Orapa Diamond Mine, Botswana

road to Orapa

Orapa mine

diamond mine

haul truck

diamond

The Orapa diamond mine is isolated in the heart of hot dry Botswana, about 300km from the nearest settlement Francistown. It is owned by Debswana, a partnership between De Beers and the Botswana Government. The mine is huge and highly productive. Diamonds are produced when volcanic activity causes carbon to be forced at extremes of pressure and temperature through a vent towards the surface. This vent solidifies and diamonds are found within the ore. When mined the vent appears in the form of a pipe extending down into the earth. The pipe at Orapa is the second largest in the world. The pit is 2km across, and 250m deep, and last year produced 17m tonnes of ore from which 18m carats of diamonds were recovered, with a revenue of $3 billion. This all produced by 3000 staff.

Debswana was the first private company in Africa to provide free antiretrovirals to its employees. Currently 600 employees and 300 dependents are on ARVs, and a further 300 employees are positive, but do not need ARVs yet. There is a hospital and clinic at the mine. The medical team includes a dietitian, so I arranged a visit.

The two and a half hour drive from Francistown cuts straight across the red scrub of the interior of the country. As I approached Orapa the mine works in the far distance looked similar to the open cast coal mines in Scotland. However unlike those mines there was a high security road block barring the way. Ndiko the dietitian had arranged a visitor's access permit for me, and once I had been issued with this I was able drive on into Orapa. To the South of the mine is the Orapa settlement. This is where the miners, their families and support personnel live and work, all within the high security perimeter. There are two banks, supermarkets and shops, restaurants, schools and of course the hospital and out patient clinics.

Ndiko carries out weekly education sessions with the miners, covering healthy eating, and issues around HIV and nutrition. These sessions form an integral part of the occupational health programme provided by Debswana, and take place within or near the workplace.

We were taken for a tour of the mine itself, passing through several high security measures. The mine is awesome to view, and the diamond-bearing core is clearly visible as a blue-grey area. The diggers and trucks are enormous. I climbed into the cab of one of the trucks – about 20 feet off the ground. The tyres were at least twice the height of me. We did not have security clearance to visit the part of the mine where the ore is refined and diamonds are extracted. Ndiko told me that she dreads the days when she has to do workplace nutrition training in those secure areas. When leaving all staff have to remove their clothes and pass through scanning equipment to ensure no diamonds leave the area! Even when I left the mining area to return to the hospital I had to pass through a scanning system, although thankfully I wasn't one of those randomly chosen to strip off my clothes.

Ndiko showed me round the hospital. It is impressive, with modern facilities including operating theatres, intensive care, and several wards. There is usually only 60% bed occupancy, compared with 120% occupancy in the state hospitals I had visited (the wards there had mattresses on the floor between beds).

Although the hospital and clinic are within the high security perimeter, people who live nearby are also welcomed for treatment, under an agreement with the Government. Ndiko and I discussed the case of an inpatient at the hospital from a nearby community.

A 7 month old infant on the paediatric ward had been admitted with Kwashiorkor, the most severe and often fatal form of malnutrition. Under the care of Ndiko and the medical team, the infant was recovering well, receiving a high protein and high energy infant formula. I was interested to know how the infant had come to develop Kwashiorkor, usually only seen in the most deprived areas, or under famine conditions.

The infant was from a San family. The San are the indigenous people of Southern Africa; in the past they were known as Bushmen, but this is considered a rather racist term now. The San had been living a nomadic hunting lifestyle for thousands of years before the arrival of both the White settlers from Europe and Black tribes from central Southern Africa. However their land was colonised by both, and gradually their communities were confined to the more inhospitable regions such as the Kalahari Desert.

Similarities can be drawn between the fate of the San and the indigenous people of Australia. Both have largely given up their traditional way of life under pressure of the majority populations. Alcohol has had negative impact on many from both communities. Both are viewed with a pitying paternalism but little real commitment to understanding their needs or of course returning their mineral-rich land.

This San family's nearest medical facility was Orapa mine. Mum had developed a nipple infection when the infant was two months old, and so had to cease breast feeding. She had no knowledge about infant formula, and so gave cow's milk diluted with water. Diluted cow's milk is significantly different to breast milk, and so over the next few months the infant's nutritional status declined rapidly.

When I discussed this case with other healthcare workers in Botswana, without exception they suggested that the mother was probably an alcoholic, had undoubtedly been seen by a social worker who would have provided formula and food baskets, but was likely to have sold the food in order to buy drink. One doctor even told me that the mother may even have used the infant formula itself to brew a kind of beer.

In fact, this mother lacked knowledge and support. This is not a problem peculiar to Botswana, however. I remember a similar case in London several years ago, although intervention occurred with that infant long before severe malnutrition could occur. This mum and infant at Orapa will now receive social work support, and both certainly looked happy and healthy when I saw them.

(Extracted with permission from http://hivnutrition.org.uk/) More to follow

Back To Top