Voices of Miners Improving the Health and Safety of Miners in Eastern Ukraine VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Published by the United Nations Development Programme (UNDP) in Ukraine Kyiv, Ukraine, December 2012 © UNDP, 2012 — All rights reserved All rights reserved. The views expressed in this publication are the author’s and do not necessarily represent those of the United Nations, including UNDP or its Member States. The mention of specific companies does not imply that they are endorsed or recommended by UNDP in preference to others of a similar nature. UNDP does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. United Nations Development Programme in Ukraine 1 Klovsky Uzviz Kyiv, 01021, Ukraine VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

CONTENTS

1. INTRODUCTION

2. MINERS PAVLO VRONSKYI ������������������������������������������������������������������������������������������������ 5 OLEKSII MALANIN ������������������������������������������������������������������������������������������� 11 OLENA PROKOPENKO ����������������������������������������������������������������������������������� 13 OLEKSANDR PYSARENKO ���������������������������������������������������������������������������� 17 MYKOLA IVASHKO ������������������������������������������������������������������������������������������� 25 VASYL KHOLOD ������������������������������������������������������������������������������������������������� 32 VOLODYMYR PROKHOROV ������������������������������������������������������������������������� 36 MARYNA OMELCHENKO ������������������������������������������������������������������������������� 44

3. WIVES OF MINERS ZOIA IVACHYKOVA ������������������������������������������������������������������������������������������� 49 OLEKSANDRA PODOLSKA ����������������������������������������������������������������������������� 56 LIUDMYLA KARHALEVA-TEMYR ������������������������������������������������������������������� 62

4. MEDICAL WORKERS SVITLANA SHMYHOVA ������������������������������������������������������������������������������������� 68 IRYNA VLASOVA ������������������������������������������������������������������������������������������������� 72 OLEH VATANSKY ������������������������������������������������������������������������������������������������ 82 YEVHEN SKLIAR, SERHII DEMYDENKO AND OLEKSANDR SUKOLENOV �������������������������������������������������������������������������������������������������������� 90 MINERS

3 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

INTRODUCTION The “Voices of Miners” is a collection of interviews with miners, miners’ wives, and doctors regarding the health and safety of miners in Krasnodon, Rovenky and Sverdlovsk. This report is part of UNDP’s “Improving the Health and Safety of Miners in Eastern Ukraine” project, which aims to identify and address the health and safety needs of miners. These stories complement the facts and figures provided in a related yet separate “Assessment Report.” Over the past year, UNDP conducted dozens of interviews, focus groups, and community workshops to understand the health and safety needs of miners. UNDP also worked closely with DTEK Rovenkiantratsit, DTEK Sverdlovantratsit, and Metinvest’s Krasnodon Coal to examine the working conditions of miners. In total, UNDP engaged over 650 miners, miners’ spouses, health workers, and government officials to discuss the miners’ needs and priorities. The following interviews were conducted by Mr. Hryhorii Kalashnikov, President of Life Without Barriers and a lifelong resident of Sverdlovsk, under the guidance of UNDP. The reader should note that the names in these interviews have been changed at the request of the interviewees unless otherwise noted. UNDP translated the original interviews from Russian to Ukrainian and English. UNDP translated the interviews with the intent to preserve the spirit of the interviews, not to provide verbatim transcripts.

4 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE PAVLO VRONSKYI

38 YEARS OLD A STOPE MINER, INJURED AT WORK (The first and last names of the interviewee have been changed.)

Please tell us about you and your family. Where are you from? How is your life going in this town? I’m a native of Sverdlovsk and come from a family of miners. Yet I was born in the Far East, where my father was serving in the military. In 1978, after graduating from the Institute of Mining and in accordance with a job placement process, my father moved the family to Sverdlovsk. My father worked at almost all of the mines of Sverdlovantratsit: as a heading driver, mine foreman and even site supervisor. Learning about the toils of miners’ work from my father’s experiences and not through hearsay, I didn’t plan to work in the mines after finishing secondary school. In the 1990s, miners were receiving wages with large delays, sometimes up to one year later. When wages were finally distributed, it was already not worth the same amount of money because of inflation. A MINERS

