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This hearing graph shows a typical loss of hearing in the 4,000 Hz range caused by noise damage. The AngloGold Ashanti policy to leave communities better off on departure, and our objective to catalyze development in the region, were behind the decision to implement the AngloGold Ashanti Seed Assistance Project (ASAP) in the region. AngloGold Ashanti’s support programme for medical students has been designed with a multi-pronged approach and, particularly, with our host communities in mind.
All fatal incidents are investigated according to AngloGold Ashanti’s group procedures for incident management which include incident notification and reporting, incident investigation and closeout and review. Mr Marcos Dante Apaza (33) from Jujuy Province, Argentina, died following a fall of ground incident. Mr Abdul Razak (45) from Bohyen Bantama, Ghana, died following a heavy mobile equipment incident at the Mark Cutifani Estate in Iduapriem. Mr Ramazani Tsongo (25) from Beni, DRC, died following a heavy mobile equipment incident at Mongbwalu. Mr Liphakana Ernest Lipholo (29) from Leribe, Lesotho, died following a fall of ground incident. Mr Mahlasinyane Sidwel Leipa (32) from Buthe Buthe, Lesotho, died following a fall of ground incident that occurred mid-September 2011.
Mr Phakiso Cletus Fosa (36) from Mafeteng, Lesotho, died following a fall of ground incident.
Mr Bangindawo Mninawe (50) from Fort Malan, South Africa, died following a mud rush incident.
Mr Maile Patrick Thobi (39) from Leribe, Lesotho, died following a fall of ground incident. Mr Thuso Ernest Manosa (52) from Maseru, Lesotho, died following a fall of ground incident. Mr Tsebang Justice Ntsatsi (50) from Leribe, Lesotho, died following a fall of ground incident. Mr Middleton Zitulele Nojoko (50) from Qumbu, South Africa, died following an electrocution incident. Mr Gerhardus C Krugel (55) from Fochville, South Africa, died following a mud rush incident.
In compliance with the Mine Health and Safety Act (MHSA), medical surveillance continues at the company’s four medical surveillance centres. Harmony aligns its reporting on occupational health statistics to international standards such as the International Labour Organisation (ILO) code of practice on recording and notification of occupational accidents and diseases, as well as the MHSA. Rand Mutual Assurance Company – an industry body providing compensation under the Compensation for Occupational Injuries and Diseases Act of 1993.
In Papua New Guinea, the joint-venture partners use an integrated business information system, a web-based application that provides numerous administrative functions for health, safety, risk management and human resources as a foundation for sustainable business management.
Happiness Mawele became a Harmony bursar after completing her matric at Kgothalang Senior Secondary School in 2006. In PNG, develop an integrated strategy, aligned with the Millennium Development Goals, on TB, malaria and HIV – building on systems already in place. We value the health and well-being of all our employees and the communities affected by our activities. Harmony Healthcare provides tertiary, secondary and primary healthcare as well as occupational health services to around 80% of its employees through company-managed healthcare facilities and preferred provider arrangements. Company-owned facilities currently include two private hospitals, two private pharmacies and shaft-based medical stations. The health and well-being of the balance of Harmony employees, their dependants and contractors is ensured through medical aid membership or third-party service providers as part of their employment benefits.
For the review period, the former medical station at Target operated as a fully fledged health hub, providing an integrated, proactive healthcare service.
In the first of these roll outs, the Evander health hub opened in February 2012 with a celebratory health day supported by the DMR. Harmony Healthcare continues to entrench a proactive strategy, focused on preventative healthcare. This healthcare initiative supports Harmony’s strategy to ensure continued health improvements and is leading to notable improvements in employee attendance and workplace productivity. In PNG, medical centres at Hidden Valley, Wafi and Wau provide full-time primary healthcare and occupational health surveillance to employees, dependants and the local community.
