This report examines what has been done since the 1998 Asbestos Summit brought together all stakeholders to address the health burden caused by more than a century of exposure to asbestos. We focused primarily on the challenges faced by people located around the former asbestos mines and mills of the Northern Cape and North-West provinces. We found that many aspects of health care, compensation, documentation, rehabilitation, education, surveillance, alternatives, and litigation still require significant improvement to respond effectively to the substantial challenges of asbestos in South Africa. However, we also observed widespread energy, good will, and support for changes among residents of asbestos-contaminated villages, government officials, trade unionists, and researchers. Of particular significance is the local organising in some affected villages and towns. By working hand in hand with government departments, such as the DME and DoH, these organisations have the potential to not only educate the populations about health services and compensation, but also to mobilise the population to rehabilitate asbestos mines and clean up contaminated areas - if they were to have additional resources.
The mining, milling, and manufacture of asbestos and asbestos products has
always been part of a global network, and the problem of asbestos remains a
global one. By sharing the tragic, yet inspiring, experience of its people grappling
for a better quality of life, South Africa can play an important role in increasing
awareness of ARDs, and developing better preventive measures world wide. The
burden of ARDs weighs heavily on South Africa because its unequal social structure
left many people vulnerable. Because of its history, South Africa is uniquely
positioned to find collective solutions. The opportunity now, one that was recognised
by the 1998 Asbestos Summit, is to link together the actions taken against ARDs,
political disenfranchisement and poverty. Participatory decision making, support
for democratic community organisations, equitable compensation, better health
care and employment in rehabilitation operations will help remedy both ARDs
and disinheritance. If this happens, it will provide an instructive case --
not just for South Africa, but the world -- on how to make other public health
programmes more participatory. This is the opportunity promised in the title
of this document. We fervently hope that South Africa will continue to work
to make it real. Through this project we hope to contribute to international
collaborative efforts that values the dignity of humanity such that this contamination
of the land and resulting burden of disease never occurs again.