Ex-miners queue at TEBA in Mafeteng during a Tshiamiso Trust outreach

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BILLY NTAOTE

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Much of today’s news about Basotho mine workers centers on illegal gold mining and the violent turf wars spilling into South African townships. Their clashes dominate headlines, painting them as a menace.

Much of today’s news about Basotho mine workers centres on illegal gold mining and the violent turf wars spilling into South African townships. Their clashes dominate headlines, painting them as a menace.

In Stilfontein, hunger itself was recently used to force men out of an abandoned shaft.

Yet the story of illegal miners cannot be separated from history. Their fathers and grandfathers once worked legally in those same shafts, recruited as cheap labor to power South Africa’s gold industry. From the villages of Lesotho, generations of men came of age by crossing the border to dig gold for multinational companies.

Now their children descend into the same mine shafts illegally, while their families at home still see them as breadwinners carrying on a legacy that left deep scars.

Behind the daily headlines lies a quieter story: the lingering damage to the men who built the mines and were abandoned by them. Former miner and ex-miners’ advocate, Rantšo Mantsi, says the same shafts where Basotho ex-miners once extracted gold for wealthy companies are the ones their grandchildren now risk their lives in as zama zamas.

He argues that the ex-miners’ plight is one of courage in the face of betrayal, having been exposed to hazardous conditions without proper protection or fair compensation.

“These men were the backbone of South Africa’s gold mines,” Mantsi says, pointing to Anglo American, African Rainbow Minerals, AngloGold Ashanti, Gold Fields, Harmony, and Sibanye-Stillwater. Yet today, many live in abject poverty in Lesotho; their only inheritance is the gold dust lodged in their lungs.

Dr Llang Maama, who heads Lesotho’s Tuberculosis Programme, calls this inheritance “fatal.” The dust eats away at their lungs day by day, leaving most with silicosis, many battling repeated bouts of TB until their deaths.

Lesotho faces one of the highest tuberculosis (TB) burdens in the world, with an estimated 15,000 new cases annually and an incidence rate of 664 per 100,000 people, according to Dr Maama. She notes that nearly half of TB patients are HIV-positive, intensifying the country’s public health challenge. Yet, only about 42 percent of TB cases are detected and treated, leaving thousands of infections unaddressed.

Dr. Maama highlights that ex-miners are particularly vulnerable due to occupational exposure to dust and silica from the South African mines.

A living testament to the lingering scars of mining gold that ex-miners endure can be seen in ex-miner Patlo Phamotse, whose tale of agony is documented in his medical records, obtained by the MNN Centre for Investigative Journalism (MNN).

A handwritten radiological report dated 2008 bearing Phamotse’s name is undeniable evidence of the suffering inflicted on ex-miners by multinational corporations running mines in South Africa. The radiological report is a map of a man’s ruined health.

Phamotse’s radiological report, issued by the South African National Institute for Occupational Health’s occupational medical section, describes a battlefield inside his chest.

“In the left lung, the very structures that deliver air and blood are distorted and crowded. The right lung shows a ‘distorted’ vascular bed and a cluster of abnormal shadows, opacities, measuring 2.5 cm.

His diaphragm, the muscle that should power his breath, is distorted. The background of both lungs is littered with nodular or irregular linear opacities, the lingering scars of dust inhalation.”

The report further notes that Phamotse’s long exposure to silica dust owing to his labour in the gold mines of President Steyn Mine and Vaal Reefs Mine has resulted in a debilitating, and likely fatal, combination of “Silicosis and repeated bouts of tuberculosis.”

Phamotse has told MNN he should have been hospitalized a long time ago, but he postponed it to personally visit the Tshiamiso Trust’s lodgement centre and get first-hand feedback on his compensation claim during the Trust’s outreach in the northern district of Leribe, Lesotho, in July.

He says he now finds it very difficult to breathe or even walk long distances as a result of his deteriorated lung function.

Phamotse further disclosed his TB treatment cards showing that he underwent treatment in Leribe district’s Motebang Hospital. The two cards indicate he completed an eight-month-long multidrug-resistant TB treatment from October 2017 to May 2018, and again underwent treatment from February to July 2022.

