Dr. Munawar Aziz MCPS*
A middle-aged miner who had been working in the mines for about three decades in the Sherwan area, located about 35 km west of Abbottabad in the hilly terrain, developed a cough and became breathless while walking. This area is rich in natural resources, including soapstone (locally called as “glass mohra”)
Dr. Munawar Aziz
He was started on anti TB drugs by a local quack after an X-ray chest, despite having no fever and without undergoing essential diagnostic tests such as a sputum smear for AFB, AFB culture, ICT tuberculosis or the newer blood test (IGRA – Interferon Gamma Release Assay), which confirms whether TB is present or not. Most importantly, the quack failed to take the patient’s occupational history.
The patient attended my clinic with his X-ray chest and was examined after taking his detailed history, was assured that he was not suffering from TB. He appeared happy, as TB is still considered a stigma in many communities. However, his actual diagnosis, Silicosis was a lifelong problem that he had developed due to a lack of precautions on his part and the absence of education or safety measures provided by his employers.
Silicosis is a chronic lung disease caused by inhaling fine particles of crystalline silica dust, commonly found in industries such as mining, construction, sandblasting, and stone cutting. Prolonged exposure leads to inflammation and scarring in the lungs, resulting in difficulty breathing and decreased lung function.
Common symptoms include persistent cough, shortness of breath, fatigue, and chest pain. In severe cases, it can lead to respiratory failure or increase the risk of tuberculosis and lung cancer.
Silicosis is preventable but irreversible. Prevention measures include proper ventilation, the use of water sprays to suppress dust, wearing protective masks, and regular health monitoring of exposed workers. Unfortunately, in many developing countries, poor workplace safety standards contribute to the rising incidence of silicosis.
Awareness, education, and strict enforcement of occupational safety laws are vital to combat this preventable disease. Employers must ensure safe working conditions, and workers should be trained in protective practices. Early diagnosis through chest X-rays and pulmonary tests can help in managing symptoms and slowing disease progression.
Mining department should make sure that all the necessary precautions are taken to ensure the safety of the miners including a healthy environment for the workers.
About quacks in health sectorI feel sick and tired of speaking about it, because all the hue and cry has fallen on deaf ears so far.
- Dr. Munawar Aziz
Abbottabad, Pakistan.
aziz.munawar@gmail.com
It is heartening to note that you are disseminating medical information and preventive measures for the common people. People like you are an asset of a nation and their services should not go unrecognised. My heartfelt gratitude.
Employers don’t listen unless there is a deterrent – the law. That, unfortunately, is not to be seen in our land of pure ! An elderly man with Non Hodgkins Lymphoma ( cancer of immune sytem) died at 85 years in UK. His work history included working on a nuclear test site in Africa with very little protection. I took up his case and the UK government accepted liability because there was a law AND it was respected. His wife received a good compensation.
Sir we are waiting for the compilation of these articles in the form of a book. Topping will be Urdu translation
A very sad and moving account of the plight of the miner. It reminds me of the plight of the coal miners and other miners in Britain and the British colonies (including then-India) in the 19th and early 20th centuries . The colonists went away but the exploitation of poor miners continues , at many levels – both by the rich employers and by the medical quacks that are mentioned herein. Governments don’t care to enforce existing laws and regulations and public ignorance and lack of basic education compounds such serious problems . Things are only getting worse , day by day.