure on doc-tors was not always explicit. Management might speak with a doctor about a miner’s injury and ask, ‘Do you think this is a minor or a major injury?’” the report quotes Dr Mapitse as saying.
According to the report, former Debswana Chief Medical Officer, Doctor Anorld Onneetswe Motsamai, has similarly stated that there is lot of interference by mine companies in doctors’ work.Dr Motsamai, who was stationed at the Debswana mine hospital in Jwaneng, is quoted as saying his recommendation for the mining company to recruit specialists to attend miners on site was refused, resulting in delayed access to critical care for miners.
The joint report quotes Dr Motsamai further: “There is an element of a com-promise of ethics. For doctors, normally ethics is our backbone. We should not depart from ethics. That is what protects us, but there is a challenge in terms of the mines and medical ethics where you have a company policy in order to keep your job. You have to bend your patient’s care to accommodate the system.”
According to the report, Dr Motsamai is now in private practice, says he sees miners on a monthly basis who got injured or fell ill at the mines but were not properly diagnosed despite repeated visits to mine hospitals over months or years.