5 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

family couldn’t even prepare a “tormozok,” or bag lunch, as there just wasn’t enough money to buy it. Staple products such as lard, sausage, and meat were becoming very expensive. When you work underground, in conditions with insufficient air and intensive physical exertion, the human body experiences stress. That’s why calories are burned very quickly and a worker always feels hungry. And how efficient can you be in the mines when you are hungry? Knowing the situation at the mines, the youth was not eager to work there. The same was with me. I preferred private entrepreneurship. As the border with Russia was close and the prices of goods differed, I was buying goods in the Rostov region and selling them at the market in Sverdlovsk. In parallel, I entered Donbas State Technical University and specialised in “Industrial and Civil Construction.” I graduated in 2003 but never worked in construction. You can see, again, that I didn’t choose to become a miner. In 2004, I married, my wife and I were expecting a baby, and I had sort of come to my senses that family life was a big responsibility after all. By that time, my wife had been working for several years already at the mine, and I also decided to go to work at the mine. Having been trained in the training centre, I started working as a stope miner. The work was hard, but it paid well. Not all of the mines and teams can boast of good wages. I was lucky with that. When our daughter was born, we started thinking about our personal dwelling, as we were living with our parents before. We saved some money by ourselves, received some from our parents, and bought an apartment in the centre of town on the fourth floor. And everything would have gone well if not for a disastrous incident. In 2011, the roof collapsed at my place of work, and I was seriously injured. Everything happened instantaneously, during the second half of the work shift around 18:00. In such cases, it’s very hard to predict and avoid injuries. It’s next to impossible. It all depends how lucky you are. A small piece of rock can fall on you, just marring or scratching you, or it could be a lump of a rock, five-by-five metres. Because of very noisy machines, you cannot, for instance, hear the sounds to predict a fall. Workers signal each other with gestures, as it’s not worth yelling as nobody would be able to hear you. For several minutes, probably because of the shock of the pain, I was unconscious. At that time, I didn’t know how serious the injury was, and only now I can assess whether I was properly

6 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

evacuated from the mine to the hospital. It takes about one hour and a half to cover the distance from the closest first aid station of the mine to the place where I work. That’s why the workers of my team brought me to the grass: they used a wooden ladder in place of a stretcher. Then, a doctor and mine rescue brigade (MRB) employees arrived on the scene. As soon as I was in the first aid station, they put me on a hand frame. Soon after, they loaded me in the MRB car, which wasn’t suited to transport a person lying on a hand frame. Somehow they managed to put me on the floor between the seats. I was transported to a city hospital in this state. Each hill on the road caused intolerable pain all over my body. I found out later that it was a vertebral fracture and crushed bones. I was brought to the reception ward of the hospital. There we began a long procedure of registration and other formalities before making the first injection or diagnostic examination. The torments continued as I was shifted to a metallic rigid wheelbarrow and transported for an x-ray. When they were placing me on the x-ray table, I could not help but whimper with pain. Fortunately, the director of the mine came to the hospital and insisted on transporting me to the regional clinical hospital in the city of Luhansk. It was Friday, so local doctors would hardly do anything with me until Monday. And it would be useless anyway as they could not do any surgical operations on the spine. If during the first 12 hours after the accident, the spinal medulla is not freed from the compression of damaged spine fragments, the consequences would be irreversible. At about 22:30 I was put into a “GAZelle” type ambulance to be delivered to the Luhansk regional hospital. Again, the whole way, I suffered from the movement of ambulance’s suspension. The pain didn’t go away. In less than one hour after our arrival to the Luhansk hospital, I was lying on the surgical table. The surgery was to be done immediately. My wife had already arrived and was giving her written consent to the doctors to conduct the surgery. I cannot judge how successful the operation was, but the doctors did their best. The financial expenses of the treatment were covered by the administration of the mines and the Social Insurance Fund for Occupational Injuries. Everything that was necessary for my treatment was provided. In two months, I was discharged from the hospital home. I could only lie at that time, and there was no wheelchair yet. I received the wheelchair by the Social Insurance Fund nine months after the injury. Five months MINERS

7 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

after the injury, the mine paid for my 45-day treatment in a specialised health resort for people with spine injuries in the town of Sloviansk in the Donetsk region. It is there where I learned about all of the peculiarities of a new life with an injury to the spinal medulla. Finally, I understood how serious my injury was. Our new apartment, the purchase of which had brought us so much joy recently, became a confinement for me with four walls. It is on the fourth floor of the five-storied “Khruschov- era” apartment complex. During the last year after the injury, I was brought outside only three times: to go to the health resort and to pass an exam with the Medical and Social Experts Commission. What can I say? I cannot even go and walk with my child in the yard. In such a case, I would have to ask four strong men to bring me down the stairs. With the wheelchair in our apartment, I cannot enter the kitchen or bathroom. Can you imagine how it is? When I was healthy, coming back from work, I often saw the following: in one of the apartments of our building, there was a cat sitting by the window. He was probably waiting for his masters. I remembered it very well. Now, like that cat, I sit in front of the window and wait to watch the street near the building where my daughter first appears, returning from school. And then my wife returns from work. Psychologically, it’s also hard.

You’ve mentioned your wife. How has she coped with your injury? My wife is my fortress! She is superb. She received news about my injury in the mine when she was in the train on a business trip to a different city. She asked me to join her, to take days off, as if she felt that something was going to happen. Since that time, I’ve been under her kind care. It was her who became my human rights defender, and there were and still are things to defend.