This is not just Phamotse’s reality, but a reality faced by many ex-miners who were once mine workers in the South African gold mines.

Phamotse’s long exposure to silica dust mirrors the stories of many Basotho ex-miners whose decades of labor in South African mines resulted in a debilitating, and likely fatal, combination of “Silicosis and tuberculosis.”

Rabi Tšehlahali says his 36-year mining career began in 1982 at Saaiplaas Mine under Anglo American, moved to Tshepong Mine and later to Harmony Gold. While there, he was diagnosed with TB.

“It was treated, and it seemed to be cured,” he says.

After retiring in 2018, he developed TB again and lodged a claim with Tshiamiso when it came to Lesotho in 2021.

He says the mine never told him he had silicosis. “I was admitted to the mine hospital for many years, but I suspect the mine realized I had silicosis but did not inform me,” he told MNN.

At home, a doctor confirmed he had both TB and silicosis. At Sankatana Hospital in Maseru, Lesotho, Tšehlahali took a medical test that enabled him to access a certificate confirming silicosis for his Tshiamiso claim.

But Tsehlahali showed MNN a certificate of first-degree silicosis dated 21 October 2022, issued by the South African Ministry of Health’s Medical Bureau for Occupational Diseases, which further noted his previous certification of silicosis was on December 10, 2018, when he retired, but he argues he was never informed until he received the certificate in 2022.

Widows’ plight

The struggles also extend to widows of ex-miners seeking compensation. Several widows trying to access compensation for their late husbands who died from TB and silicosis told MNN they have made repeated trips to Tshiamiso lodgement centres without clear answers.

Their claims are further undermined by health records and death certificates that often omit the occupational causes of death, with most documents seen by MNN simply listing “natural causes.”

Phamotse has the proof of his illness, a document that should have been his key to justice. But these documents have failed to guarantee him compensation from the Tshiamiso Trust. Phamotse is joined by many other ex-miners like Tšehlahali, whose evidence of having worked in the mines has been dismissed by Tshiamiso.

Broken promises: The Tshiamiso Trust

The Tshiamiso Trust was set up in 2019 to compensate gold miners who contracted silicosis or TB after years underground. Many were migrant workers from Lesotho and other countries.

The Trust followed a class-action lawsuit against six mining giants: Anglo American, African Rainbow Minerals, AngloGold Ashanti, Gold Fields, Harmony, and Sibanye-Stillwater. Instead of admitting liability, the companies signed a no-fault settlement that created a 12-year fund to pay eligible miners and their families.

Compensation ranges from M70 000 to M500 000 for silicosis and from M50 000 to M100 000 for TB. Families of deceased miners can also claim.

Trust chairperson Mavis Ann Hermanus, in her paper titled Tshiamiso Trust – Mandate, Uncertainties, and Dilemmas, says that while the fund is a step forward, it still faces dilemmas and uncertainty in delivering real justice to thousands who gave their health to the mines.

Tshiamiso has set up an eight-step claim process that claimants must follow to access compensation:

1.     Checking eligibility details on the Tshiamiso Trust website

2.     Booking an appointment at a designated site

3.     Lodging the claim by submitting the required documentation

4.     Undergoing a Benefit Medical Examination (BME) if required

5.     A medical panel review of the documentation

6.     A Trust Certification Committee review

7.     A review by the Founding Companies’ Agent

8.     Claim approval and payment

On October 2, the Tshiamiso Trust’s progress report on Lesotho shows that miners, ex-miners, and beneficiaries have lodged 55 639 claims. Of the 55 639 claims lodged, Tshiamiso has conducted 22 712 benefit medical examinations on living miners and ex-miners. Of the 22 712 completed BMEs, 9 747 claims have been paid, totaling M906 798 842.

Despite these figures, Phamotse’s case presents a real-life story of a claimant who continues to struggle to access compensation despite medical proof. His pathology report should have been the key to justice. Instead, the documents have not secured him compensation from the Tshiamiso Trust.

