China Labour Bulletin is quoted in the following article. Copyright remains with the original publisher.
December 15 2014
GULI TOWNSHIP, China-When the shortness of breath he suffered for months became so laboured that it fractured his sleep, coal miner Ruan Fayou knew he needed help.
It took another year, multiple hospital visits and repeated shunting between bureaucracies for Mr. Ruan to determine he was suffering from pneumoconiosis, a disease commonly known by its most vivid symptom: black lung.
China is grappling with a surge in the deadly disease, a consequence of decades of coal-fired development. Cases of black lung in the U.S. peaked in the 1960s. But the world’s second-largest economy and top coal consumer is just starting to deal with the fallout.
Miners such as Mr. Ruan were the front line of China’s boom, working in an often-lethal industry that is powering China’s transformation. Now they are among its casualties, struggling to get treatment and to pay for it. “I was in despair when I learned I had the disease,” he said. “I didn’t have the energy, but I had to slowly find a way.”
During the dozen years that he worked in mines around his hometown of Guli, Mr. Ruan, 55 years old, said his employer only once provided him with a mask. The mine bosses were indifferent to whether the workers wore them, he said.
Masks reduce the risk of black lung, and Chinese companies are required to supply them. But the law doesn’t specify how often they should be worn, and many miners don’t wear them, according to China’s leading black-lung support group Love Save Pneumoconiosis.
For months before Mr. Ruan was diagnosed, he was often breathless. He caught colds easily, and the coughing never seemed to stop. “When it gets bad, I would go to bed at 10, and it would take me four or five hours to fall asleep,” he said. “I would toss and turn. I could hardly breathe.”
It was at the county hospital a short ride from his village in south China’s impoverished hill country that Mr. Ruan learned he might have contracted coal workers’ pneumoconiosis.
When he returned from the hospital, Mr. Ruan’s bosses at Guli’s Shiqiao coal mine were dismissive. “They told me it was tuberculosis,” he said. “They said it has nothing to do with the company.”
China’s struggle with black lung is likely to outlast its addiction to coal. China last month made a commitment to start reducing its annual volume of coal usage by 2030. That turning point-called “peak coal”-could occur years before that as this country cleans up its degraded environment.
China’s diagnoses of pneumoconiosis have risen sevenfold from 2005 to 2013 to about 750,000, at an average pace of 35 per cent annually, according to official data.
That is likely to be an underestimate. Watchdog groups say 90 per cent of China’s coal miners lack labour contracts and so don’t qualify for inclusion in official health surveys. That would indicate that black-lung sufferers number closer to six million, said Wang Keqin, founder of Love Save Pneumoconiosis. Hong Kong-based watchdog China Labour Bulletin agrees with the estimate.
Black lung occurs when particles of coal dust become trapped in the lungs. Over years, the sufferer’s lungs harden and wither in an attempt to expel the dust. It is incurable. If the disease is left unchecked, the organs eventually blacken.
A treatment, called a lavage, flushes the lungs to ease the symptoms. But a 10-day course can cost twice an average Chinese miner’s annual salary.
The disease isn’t confined to the coal industry. Variants of the affliction include those stricken after breathing in metal dust. Many metal workers thrived in the China’s industrial boom, with little enforcement of safety regulations. Now, they are turning up sick at hospitals, often in China’s poorest areas.
At Guiyang Pulmonary Hospital, a 16-story hospital in the provincial capital of Guizhou, doctors told 42-year-old Yan Yutai that he may have contracted pneumoconiosis from his job casting aluminum molds.
Mr. Ruan knew about black lung before he developed symptoms. A 30-year-old cousin, Zuo Shunyou, started work at the Shiqiao coal mine two years before Mr. Ruan. In 2010, after recurring fevers and breathing trouble, Mr. Zuo sought help.Doctors at Guiyang Pulmonary Hospital suspected black lung from the tissue scarring found in an X-ray scan. But they wrote a question mark on his diagnosis because further tests were needed; Mr. Zuo said he didn’t have the 13,000 yuan for the additional tests, and, he said, the mine’s owners wouldn’t pay. Mr. Ruan calls coal mining “the hardest job.” At Shiqiao, coaling went around the clock in three shifts, seven days a week. He and his colleagues dug up more than 400 tons of coal a day.
Mining wealth also paved local roads and built basketball courts in Guli. Coal lifted Mr. Ruan from living in a mud-walled three-room hut to a two-story concrete townhouse.
Perched 4,000 feet above sea level, Guli is surrounded by hills so steep that, farmers say, mechanized agriculture is impossible. To make more money, they dug into the hills, which are rich in anthracite coal. A miner can make two or more times the average yearly farming income of 5,000 yuan, around US$800.
The dust thrown up when miners blast the coal face gets so thick that two colleagues three feet apart couldn’t see each other. “I can only see the light on the other guy’s helmet,” Mr. Ruan said.
Chinese law requires coal companies to provide medical checkups before a miner starts the job, after he leaves, and annually between. Labour watchdogs say Chinese companies mostly don’t meet these obligations.
After county doctors told Mr. Ruan in August 2012 they suspected he had pneumoconiosis, Shiqiao’s owner, Yonggui Energy Resources Development Co., dismissed the finding, he said. Mr. Ruan traveled two hours away to Guiyang to get a second opinion.
When he returned to Guli with confirmation from Guiyang Pulmonary Hospital, Mr. Ruan’s supervisors said they needed another hospital to confirm the diagnosis. Back he went to Guiyang’s No. 5 People’s Hospital.
When No. 5’s staff alerted officials at Guiyang’s work-safety administration, Mr. Ruan’s bosses opted to dispatch him to the city’s No. 3 People’s Hospital. Mr. Ruan figured it was just a way for his bosses to stall him. “This hospital can’t confirm black-lung cases,” Wang Shao’an, chief of No. 3’s intensive care unit, said.
Yonggui, which didn’t respond to requests to comment, had by then put Shiqiao up for sale. Privately owned Chongqing Dongying Group Co. took over.
Dongying initially told Mr. Ruan it wasn’t liable for his medical bills, but eventually agreed to send Mr. Ruan to a small hospital near Guli, where a doctor spelled it out. “He said, this illness is incurable-you will take this into your coffin,” Mr. Ruan recalled.
He is now in an uneasy truce with his bosses. In March, they offered him a lighter job, above ground, which he accepted. “They asked me not to sue them,” he said. He hasn’t decided what he will do, he said.He needs the money. An unemployed son depends on him, as do his mother, wife and granddaughter.
“You just have to look out for yourself down there,” he said. “No one will look out for you.”