What do you think about safety techniques applied at your work? What do you think about medical services in your town? What can be improved about medical services, specifically for miners? Before I started working at the mine, I believed that I was an absolutely healthy man. I played sports and regularly attended a fitness center. From the first days of working underground, I started to have colds, small injuries (mars, scratches, etc.). Within those working conditions, it is inevitable, and I don’t

8 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

know how to prevent them. If there is no acute pain or if there is just a slight fever, you have to go to work. They don’t like malingerers at the mine. Several times I had to take sick leave, for instance, because of bursitis: the knee joint got swollen and it was not possible to stand on my feet. I stayed home 10 days at maximum and then again go back to the stope. And how would it be possible not to catch a cold? It’s either too hot or there are drafts of wind. Wet from sweat, if you went under a fresh stream of air, you would catch a cold. And in the winter after taking a bath, they give us a bus with no heating, where the inside of the windows and seats are covered with frost. And it takes half an hour to get to town. I had to stop playing sports. During one shift, I moved so many tons of iron, even a weightlifter could not have dreamed about moving so much. On the weekend, I wanted to spend time with my family and let my body recover. I don’t believe in our local medical service, I only rely on the strengths of my body. I’ve already told you that right after the injury I was brought to the municipal hospital. So what? Neither a precise diagnosis nor an adequate treatment was provided. It was only a waste of time and more suffering.N ow, I would not go to our hospital either. In-patient hospitals do not even have normal orthopedic beds and mattresses to just let me lay in without a threat of getting bedsores. Restrooms cannot be accessed by a person in a wheelchair either. Before the injury, I went to the local health resort Slavutych three times in order to improve my health. Once the trade union committee gave me a family voucher to Yevpatoriia. It’s good that the trade union committee takes care of our health. There are sort of work safety devices in the mine, but people still get injured and ill. According to the safety rules, one should use breathing masks while working. But it’s not always possible. If it’s just to sit doing nothing, then it’s all right. But working in conditions without air, with heat, and at the same time using a breathing mask – that’s too much! Here, you choose, either to have heart failure or to breathe the air even with the dust. That’s why in only three years of such work it’s inevitable that we get silicosis. One of the factors affecting injuries at coal mines has been inherited from the USSR. It involves all kinds of work shifts and constant increase of withdrawal rates. People work intensely until they knock themselves out, and the management itself MINERS

9 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

implicitly encourages that we ignore safety measures. The principle is simple: if a plan is fulfilled, we get paid. Only top management receives huge bonuses for certain achievements from the work shift, but a common worker gets an extra 50-100 hryvnias added to his salary. If a couple of years ago the daily norm of production per site was 1,000 tonnes of coal, it is now 2,500 tonnes. This practice should be eliminated. You should work responsibly and cautiously in the mine and not chase after records. This is the main reason. It’s not possible to improve medical services exclusively for miners as most of the town’s inhabitants include miners and members of their families. It means that medical services should be of high quality and affordable for everybody. I’ve told you this not to complain about destiny, but with hope to improve the safety and health of miners. For me, mines are already in the past. For others, it can be their present situation, and I don’t want them to repeat my story.

10 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE OLEKSII MALANIN

34 years old A HEADING DRIVER, INJURED AT WORK

I went to work in the mines as an apprentice miner right after finishing school. After military service in 1997, I returned to Komsomolskaya mine in the town of Antratsyt. At the same time, I was studying at the training centre to become a heading driver. In 1999, I switched and started working as a heading driver at the Frunze mine in Rovenky. My father was working there, and it was him who called me. At that time, wages at that mine were good in comparison with other mines so this is how I chose where I wanted to work. I wasn’t thinking a lot about occupational safety at the mine. I knew since childhood from my father’s experiences that it was dangerous at all of the mines. I’ve never paid attention to small injuries. Mars, scratches, slits, colds, and other ailments are not considered a reason for not going into work. If there is no acute or intolerable pain, it means that you should go to work. In the winter of 2011, the state-owned company Rovenkiantratsit became DTEK Rovenkiantratsit based on a concession agreement. Since that time, wages have sharply decreased, almost twofold. The workers began to leave and moved to kopankas, or makeshift illegal mines. In our area, there are plenty of them as coal seems to lie close to the surface. The coal is extracted with the help of an old grand- father’s technique: using a pick hammer. In May 2012, I also went to work in a kopanka. They paid well: 130 hryvnias for MINERS