He first lodged a claim in 2023 after undergoing a chest X-ray and lung function test. Months passed with no feedback. When he followed up at the Trust’s lodgement centre at TEBA in 2024, he was told to repeat the tests. His earlier X-ray and results had vanished from the system.

“It did not even show that I ever went for an X-ray and other tests,” he says.

“I had to go through the X-ray again, but until now, nothing has ever happened.”

A document he shared shows his claim had advanced through several of the Trust’s eight-step process but stalled at the Trust Certification Committee review stage.

“I was told that I must pass from that stage to the next so that I can be compensated, but I have been stuck there since 2024,” Phamotse says. Each time he checked, the same answer came back – his claim was “not completed.”

Even Tshiamiso agents who later checked his file during outreach in Leribe confirmed that his case was registered and at an advanced stage. But when they escalated the matter to headquarters in Gauteng, the response came back: there was no clear reason why his claim had not been finalised. The advice was to start the entire process anew.

Phamotse has since gone through another round of medical tests, and a new file has been opened.

“I am hopeful that they will pay me this time around as my health continues to deteriorate even further compared to when I first lodged my claim in 2023.”

Like Phamotse, Tšehlahali has records showing he contracted silicosis and underwent TB treatment, yet he has received no compensation.

He says Tshiamiso took five years to process his 2021 claim, only to declare him ineligible for payment. Tšehlahali argues that silicosis is a progressive disease and insists he should be allowed another benefit medical examination, paid for by Tshiamiso, to assess how far the illness has advanced in his lungs.

“I believe my condition is worse than it was in 2021 when I was first tested. My health is deteriorating, and I have medical documents proving this,” he says.

Instead, he complains, the Trust relies on outdated results. “They are using results from the 2021 examination rather than our current history. This is suspicious and needs investigation. I expected to be tested again in 2025 because these illnesses progress over time.”

His red card still states he is ineligible for compensation despite a third TB diagnosis and confirmed silicosis.

“They refuse to listen to our complaints. When I asked about the old results, the staff told me only decision-makers could explain,” he adds.

Tšehlahali says Tshiamiso now demands M1 400 for a new medical test.

“Most people tested in 2021 are being sent home without updated testing. Tshiamiso refuses to provide new tests unless we pay M1 400. Why should we pay when these illnesses were caused by working in the mines and nowhere else?”

Tshiamiso Trust response

In response, Chief Executive Officer of the Tshiamiso Trust, Dr Munyadziwa Kwinda, says the benefit medical examinations (BMEs) are a critical step in the claims process used by Tshiamiso.

“The BME provides crucial evidence of lung damage from silicosis or tuberculosis, the two occupational diseases compensated by the Trust under specific conditions,” said Kwinda.

Kwinda adds that it is important to note that Tshiamiso Trust BMEs do not include tests for active TB. If a claimant is found to have active TB or is suspected, the claimant is referred for testing and must be cleared of TB before their BME can be scheduled.

“As the trust, we would love to compensate everyone, but the trust deed compensates for permanent lung damage resulting from these diseases, not for merely having TB or silicosis,” he says.

He further says this compensation adheres to specific medical eligibility criteria outlined in Schedule H of the trust deed establishing the Tshiamiso Trust.

Following the BMEs, Tshiamiso’s next step is a Trust Medical Panel that Kwinda says “meticulously analyzes the findings to determine whether a claim is eligible for compensation. That is, this medical certification process determines if somebody has a qualifying disease. And as you know by now, our medical eligibility rate is quite low.”

Kwinda revealed that data indicate that 70 percent of claims are certified as ineligible owing to claimants’ failure to “meet the qualifying disease criteria set out in the Trust Deed.”

“Although in the past we reported less than 30 percent success, currently we have seen our medical eligibility rate sitting at 30 percent. And what that simply means is that out of 10 claims that go through our medical certification panel, only 3 are medically eligible and 7 are medically ineligible. And that is where the unhappiness comes in.

“And because the trust is working, is doing lots of work, everyone has hope that they will be compensated, and when they are not compensated, it becomes a disappointment,” said Kwinda.

