Occupational safety and health

The Edwin Cade Memorial Hospital at Obuasi, which has been open for some 70 years, has played a crucial role in health care in the vicinity of the Obuasi mine. The hospital, which has a capacity of some 170 beds, caters for about 70,000 patients per year, currently drawn predominantly from the non-employee community.

The hospital has five doctors (two of whom are specialists), two medical assistants, 16 senior nurses, 50 junior nurses, and 10 support staff in other medical disciplines. It caters for some 14,000 out-patient visits and 500 admissions per month, with an average length of stay of five days. About one third of the patients are drawn from the community, with a recovery of only 25% of costs. (The policy has always been that community members should pay, but this has not been enforced. Even though there is a government hospital in Obuasi, many community members prefer to use this mine hospital, which also receives referrals from the government hospital.)

In recent years, the burden of a large, non-paying community and ageing equipment and infrastructure have led to reduced levels of service for employees and their dependents. This has resulted in some of the more senior employees making use of private health care providers. Another burden for the hospital is the malaria pandemic, with between 6,000 and 7,000 new cases diagnosed every month. Employees comprise 27% of malaria cases, while their dependents and the community make up 40% and 33% respectively.

A recent review of service levels and facilities has precipitated a review of hospital policies and procedures to ensure:

• that the same level of care is accessible to all employees and their dependents;
• that this will be provided at the company's facilities in the first instance (prior to referral to an external service provider should this be required); and
• that employees will have preference, in terms of access and hospitalisation, over private, non-employee related patients. A costing structure to provide health care at reasonable cost levels for the community is being devised.

A $1.235 million upgrade of facilities and infrastructure is planned over a three year period, alongside the appointment of additional medical practitioners, nursing and other staff (including a malaria laboratory technologist). A number of immediate remedial actions has been taken although the upgrade is likely to only be completed in 2007. In addition a major malaria campaign is being embarked upon. (See case study: A scientific approach to malaria control at Obuasi in the HIV/AIDS and malaria section of this report.)

Included in the upgrade are the planned refurbishment of the casualty and maternity sections; new kitchen facilities; the setting up of an in-service training facility; a staff room; and malaria laboratory. Plans are also in place to improve the medical information and reporting system. An important part of this plan is refurbishment of the radiology facility and the occupational health department, to enable the establishment of an occupational health service. Audiometry facilities will also be installed, and additional training will be provided to existing medical personnel in occupational health. Increased attention is being focused on HIV/AIDS programmes including peer educator training, condom distribution, and voluntary counselling and testing. In addition, an emergency response/mass casualty plan is being developed as well as a cyanide response plan.