11 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

each tonne of coal produced. It was a salary of about 10,000 hryvnias per month. I have a wife and two children aged 2 and 5. And as you understand, I had to sustain my family somehow. And the day of disaster for me, on 11 June 2012, I got caught under a rock fall. As a result, I sustained numerous rib and spine fractures. On the same day, I was delivered to the intensive care unit of the Rovenky municipal hospital. I still don’t know what kind of a vehicle was used to transport me and whether it was an ambulance and if the call was officially registered. Local doctors never gave me the complete story. Our hospital does not have modern diagnostic equipment, and there are no doctors with the necessary qualifications to quickly and precisely diagnose injuries. That’s why on the third day, I was sent to and hospitalised at the Luhansk regional hospital. I found out there that all of my ribs and lumbar spine were fractured. The owner of the illegal mine paid for the surgery and post-surgical treatment. But the most horrible thing I learned before being discharged from the hospital was that the medical statement stated that I got injured from falling off of a roof. This meant that it was a “home accident” and that the state did not owe me any cash coverage for the occupational injury or for any relevant disability pensions. I addressed the prosecutor’s office with the request to recognise the fact that I suffered an occupational injury but without any success. Even written statements of other workers of the kopanka confirming the facts of my injury were not taken into consideration. Soon, the owner of the kopanka stopped assisting me and told me, “If you hadn’t written your request to the prosecutor’s office, we would have continued to help you.” But I hardly believe it. Today, I’m a person with a disability confined to life in bed. I cannot even sit up. The metallic structure that was installed in my spine by the doctors of the Luhansk regional hospital is not of the best quality. Now it has become clear to me that they paid the minimum for the treatment. Such are those “kind-hearted” employers. For a surgery from the medical centre of Kyiv, I would have needed 30,000 hryvnias—and where would I have gotten this money from? I’m no longer a bread winner. My wife continues to visit doctors to help me qualify for a pension, even if it’s for a home accident pension. The pension of 1,000 hryvnias per month is not much money, but at least it’s something. How should I continue to live? I’m in despair. I don’t know.

12 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

OLENA PROKOPENKO

48 years old A HOIST OPERATOR (The first and last names of the interviewee have been changed.)

Olena, could you please tell us about yourself and your family? Where are you from? What is your life like in this town? I was born in Rovenky. In the 90s, during the post-Soviet crisis and inflation, I was working in distribution.T hat’s what many people did for a living. Coal enterprises were on the wane, salaries were paid late, and fatal accidents became more frequent. Half of the town was selling goods in the marketplace; the other half was finding work wherever possible. That was life then. I could not earn much selling goods and in 2000 was employed as an attendant of a mine ventilation system. The work was not hard: I just had to report ventilation malfunctions to the manager on duty. I did not stay there for long. I was frightened to work there, especially during the night shift. When on duty, I was alone in the field, and the salary was very low too.

For how long have you been working in the mines? What mines have you worked at? Could you please describe your job? In 2001, I had been taking classes at the training centre for 6 months to become an operator of “surface lift machines.” After those classes, I had on-site trainings at the mines as an operator of the auxiliary lift. The auxiliary lift is used only for

MINERS freights, so the responsibility is not as high as when lifting

13 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

people. Our mine belongs to DTEK according to a concession agreement. We have 12-hour shifts, day and night, with 2 days off. Generally speaking, we’re supposed to work 8 hour days, but we work something more like 12 hour shifts. Otherwise, there are no means to get home and back. We have to conform to the bus schedule. My job is to operate the lift to take men down to the mine. On average, during one shift, we make around 14 trips. According to the rules, the lift is supposed to be operated by two people, but now, we are not fully staffed so I have to work alone.

Have you ever become ill or been injured at work? If yes, please tell us about those cases. Thank God I did not sustain any injuries. It is quite difficult to get injured in my field of duty. I haven`t experienced any serious accidents, though I have heard about accidents at other mines. As for diseases, workers, like other ordinary people, experience colds, flus, and sometimes radicular pain.

What is your opinion about the safety methods of your workplace? Hoist operators have special work regulations. We have to know, not only the operational processes, but the equipment itself. But in fact, the detailed structure of a machine is more relevant for mechanics; therefore, we don’t interfere with it. We have to pass exams on a regular basis. On the surface, the voltage power of the machine is 6,000 volts—this requires special attention. Underground power is 380 volts. The facility we work at is on the surface and very old. The window frames have not been changed since the 1960s, I think. The resistors generate heat, so in the winter, it is very good as the facility is heated. But in the summer, the heat is horrible. Just imagine when it is plus 40 degrees Celsius outside combined with the heat from the machines inside the mines. We really suffer during the summer. We get sick and sometimes have heart seizures. We complained to our management and asked them to install air-conditioning. In April, the commission came to examine the temperature and their decision was that the labour conditions were normal. But that was in April, and they should have visited us in July! Air-conditioning has not been installed yet. A couple of years ago, we had another, better manager. Every two to three months, he shifted the operators from the man- lift to the auxiliary one. Such changes in the work place were

14 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

very nice for me, since at least I had some kind of variety in my work. Before the start of each shift, we visited the infirmary to be tested for “booze breath.” If the nurse smelled something, one had to blow into the tube. If the person passed the test, he got a paper, which had to be signed in the lamp room before this person got to go back to work. Each month, we regularly test the integrity of the lift cable— this is obligatory. The specialist comes to conduct the tests and examinations. I perform the trial hoist, and the specialist makes the required measurements at that time. For instance, not long ago, the brakes of the lift drum started to rattle. The instructions say that such rattling means that the brakes have been overused. When I informed the chief mechanic of the lift, he told me, “Don`t make stuff up.”H e knows better than me, of course. My job is to simply inform him.