In South Africa, the primary occupational health risk areas in FY12 were noise-induced hearing loss (NIHL), occupational lung disease including silicosis, tuberculosis (TB) and other HIV-related illnesses and heat stress. In South Africa, we are implementing a R17 million safety, health, environmental risk and quality assurance system to improve our ability to manage the safety and health information of our employees. Based on results of an occupational hygiene assessment conducted at the Hidden Valley operation in 2009, activities do not exceed regulatory standards. Central to the success of Kusasalethu’s absenteeism strategy is an approach that makes management of sick absenteeism and abuse of sick-leave entitlement the joint responsibility of medical staff and all stakeholders. Voluntary non-attendance at work without valid reason is a major challenge for any organisation, and Harmony is no exception.
During the year under review, Kusasalethu achieved a milestone with a significant drop in the number of employees absent per day. Central to the success of this strategy is an approach that makes management of sick absenteeism and abuse of sick-leave entitlement the joint responsibility of medical staff and all stakeholders.
Above all, the team believes this success reflects employees’ appreciation of the care and respect accorded to them as individuals. At year-end, 4 066 employees were on HAART treatment at an average cost of R475 per person per month or close to R23 million per annum. Pre-counselling and VCT are offered through ongoing interventions at all Harmony healthcare centres. The clinic is available to all women on Harmony’s workforce, irrespective of their medical insurance status. Three years ago, in response to the changing demographic mix in its workforce, Harmony established a unit focused on women’s issues at the Ernest Oppenheimer clinic in the Free State region. Importantly, in line with Harmony’s integrated and proactive approach to healthcare, 242 women were examined for early signs of uterine, cervical or breast cancer, with ten requiring surgery after a positive diagnosis.

Total noise emitted by all equipment in any workplace must not exceed 110dB(A) at any location (includes individual pieces of equipment) by December 2013 – the graph alongside indicates engineering equipment that emits noise levels above 110dB(A) and has been fitted with sound attenuators.
The hearing conservation programme at Harmony includes issuing individually moulded hearing protection devices for working areas with high noise levels. To date, we have issued a total of 25 062 personalised hearing protection devices, 22 128 units for mine employees and 2 934 to contractor employees.
The project initiated at Oppenheimer Hospital in the Free State three years ago to detect NIHL (5% to 10% hearing loss) early is now available at the healthcare facilities. In addition to normal hearing tests, Harmony has instituted personal hearing protection devices based on oto-acoustic emission to detect early deterioration annually before actual hearing loss occurs. In tandem with issuing devices, comprehensive training and coaching is taking place to help affected workers identify early signs and seek treatment. Silicosis and TB are the two primary occupational lung diseases in the gold mining industry in South Africa and long-term concerns for Harmony. Silicosis is linked to long-term exposure to high quartz silica dust and can cause increased susceptibility to TB. From December 2013 – using present diagnostic techniques, no new cases of silicosis among previously unexposed individuals (not exposed before 2008, or entering the industry in 2008) – this milestone is monitored by the compensation department, in-house technology and Rand Mutual Assurance. Harmony is implementing fogger systems at strategic areas underground and using spray cars in intake airways to allay dust as part of the strategy to reduce dust exposure. The MOSH team and suppliers are currently evaluating different spray cars for dust allaying as those currently deployed in shafts have water-pressure problems, resulting in poor sidewall coverage of airways.
Dust-sampling frequency was increased from the compulsory 5% minimum to 10% in the prior year to improve the confidence level of sampling results. Silicosis is publicly receiving heightened attention, given a recent court case against a major mining group by a former employee.
On 23 August 2012, Harmony and all its subsidiaries were served with court papers entailing an application by three former employees requesting the South Gauteng High Court to certify a class action. TB hampers the health and productivity of workers (absenteeism, treatment costs, compensation, allocated resources, etc) and there is increasing pressure on the gold mining industry to reduce its incidence. In line with the World Health Organisation (WHO) and the national TB strategic plan in South Africa, Harmony’s comprehensive TB control programme includes early case findings, directly observed therapy short-course (DOTS), chemotherapy and a radiological TB screening project. This process has been designed to identify contributing factors at an individual, workplace and organisational level. A total of 47 894 medical surveillance examinations were conducted in FY12 (FY11: 53 412) including entry examinations (for new employees), annual examinations, exit (end of service) examinations, and out-of-cycle examinations (for transfers, for example).
