It is not easy to gauge the commitment of mine operators to compliance with worker safety in South Africa, through amongst other requirements, the provision of Emergency Medical Care Services on-site. Nevertheless, what is evident is that the Department of Minerals and Resources’ approach has significantly resulted in a mindset shift. Markedly, the Department is very strict on enforcement of worker safety and does not hesitate to shut down operations in the event of a fatality or serious injury if there is concern regarding safety. Fortunately, many mines do have a proactive approach and ensure that Emergency Medical Care services are available onsite and that proactive deployment of resources occurs during potentially dangerous operations, according to Dr. Vernon Wessels, a veteran medical doctor for Site Based Medical Services at ER 24. However, this does not apply across the board and smaller operators are still dependent on external response (other than first aid) in the event of an accident, he acknowledges. So, what is the impact of lapses on operations? What could be the practical approach? Has the economic slowdown affected how mines approach Emergency Medical Services? Dr. Wessels addresses each of these questions.
Impact of lapses
There is no question that inadequate emergency medical care solutions can greatly affect mining operations, states Dr. Wessels, citing trauma as a case in point. “In trauma, time is the most critical factor in many injuries that can affect the outcome of the injured employee. Control of bleeding, re-establishment of perfusion to areas that have had blood supply compromised and proper management of head injuries are a few examples of where proper management can make a difference, whether the patient survives or not, or will be able to have a functional life after the incident. However, inappropriate care and preventable loss of life or functionality can negatively impact on the workforce which can lead to unproductivity and even labour unrest. The duty of care that falls on the employer can also expose them to possible civil and criminal legal action.”
Relevance of specialised Emergency Medical Services
To manage traumas effectively, an emergency medical services team with skills and experience within the mining sector is highly recommended, says Dr. Wessels. “The emergency medical services team can assist a mine not only in providing adequate response in the event of an incident but also ensure that pro-active measures are in place,” he explains. “Furthermore, it can assist the HSE representatives with identifying risks that can be mitigated or corrected, above and beyond, preparing first responders to be able to stabilise an injured person until the service can reach the patient.” Most importantly, Dr. Wessels emphasises, “Although first aid training is provided to the workforce, regular refreshing of their knowledge during toolbox talks and health talks helps to keep them more alert.”
The scope of site-based emergency medical care
The scope of site-based emergency medical care provided varies, depending on the type and scale of the mine. In some cases, all that is required is a single advanced life support practitioner to augment an existing in-house emergency response team. In others, the full scope of emergency care from Basic Life Support to Advanced Life Support is provided including crewed ambulances, primary response vehicles, rescue services and offsite aeromedical response and transport. In addition, there is clinical oversight and consultancy available to crews, as well as formal and informal training options ranging from first aid for the mine employees to professional training courses for the emergency care staff. Medical risk assessments can also be performed, along with assistance with procurement of emergency equipment and consumables.
Mapping out a unique solution
Every mine is unique, and so are the potential emergency medical challenges faced. Consequently, Dr. Wessels advises, vital steps have to be followed to address a mine’s emergency medical care requirements when consulted to map up a solution. “The first step is to perform a medical risk assessment which will highlight the potential risks, the workforce demographic, the available infrastructure and surrounding medical resources (hospitals and external emergency medical services) and environmental factors that could affect the workforce and the response to emergencies. Based on this assessment, a client specific solution is proposed which is then adjusted with the client to satisfy their need.”
Impact of economic slowdown
A recent development that cannot be ignored is the slowdown in the global commodities market, which has resulted in the reduction of revenue in the mining sector. This has prompted mines to optimise efficiency in order to survive, observes Dr. Wessels, pointing out that emergency medical services, which are viewed as a non-core function within a mine, can be targeted for down scaling. He sees consultants increasingly playing the crucial role of identifying potential cost savings that can be incorporated within a solution. “The consultant would help ensure that the changes have a minimal impact on the service provision. In this manner avoid cuts which the client may have proposed that would have significant impact.”
High level of awareness
Despite the persisting challenges, Dr. Wessels underlines, what is most refreshing to note, from ER24’s perspective, is that mine management in South Africa, for the most part, are very responsible when it comes to emergency medical care provision on their mines. “While the pressure to save costs is high, the temptation to downscale will be high. From our experience, the mine management does engage with the service providers in order to look at alternate options.”