And what is the situation with uniforms and drinking water for employees? We do not wear uniforms. In the summer, we work in our shorts and tee shirts. Nowadays we are required to wear branded uniforms. It’s okay, but not during the summer heat and only if we can get it in the proper size. We get water in flacks from some source. Sometimes it’s fine, but sometimes it’s green, as if it has ooze in it. In such cases, we either boil it, or we bring water from home.

Are you satisfied with your salary? Satisfied. Do we have an option? Does a woman have a choice in our town? We have a fixed salary. When DTEK entered, our salary was even increased by 100 hryvnias. But underground employees had their salary cut and sick leave was low paid as well. I feel sorry for men. They have to wear dirty and smelly uniforms: they should be paid just for that.

What is your opinion regarding medical care in the city? I am shocked with our medical care. Not long ago, our doctors at the hospital in Rovenky diagnosed me with cancer. I immediately went for an alternative examination at Krasnyi Luch, and thank God the diagnosis was not confirmed. Can you imagine how I felt? I think that doctors are more careful there. Everyone goes there; people don’t even go to Luhansk anymore. Our doctors are “full of themselves.” Krasnyi Luch MINERS

15 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

is a town that is probably more depressed than ours, but their doctors care more about their patients. Regarding occupational health examinations, I don`t even want to talk about it. They are mostly to observe formalities. And everyone is to blame for this situation: both people and doctors. I cannot get one thing: how can one buy a phony medical note to use the swimming pool, for instance? Just imagine that half of those swimming in the pool may be ill and may infect you. That’s why I will never let my kid go to the swimming pool.

Have there been changes in the health care system during your time working at the mine? What do you think? Even if we root out the corruption in health care, there is still the problem of lowly qualified doctors. After all, everyone knows that most of the students at the medical educational institutions for the last 20 years have been buying their credits, exams and diplomas. You can’t get smart and honest doctors suddenly out of nowhere. For how many years have we been promised medical reform? And where is it? The necessary action is to make doctors fully responsible for the treatment of their patients, as they currently care only about making money from patients’ health issues. I don’t have strong hope for improvements in medical care. For the last 20 years, the government has not cared much. I’d rather vote for the return of the USSR medical system. Those were the days!

16 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

OLEKSANDR PYSARENKO

50 years old AN ASSEMBLY WORKER WHO WAS INJURED AT WORK

Please tell us about yourself and your family. Where do you come from? What is your life like in this city? Originally I am from the city of Krasnodon of the Luhansk region. In 1961, my parents came from Poltava to work in the Komsomol programme to rebuild postwar Donbas. In 1984, I got married and moved to Rovenky. Recently our daughter got married and had two children, and I became a grandfather. In 1991, I became a disabled miner, being categorised into “disability group 1.” And I found out that other disabled miners and their families lacked knowledge about the care, legal assistance, and health rehabilitation that people with spinal cord injuries required; thus, I became one of the founders of the municipal public organisation of disabled miners. In 2009, I was entrusted to lead the Rovenky-based organisation, “Union of disabled miners and those injured at work,” and re-registered the organisation as was required by law at the time. Our organisation is a member of the regional MINERS organisation of the same name. We consolidate our efforts

17 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

in order to defend the rights of disabled workers, which are regularly trampled upon.

For how long have you been a miner? What mines have you worked in? Have you experienced any work-related diseases or injuries? If so, please tell us more about those cases? I got a job at Rovenkovskyi in the assembly and disassembly operations division (ADOD) as a miner in division #4. A year later, due to operational needs, I was transferred to the newly established division #1 of ADOD as a mining equipment assembler. Despite my studies at Rovenkovskyi Mining Secondary School, I also studied at a vocational school to be trained as a mining equipment assembler. Upon completion of the training, I earned a “4th degree ranking.” A month later, on 5 September 1986, following our chief’s orders, I was sent to work in an unsecured space. While I was trying to save mine equipment from damage, the roof collapsed, and as a result, I was seriously injured. It happened during the night shift. Workers of my team, having got me out from underneath the collapsed slab, placed me on a wooden board, on which shot-firers knead clay, and in this position they began to lift me out to the surface up and down the slopes. At one of the slopes, there was a change in shift, and the group which was on its way into the mine joined my tired team to help them out. After dispatchers had been informed of the accident, a team, along with a physician from the mine rescue brigade, was waiting for us by the mine’s electric locomotive. He tried to resuscitate me with a ball syringe as he didn’t have any other equipment for doing it. But this only added to my condition, as a broken back bone and rib cage did not give me a chance to breathe in deeply, leading to pulmonary edema and my lungs being filled with fluid. They brought me to a bath, put me on the floor, and poured buckets of water on me, as they tried to somehow wash me as there was no possibility to touch me due to the unbearable pain. Then they put me on a stretcher and sent me to the city hospital by mine rescue brigade car. Nobody knew that I had suffered a spinal fracture and spinal cord trauma, so I was being moved without special care. It certainly had an impact on the future consequences of my injuries. At the hospital, they could not make an accurate diagnosis due to the absence of specialised portable diagnostic equipment. And using stationary equipment, it’s impossible to have a clear