Where employees are diagnosed with a compensable occupational illness, Harmony submits details on their behalf to the relevant bodies, depending on the illness and associated legislation.
This includes a medical register that tracks and reviews each patient’s progress from initial health contact throughout the treatment process.
She completed a national diploma in computer systems engineering, supplemented by in-service training at Harmony in the IT department. As such, we focus on preventing all illnesses – from occupational illnesses to lifestyle diseases such as hypertension, diabetes and HIV – through ongoing medical surveillance, active case finding, early detection and treatment as part of an integrated managed healthcare system.
In South Africa, the annualised cost of healthcare delivery is around 10% of Harmony’s total labour cost. Casualty departments at the private hospitals continue to provide 24-hour emergency services to local communities and to company employees.
The Target health hub (see here) is a particularly good example of a proactive and integrated pilot project to bring primary, occupational and wellness services closer to the mine. Encouraging indicators include an absenteeism rate below the company average and strong employee support for proactive initiatives focused on wellness.
Integrated individual healthcare is now provided to employees, supported by management information systems that enable the company’s healthcare team to monitor and track the risk profile of individuals in terms of health and well-being. While the Wau centre is only available to dependants and community members for emergencies, four community health facilities provide services at Babuaf near Wafi and Nauti, Kwembu and Winima near Hidden Valley. In PNG, primary health risks at Hidden Valley were again upper respiratory tract infections (URTIs) and malaria, neither of which are occupational illnesses.
Staged implementation of the customised occupational health module began in August 2011 and the safety phase is scheduled for later in 2012.
While most issues have been successfully addressed, returning to work after a leave of absence has been raised as a concern by the department. The assessment spanned respirable dust, respirable crystalline silica and noise monitoring.
Through the decentralised pilot intervention at Kusasalethu, 92 defaulters were re-enrolled on ART treatment, and 47% of primary healthcare visitors referred for psychosocial matters to the social worker based at Kusasalethu. However, the Kusasalethu team – comprising medical station staff, management and unions – is implementing a successful strategy to curb absenteeism.
This reflects a strategy where the medical team manages sick leave, knows its patients, maintains the focus on service delivery and provides appropriate treatment. In practice, this means operational management, union leadership and other related parties have equal responsibility to ensure compliance with company policies and ascertain that employee behaviour and attitudes are aligned with the long-term vision of the mine. This approach will be rolled out through a focused work management programme, where best practices are adopted and shared with the entire operation. Evident in the growing number of visitors, this has been very well received by our staff members, who prefer the attention of knowledgeable female medical practitioners and nursing staff.
In addition, the baseline survey to identify noise levels of individual pieces of equipment is continually updated as new information becomes available from routine occupational hygiene inspections. This includes all categories of underground employees and selected categories for surface occupations. This project is monitored through annual audiograms for all employees exposed to noise risk at work. The industry target to prevent any hearing loss of more than 10% remains a challenge for Harmony. The new central laboratory was commissioned in November 2011 and is capable of handling the increased sampling requirement. The annual rate for certified silicosis cases can fluctuate as a result of any backlog at the reporting authority.

Harmony, as a member of the Chamber of Mines, is participating in processes to address issues relating to historical silicosis cases.
In essence, the applicants want the court to declare them as representing a class of people for purposes of instituting an action for relief and to obtain directions as to what procedure to follow in pursuing the relief required against Harmony. While the trend for TB across the industry is gradually declining, the incidence is still unacceptably high. It is therefore a logical inference that seafarers working in engine rooms have a higher propensity to encounter hearing disabilities. For a musician, rapid hearing loss is always a disaster and a good reason without any hesitation to consult an ear specialist. Age-related hearing loss is highly hereditary, and its progress can vary significantly between individuals.
