Gul Afsar had been working as a coal worker for 22 years in a coalmine at Hangu district of Khyber Pakhtunkhwa before he developed what is known as the black lung disease. Also known as coalminer’s pneumoconiosis (CWP), he has been living with the condition for the last nine years.
“My brother also died after four years battling with the deadly illness pneumoconiosis,” says Afsar, whose brother was also a coalminer. “Now my lungs have collapsed like punctured tyre.”
Afsar said that due to the covid-19 pandemic, he and other miners in Shangla with CWP who have to go for regular medical checkups in the country, have been avoiding to visit hospital. CWP as a pre-existing condition makes them vulnerable to the virus which could also cause pulmonary damage.
“We are more vulnerable to pulmonary failure because of the virus,” said Afsar, struggling for breath.
Shangla, the mountainous district in Pakistan’s north, has a large population of mineworkers. Since there is little industry or employment opportunities, the people in the villages travel to remote districts in Balochistan, Punjab, Khyber Pakhtunkhwa and Sindh. Once employed there, they pull in other members of the family to work in the mine sector.
But the flip side of this vocation is that Shangla also has a big number of coalminers who have black lungs from years of work in the coalmines. A progressive disease, the coal workers’ pneumoconiosis (CWP) develops from inhaling coal dust while working in the deep coalmines. It is a common disease in the upper parts of Shangla, with patients found in tehsil Alpuri, tehsil Kana and tehsil Puran because of a vast population associated with coalmining.
According to the Shangla Coalmine Workers Rights association, the data of the patients with pulmonary conditions collected in 2018 showed 4934 people suffered from the black lungs only in the Shangla district.
Mian Bacha, a local activist in union council Mian Kaly, Shangla, said nine patients of the CWP had been died in the current year 2020 in his union council Mian Kaly, Pir Abad, however, the district health department has not available any data of the patients.
Gul Afsar said that the government neither taken special measurement for their safety from the covid-19 virus nor provided safety kits and medicines.
Doctor Shafi-ul-Mulk, medical superintendent at the district headquarters hospital, Shangla, said 80 percent of the coalminers belonged to the tehsil Alpuri and the number of patients with CWP was higher in the area.
Replying to a question, he said there was no pulmonologist and nor ward for these patients in Shangla existed despite the the high number of patients with CWP in the area.
He said that he had been most concerned for the poor people since the pandemic because their respiratory system already did not work properly.
“The coronavirus could potentially take their lives,” said Doctor Shafi-ul-Mulk.
Rahimuddin, a patient with the black lung condition, said he had been suffering from CWP since 2014. He had worked as coalminer for 16 years when he was diagnosed to the disease.
“My breath is temporary and I cannot breathe without consuming heavy medication that causes problems in my stomach,” he said. “I spend Rs 4000 to 5000 monthly on medicine with the help of local people.”
Rahimuddin and other CWP patients get emergency treatment when their condition deteriorates, especially during the bitter mountain winters. They buy medicine from the market it is not available for them in the DHQ hospital.
36 years old Sher Nawab of Banar Khwargai, Shangla has migrated to Peshawar for his treatment due to harsh weather in Shangla which worsens the disease. CWP patients often do not survive the winters.
He said if there was a special ward in Shangla for them they would not have to migrate during winter.
“Staying in general wards of the hospital could expose us to other diseases like coronavirus,” he said.
Doctor Akhter Ali Khan, who is head of the Pulmonology department at Saidu teaching hospital in Swat, said that pneumoconiosis patients in Shangla were in a high number but they had not documented how many coalworkers were infected by the coronavirus.
Replying to a question, he said there was no specific ward for the CWP patients at Saidu Teaching Hospital, however, daily 2-5 patients visited his clinic and the outpatient department at the government hospital for monthly check-up.
Assistant Professor Akhter Ali Khan further said the CWP had different stages. Patients needed continuous treatment and with the passage of time their lungs did not absorb oxygen and they died when their lungs collapsed. He said these patients visited to all pulmonologists in Swat and Peshawar for their treatment but the flow had decreased due to the covid-19 pandemic.
Said Faqir, a 60 years old patient of CWP, said that he had been suffering from the chronic disease of lungs for the last 10 years and had worked as collier for 41 years.
He said around 40 people he saw in his life died after battling with this disease.
The elderly man also claimed every coal worker got the disease after the age of 50, after which visits to doctors and herbalists for treatment become their routine.
Abid Yar, president, Shangla coalmine workers rights association president, said all the coalminers were living on the mercy of Almighty as despite the second wave and certain surge in the covid-19 cases in the country, the contractors still forced the labourers to work in the mines.
He said mines labour work in a dozens of groups in these deep mines and never adapted standard operating procedures set for protection from the coronavirus.
Mr Yar claimed all the CWP patients in Shangla and other parts of the country were vulnerable to the virus and despite their repeated requests government did not set up special ward and nor taken steps for ill people’s protection.
The miner’s rights association activist further said the rocks in coalmines of Aurakzai of Khyber Pakhtunkhwa were full of asbestos and during drilling, the dust inhaled into the lungs caused severe pulmonary damage.
He said the contractors of mines also used sub-standard drill’s bit and did not even provided workers face mask for protection.
Mr Yar said the government should make treatment of the high number of CWP patients possible and conduct research to control this deadly illness, while takin steps for protection from corona virus.