18 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

understanding of the complexity of such an injury. Therefore, for a long time, they could not determine the extent and level of backbone and spinal cord damage. Because too much time had lapsed before medical procedures and surgeries were conducted, it was not possible to restore my health as well as it could have been. Now, after I have lived so many years with my disability and studied the consequences of the injury, I understand that it was necessary to operate immediately in the first few days, or a week at most, in order to release the spinal cord from shattered fragments of the spine and ribs, which were compressing the spinal cord. But life and circumstances dictated otherwise. When I was injured at work, my daughter was only nine months old, and I had to re-adjust to life in a wheelchair. In the 80s, housing units in the city were still under construction, and in 1988, my wife fought for a three-room apartment on the first floor of a new nine story building. In order to receive a car, we also needed to fight as I am very tall: 190 cm.A ccording to the law at the time, I was entitled to a car with manual control, but the officials, ignoring my physical traits and abilities, were stubbornly unwilling to provide me with the necessary car so that I could be mobile. Instead, they insisted on me getting a cycle-car. Disagreeing with the officials’ proposals, I continued to argue with them and insisted on being provided with a car that would fit the recommendations of the Medical and Social Expert Committee (MSEC). My long struggle with MSEC and Rovenkiantratsit and its management was successful. In 1990, I received a “Moskvich-2141” car that I long awaited for. It gave me a certain freedom of movement, and I became more mobile and connected to society. Step-by-step, I turned from passive member of the family, who is in need of help and care, into a full-fledged member of society.

Miners in Rovenky complain that their salaries dropped by almost half after the state-owned Rovenkiantratsit was transferred to DTEK due to a concession agreement. What are your comments on this situation? In my point of view, the mines’ management tries the patience of their workers. If the workers tolerate it and don’t protest actively, then the management takes this as meaning that the workers can be paid less. I could understand this if some of the miners didn’t fulfill their production plans, but not for all of them. Rovenky citizens gratefully recall the former MINERS

19 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

general director of Rovenkiantratsit, Mr. Astrov-Shumilov, now deceased, who was subsequently elected as the people’s deputy. Through his initiative, privatisation of strategic enterprises was banned in Ukraine, but then interested parties introduced the idea of “concession agreements,” which would last for a period of 49 years. Concession is the same as privatisation, and when the concession period is over, there will be nothing good left, neither underground nor on the surface. Mr. Astrov-Shumilov also treated disabled workers with great understanding. He built cottage houses at the association’s expense for just about everyone with a disability who was in need of housing. He was benevolent. And now the harm-doers refuse to solve problems for a person with disabilities in terms of housing and adapting to social and living needs.

What is your opinion of medical services in the city? To this day, neither local authorities nor the city administration has fulfilled their promises to create proper conditions for spinal patients in our hospitals. There are no functional beds, orthopedic mattresses or pressure reducing support surfaces. There is no specially trained medical staff to provide sanitary care, and toilets are not accessible for people in wheelchairs. Instead, there are wooden boards on bed nettings and cotton mattresses. In 2003, I started a hunger strike in protest of the MSEC’s unlawful decision to change compensation measures for those injured in industrial accidents. The case is that if one has experienced a spinal cord injury and this person lives a sedentary lifestyle with limited exposure to fresh air, he could get osteoporosis from a lack of ultra-violet radiation from the sun. Osteoporosis is a disease caused by damage or thinning of bone tissue, leading to fractures and bone deformities. It cannot be cured, only postponed. Since Soviet times, such patients were entitled to monetary compensation for supplementary healthy foods, including cottage cheese, fatty fish, eggs, cheese, milk, and other products that contain calcium and other essential minerals and vitamins. Upon the request of my doctor, they tried to hospitalise me three times, but each time they denied me, demanding that I end the hunger strike first. In addition, it turned out that the hospital was still not equipped with chambers for patients with spinal injuries. Therefore, not having found a suitable chamber to provide me with adequate care, I was sent back home several