“We are also acutely aware that key challenges remain. These include incomplete or missing documents that delay some claims, difficulties in locating or contacting many claimants, and the inability to extend Benefit Medical Examinations to all areas due to logistical constraints,” he added.

Kwinda said Tshiamiso undertook a July–August 2025 outreach in Lesotho because it is not sitting idle.

“We are here in Lesotho, actively working to resolve the challenges.”

For deceased ex-miners’ widows or beneficiaries, Kwinda said there must be evidence that TB was a primary cause of death within one year of leaving the mine or evidence of silicosis.

Kwinda added that they had made a positive development towards resolving widows’ problems, saying: “When I first came here, we faced major challenges. One being that our Trust Deed required an ex-miner’s death certificate to state TB or silicosis as the cause of death, yet most only recorded ‘natural’ or ‘unnatural’ causes. Amendment Number 7 (Amendment to Trust Deed), adopted in December last year, resolved that by aligning us with the WHO’s Certificate of Medical Finding on the Cause of Death.

This allows us to look beyond official certificates to medical records that show the real cause of death. We now recognise two categories: Category A, where silicosis caused death, and Category B, where the person had silicosis but died of other causes.”

Who profits from suffering?

The gold that ruined Patlo Phamotse’s lungs built fortunes worth more than R1 trillion for the companies that agreed to the no-fault agreement that formed the Tshiamiso Trust. The Tshiamiso Trust’s six founding mining giants: Anglo American, African Rainbow Minerals, AngloGold Ashanti, Gold Fields, Harmony, and Sibanye-Stillwater remain some of the wealthiest corporations listed on the Johannesburg Stock Exchange.

A conservative estimate based on their latest reported market capitalizations shows that their combined gold-only value sits at roughly M1.49 trillion, according to data drawn from recent market reports and 2024 company filings.

This figure includes AngloGold Ashanti (M622.5 billion), Gold Fields (M645 billion), Harmony (M185.6 billion), and the gold segments of Sibanye-Stillwater (M39.3 billion) and African Rainbow Minerals (M23 billion through its stake in Harmony).

When Anglo American’s wider group valuation is considered, the combined figure rises to about M2.18 trillion, a snapshot of the immense wealth built on the same labor that left miners like Phamotse gasping for air.

When asked about accountability for those still waiting for justice, Katherine Bester, Head of a Communications Consultancy for the Gold Working Group, which represents the six companies, defended the Trust’s record:

“The Trust is fulfilling its mandate as effectively as possible within the framework and requirements set out in the Trust Deed,” she said, adding that “23,943 payments have been made to eligible claimants, including 9,469 in Lesotho.”

But those assurances contrast starkly with the lived reality of miners such as Phamotse and Tšehlahali, who continue to wait years for compensation despite clear medical evidence.

“They keep using my 2021 results while my lungs keep getting worse,” Tšehlahali told MNN. “I did every test they asked for. My x-ray vanished from their system,” said Phamotse.

Bester maintains that the process remains fair. “We are not aware of widows with the correct documentation experiencing unexplained delays,” she said.

Yet widows interviewed by MNN in Lesotho recount endless trips to lodgement centres, only to be turned away or told to return with new documents.

Some hold red cards marked “Not eligible,” despite having medical certificates confirming silicosis or tuberculosis.

On reports that ex-miners are being asked to pay for new tests, Bester responded:

“Claimants with less than five years of risk work must cover the cost of re-testing but will be reimbursed once certified.”

For the miners, that feels like punishment for having worked the shortest, hardest years underground.

“We built the mines,” said one former miner in Leribe.

“Now we are told to pay again just to prove we are sick.”

The companies say their moral duty ends with the Trust’s 12-year lifespan and the M845 million budget set aside for its administration.

“We believe the Trust is fulfilling its obligations as set out in the Trust Deed,” Bester concluded.

But for the men and women whose lungs carried South Africa’s gold economy, and the widows still waiting for justice, those words sound hollow. The mines that profited from their labour remain thriving on the stock exchange, while the people who built that wealth are left struggling to breathe.