Case Study 06:
THE ISSUE: For companies operating in developing countries, diseases such as malaria, tuberculosis and AIDS can affect the health and well-being of host communities, including their own employees. What role can companies play to support or augment existing government health-care programs to help reduce the impact of disease?
THE KINROSS WAY
Consistent with our core value “Putting people first”, Kinross implements occupational health and industrial hygiene programs at its operations to ensure the health and safety of employees who may be exposed to health hazards in the workplace. Where employees are exposed to significant health hazards outside the workplace, such as in areas with high prevalence of endemic diseases, we take a broader approach.
We are fortunate that the majority of our mines operate in regions that are at low risk from endemic diseases. One exception is our Chirano operation in Ghana, where malaria is a leading cause of disease and death among children and pregnant women. Despite the fact that the disease is both preventable and treatable, malaria accounts for 33% of all deaths in children five years of age and under and is the leading cause of absenteeism at both the workplace and schools. At Chirano, malaria accounted for approximately 62% of annual outpatient visits at the Chirano mine’s clinic. Malaria was also the primary cause of employee absenteeism at our operations with 3,887 episodes among the workforce in 2008.
Since 2009, Chirano has invested $5.6 million in an integrated malaria control program, with $3.5 million to finance infrastructure and $0.7 million in annual operating costs.
The Chirano Malaria Control Program (CMCP) covers the mine site and the nearby 13 communities in the Bibiani-Anhwiaso-Bekwai and the Sefwi Wiawso districts. The CMCP is managed by Vector Control Consult Ltd. in partnership with the Noguchi Memorial Institute of Medical Research, the district assemblies and district health management teams of Sefwi Wiawso and Bibiani-Anhwiaso-Bekwai, the Ghana Education Service, and the National Malaria Control Program.
The CMCP is based on an integrated vector management approach (IVM), designed to:
- Keep areas mosquito-free, through indoor residual spraying, targeted larviciding, breeding habitat reduction, and the use of insecticide-treated mosquito nets;
- Improve disease diagnosis, management and prevention, through education, enhanced services at its health clinics, and the provision of preventive therapies; and
- Undertake scientific and social research aimed at prevention and elimination of local disease transmission within the catchment area. To support our research, we built a small research facility dedicated to malaria control research, the only one of its kind in Western Ghana. The CMCP is based on a sound scientific understanding of the behaviour of local malaria vectors, the forces of transmission and the susceptibility to available recommended and safe insecticides. Evidence-oriented decision-making in implementation underpins the success of the program.
At the end of 2011, the program was successful in reaching its Phase 1 target of reducing the workforce malaria incidence rate by 75%: the data show a 81% reduction in the incidence rate of malaria in the workforce, and a 53% reduction in the incidence rate in the beneficiary communities. The CMCP covers about 13,700 people, including around 2,250 children under five years of age and (on average) about 200 to 250 pregnant women. Indoor residual spraying (in which indoor walls made from porous materials such as mud or wood are sprayed with an insecticide that kills or repels mosquitoes) was conducted in 9,770 structures in the communities, covering 88% of all structures in the villages.
The success of the Kinross Chirano model has contributed to the development of standards for malaria control in Ghana by the Ghana Health Services (GHS), through the National Malaria Control Program (NMCP). The Chirano Malaria Control Program is represented on the Malaria Vector Control oversight committee of the NMCP of GHS.
The challenge for Kinross going forward is to develop the collaborative partnerships – with governments, NGOs and private-sector investors – that can sustain the existing program and, ultimately, expand its coverage beyond the current beneficiary communities.