20 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

times in the ambulance. It was only after my doctor said that he could no longer be responsible for caring for me at home that I was admitted to the hospital by its sanitary inspection unit. And after the trial of weighing me, they put me in the gastroenterology unit. The thing is that it is impossible to conduct normal and objective weighing of a person who has paralyzed his lower limbs. The hospital scales are designed for healthy people with normally functional musculoskeletal systems. Having put me in the gastroenterology room, a room unsuitable for spinal patients, on ordinary armored beds with a wooden frame and cotton mattress, I had a massive bedsore the next morning, which ultimately healed only four years later! Every year before receiving an outpatient’s permit from the Social Insurance Fund, I must pass x-ray examinations. But then again, how would I do that? Fluorography equipment is designed for examining patients while he or she is standing. Instead of a fluorography test, I was offered a survey radiography x-ray of my chest from a lying position. I am saying this to state the fact that the hospital is absolutely not equipped for patients like me. Therefore, we cannot be treated there. Since there is a lack of specialised rehabilitation centres for spinal patients, they created a special phrase for us, “hospital care at home.” Therefore, having received a medical certificate of completion for the care of seriously ill patients, my wife is the only caregiver who is trained and has the skills of medical and sanitary care for spinal patients and knows all the weak points of my body. By the way, during Soviet times, for family members of a spinal patient, such courses were conducted and medical certificates were issued, giving them the right to receive monetary compensation from the state. And they were entitled to a continuous employment record. After the injury, I have repeatedly addressed the company’s management and Rovenkiantratsit, asking them to create necessary conditions for my social rehabilitation. I mean, I have asked them to create such an environment for me where I would not have to adjust to an apartment and living conditions, but the apartment would be adjusted to my needs. How many years have passed since the injury without my apartment being adapted to me? Since the moment I was elected and entrusted as chairman of the city’s public organisation of disabled miners, I have repeatedly addressed the management of Rovenkiantratsit with a request for assistance for miners who have been MINERS

21 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

injured and lost their health at the city’s enterprises. But the association is in no hurry to provide them with the necessary assistance, shifting its duties and responsibilities to the Social Insurance Fund. Very recently, I addressed Rovenkiantratsit’s management for assistance in purchasing office equipment in order to continue the organisation’s activities according to its charter, and I’m not sure that my request will be considered positively. I also cannot positively evaluate the health care at the Luhansk oblast hospital. Neurosurgery is being operated by the same outdated methods, technologies, and equipment as 20 years ago. Specialised clinics in Kyiv and Kharkiv implement modern practices and adopt new standards and world-class technologies, while our quacks still work the same old way.

In your opinion, what about health care services could be improved regarding the needs of miners? The most important thing to do in the near future is to equip at least one special hospital room for the treatment of spinal patients in the surgical and urological departments of the hospital. Rooms should be equipped with showers, toilets, three-section adjustable beds with orthopedic mattresses and pressure reducing support service, convenient bedside tables, and other accessories. It is necessary to modernise diagnostic equipment for early prevention and detection of diseases directly related to working conditions and environmental situations in the region. Also we need new specialised staff members, who have not yet disgraced their reputation through corruption schemes and bribery, with more fresh and modern knowledge in health care. Also, we need a new modern approach to the issues of health insurance, which would include the best achievements in international and world practices in this regard. Moreover, we need to resolve the mechanism of treating disabled workers of the Luhansk oblast at the Donetsk Oblast Rehabilitation Hospital. This specialised medical facility provides highly qualified restorative care to patients with traumas and diseases of the musculoskeletal system, central and peripheral nervous systems, and cerebral circulation. Nothing like this exists anywhere in Ukraine. For patients from other oblasts, the treatment there is not free of charge and the Social Insurance Fund of Ukraine against Accidents (SIFA), in some cases does not cover treatment in hospitals of

22 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

other oblasts, which constitutes the grossest violation of civil rights of injured people. To begin, it is necessary to do that at least. That’s when we will be treated and not be crippled!

You have mentioned corruption in medicine. Please explain this issue? Almost anything can be resolved for a bribe: recognition or non-recognition of occupational diseases, issuance and extension of sick leave certificates, and determination of the link between a disabled workers’ death and his occupation. If a receiver of “regress payments” dies, interested third parties show up, who, for a certain price, offer to help the grieving family with completing the paperwork to speed up the process for receiving monetary compensation for the loss of a family’s breadwinner. And for this kind of “service” provided to the family of the deceased, they ask for 40-80 per cent of the lump sum. They guarantee an affirmative decision of the Medical Commission on the cause of death due to an occupational disease or industrial injury. What should be done about this? I don’t know, but we must do something about it.

Did you know that in the summer, public hearings were conducted as a part of the project “Improving the Health and Safety of Miners in Eastern Ukraine?” Were you invited to participate? I didn’t know about it. Only after the event took place were we informed about the meeting. When we began to know the score, our officials found an excuse, referring to the approved format of the meetings. But I think that the government does not want to hear the indignation of disabled workers, especially in the presence of international experts. I hope that I’ll be heard and that changes for the better will come. MINERS

23 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

24 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

MYKOLA IVASHKO

45 years old A SHAFT SINKER (The first and last names of the interviewee have been changed.)

Please tell us about you and your family. Where are you from? What is your life like in this town? I was born and grew up in the town of Chervonopartyzansk of the Sverdlovsk district. I have lived and worked here to this day. I’m married and have two children. My wife works as a medical attendant in the municipal hospital. My father has worked for more than 30 years at the mine as an electrical fitter. My grandfather was a miner as well. After finishing school, I studied at a vocational school specialising as a tractor operator. Then, I was called up for military service, and after that in 1991, I went to study at the training centre for miners.