After age-related hearing loss, noise-induced loss of hearing is the second most common cause of hearing loss among the adult population.
Remedial actions to address issues identified are aimed at all three levels, with a focus on organisational issues and actions. As part of our strategy, we participate in state initiatives such as TB and HIV programmes.
This model and approach is being rolled out at other mines in the company to improve the quality of healthcare, reduce the cost of centralised healthcare services and improve labour availability and productivity.
This forms the basis of individual disease management plans which are continually reviewed to assess progress.
Acknowledging the potential economic and social impact of a rising absenteeism rate, we are making good progress with establishing multidisciplinary attendance and absenteeism review boards at shaft level to proactively manage sick absenteeism and absenteeism related to psychosocial issues. However, given the impact on our workforce and communities, we have invested considerable financial and human resources in proactively combating these conditions. The new system integrates health and environmental exposure data, in turn providing the basis for improved medical surveillance data for analysis, monitoring and reporting.
Harmony’s integrated return-to-work after absenteeism framework has been accepted by the DMR and will be implemented in due course. It was conducted according to occupational hygiene practice and Australian standards for noise and dust monitoring (AS 2985-2004 and AS 1269.1-1998). In terms of VCT counselling and uptake, Kusasalethu has the highest rate in the company, underscoring the importance of professional and dedicated staff in taking full control of the process.
At present, the mine has a 4.18% absenteeism rate – well ahead of many other Harmony shafts. VCT has been introduced at all occupational health centres as part of the occupational health screening process and is aligned to the return-to-work after absenteeism strategy.
During the review period, 623 women attended the antenatal clinic, while 103 used the post-natal clinic facilities; 139 women had gynaecological examinations. A new guideline for airborne pollutants was issued late in the period as part of a mandatory code of practice.
Harmony has retained legal counsel in this regard and, on 5 September 2012, the company served and filed its notice of intention to oppose the application as it believes the applicants cannot form part of a class as, according to their own averments, they worked at different operations.
We continue to liaise and cooperate with local departments of health on specific TB training for nursing staff, and the additional resources required to improve our collective management of this disease. This is especially true if they don’t use precautionary measures such as ear plugs or ear defenders.
At retirement age, approximately every third person has suffered some degree of hearing loss, mostly as the result of ageing. Permanent noise damage can be caused by long term exposure to noise or by very loud one-off noise. Specific action plans are drawn up following each incident investigation and followed up and managed at operational and regional level. In addition, ongoing training for healthcare professionals is producing significant long-term benefits. Benchmarking Harmony against its peers and companies of similar scale, we have set 3.5% as an acceptable sick absenteeism rate. This focus on individual health risk factors is a joint effort by human resources and healthcare officials under the auspices of professional case managers based at our operations. The family planning facility dispensed oral and injectable contraceptives to 141 women and 34 women elected to be sterilised. At this stage and in the absence of a court decision on this matter, it is uncertain whether the company will incur any costs related to silicosis claims in the near future.
In keeping with wellness and fitness to work, an amended return to work strategy is being introduced for piloting and roll out in future. This reviewed strategy has wider implications for the company, as it affects all employees and contractors.
Due to the limited information available on any claims and potential claims and the uncertainty of the outcome of these claims, no estimation can be made for the possible obligation. This will ensure that operations are more focused on controlling actual dust levels instead of pollutant concentrations only. Reporting actual dust-load levels has the added advantage of timeously identifying inoperative engineering controls.
When the ears are exposed to noise over a number of years, it will eventually lead to loss of hearing.
It is performed by means of an audiometric testing machine within a sound proof booth providing an accurate measure of the damage. This would educate the crew about effects of loud noises on hearing, the purpose of audiometric testing and protective devices available to mitigate it’s damaging effects. Members who need to advise the Club of updates to their recorded ships' details should advise their usual underwriting contact.

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