A Simple Public Health Strategy for ASGM
15 million people in over 70 countries are involved with Artisanal and Small-Scale Mining (ASGM). The activity is a major gold producer and significant contributor to rural economic development. Although practices vary across the world, it is well understood that ASGM frequently has negative environmental, social and health issues. For example, it is the world’s largest source of mercury pollution.
A new international instrument aimed at curbing global mercury emissions, the Minamata Convention, includes an article and annex specifically for ASGM, obligating signatory countries with ASGM to develop a public health strategy for the sector. What would such a strategy look like?
In very general terms, the Convention suggests the following elements:
- Prevention of mercury exposure for ASGM miners and their communities
- The gathering of health data
- Health awareness raising through health facilities
- Strategies to prevent the exposure of vulnerable populations especially children, women of childbearing age, and pregnant women.
- Monitoring of mercury use through baseline estimates - this is not directly part of the prescribed health strategy but is an essential activity for understanding exposures.
Some common pitfalls that have been observed from previous public health initiatives are:
1. Incorrectly assuming that telling people mercury is harmful will cause them to stop or limit using it. Many ASGM communities live in difficult conditions. Making ends meet, having enough to eat, not contracting an infectious disease, etc., may all be perceived as more important issues than avoiding invisible odourless mercury vapours.
2. Presenting the danger of mercury without providing an adequate and convenient alternative. Simply putting up a sign that proclaims “mercury is harmful” could only increase anxiety if an alternative practice is not also provided. This leads to hazard fatigue and soon the dangers of mercury are ignored.
4. Poor relations between miners and outreach teams or agencies. Marginalization, paternalism, or persecution of ASGM workers (if they are illegal) does not lead to effective health messaging.
"We aim (...) to produce a positive, albeit realistic message, that emphasizes solutions, easy immediate changes, protection, and long term lasting changes while also improving livelihoods."
From experience in the field around the world, the Artisanal Gold Council has crafted a pragmatic and field-oriented ASGM public health strategy. It is a work in progress but mature enough to share and seek feedback. It is based on 6 main elements:
1. Changing the message:
For mining communities, messages from authorities or civil society or the press is often overwhelmingly negative. This is generally a fear-based message about poor behaviour, illegality, pollution, general irresponsibility, and about the negative health consequences of ASM including mercury. These are not hopeful messages, can be paternalistic and uninformed, and are therefore unlikely to inspire miners and their communities to change. We aim for the opposite - to produce a positive, albeit realistic message, that emphasizes solutions, easy immediate changes, protection, and long term lasting changes while also improving livelihoods. Our solutions may seem overly simple at first, but they can be implemented right away and allow for community empowerment.
2. Collaborating with technical interventions:
We believe that accessing technical know-how and solutions can play a strong role in eliminating various preventable health issues. For example, better ore concentration techniques may eliminate the need to use mercury, and replacing dry processing with wet processing and a high water recycling rate, can greatly reduce dust exposure - another major health hazard in ASM.
3. Health and Wealth - Increased community wealth to sustainably address important health issues:
We promote a model of community wealth reinvestment to address the most important health issues identified by the community. This self-sustaining fund can address community improvements such as latrines, drinking water, garbage disposal, or a medication fund for malaria for example.
We directly engage the existing health system, training health professionals to raise their awareness about ASM health and to serve the ASGM communities. This includes local health care workers through to their professors at universities or professional-training institutions. This knowledge becomes part of the health curriculum permanently so it is available where and when it is most needed.
5. Social Environment:
Just like cigarettes became less fashionable in the last decades due to anti-smoking messaging, we similarly use media campaigns including new technologies such as text messaging to influence perceptions about mercury and other health issues in ASM.
Health, environment and economy intersect in ASGM communities. For a lasting change and better health, government and civil society, and industry can work together and be involved in the solution.
Please contact us if you have any questions, criticisms, ideas, or wish further discourse. firstname.lastname@example.org