How long have you been working as a miner? At which mines have you worked? Please describe your work? After finishing the training courses, I went to work at the MINERS

25 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Dolzhanska-Kapitalna mine as a miner. I worked there until 1996 before quitting. At that time, wages were not paid on time; they were delayed for several months. The miners were striking, so this is the reason I quit. Many miners moved to work in the neighbouring—though Russian—town of Gukovo, where things were better. I worked for three years as a miner in Russia. The wages were higher there. During the first year, wages were paid without delay. Ukrainian workers from Chervonopartyzansk were transported through customs to the Gukovo mines on a regular and free-of-charge basis. We were given coal vouchers, but we could not cross the border with coal. We were selling vouchers in Gukovo and buying coal with this money in Chervonopartyzansk. In 1999, the wages in Russia started to be delayed, though it was possible to be paid by food. They began to complain to us about providing transportation to and from work, so now the money for bus transportation was deducted from our wages. My colleagues and I decided to return to work in our native town. In 2000, I again finished courses at the trainingcentre of Sverdlovsk, specialising as a heading driver and came back to work at the Dolzhanska-Kapitalna mine. In our town, most of the houses and apartments have coal furnace heating. You need five to six tonnes of coal per year, and it was always expensive to buy them. The miners receive coal free of charge, and it was one more factor, for the sake of which I went to work at the mine. In 2002, instead of underground work, our team was sent to repair a conveyor at the coal preparation plant, which was located 80 metres high. This was in winter, with a temperature of – 20°C outside, and we were wearing light work suits designed for working underground. We were not given warm clothes, and as a result, I got double pneumonia. It took a long time to treat it in our hospital, and my condition was very serious. After that, I was fired, and of course, no statements about an occupational disease were issued. Immediately after that, I found a job as a heading driver at the Chervonyi Partyzan mine, which is in the town of Chervonopartyzansk. I was now closer to work. I still work at this mine and cannot wait to retire. If the 20 years of work I put in as a heading driver was sufficient for me to be entitled for pension, I would not work even one extra day. After that, I would work for a smaller salary, but on the surface. As for me, it’s still three more years of creeping in the mine! In order to sustain my family, I always have to maintain credit debt to

26 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

buy furniture, household appliances, and computers for the children. I have to borrow money from acquaintances, as my salary is never enough, even though we live quite modestly. A sinker’s job is to “drive a heading.” We are to conduct the following cycles: 1. Drilling and blasting operations. In our language, it is called “to blast a mine face.” 2. Cleaning of a “mine face” from rocks after blasting operations, or “cleaning of a blast.” 3. Arch-setting in the mine face. The team has to move 2 meters further into the mine every 24 hours.

Have you ever been sick or injured at work? If yes, please describe the cases in detail. What do you think about safety techniques at your work? I have been sick and injured and not just once! Once, implementing a direct order from the site supervisor, I got caught under a roof fall. A piece of rock severely cut my arm. When I was caught under a fall for the second time, I got bad bruises and deep cuts. I worked my way out to the grass by myself, covered in blood. At the first aid station, I received first aid and was then sent by car to the municipal hospital. There was no better car than a 30-tonne KRAZ truck. The trauma surgeon stitched my wounds, and the driver brought me home in the same truck. When he was driving me, he was afraid of one thing: for me to not lose consciousness. And when it happened for a third time, I almost died. A DMKU winder platform broke. The breakaway safety parachutes did not activate. There were eight of us on the platform. One managed to jump out immediately, but as it turned out later on, he was badly injured and became physically disabled. As for us, we were flying down the slope for 250 metres or so, when suddenly a piece of the rope got stuck and the platform stopped with a jerk for 1-2 seconds and saved us as we managed to jump out. The platform went down for more than 500 metres, where nobody would have survived. I was about to say goodbye to my life at that time. The rope broke because it was not replaced on time. They immediately fired the hoist man but not the boss who authorized the transportation of people with an out-of-service rope. If there would be another fatal accident, the operator would be in jail. The work of a heading driver is quite labour intensive. In MINERS

27 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

accordance with safety rules, a worker should not lift loads of more than 50 kg, but he has to. We carry the equipment by hand to work. For instance, an engine of 11 kW is more than 100 kg, and we are two people ordered to carry it from the warehouse to our work place on a metal chain for 2-3 km underground. The drilling device for “columns” is 120 kg, and we carry it on our shoulders. If you don’t fulfill the supervisor’s orders, it’s a violation. If something happens to a worker, it’s the worker’s fault as it is him who violated safety rules. This results in spinal conditions, in particular, intervertebral hernias. In accordance with safety norms, it’s strictly forbidden to weld underground without a special permit; for instance, if a drilling machine is broken—and just imagine that this is something the size and weight of a military tank but located underground. In accordance with safety rules, it should be taken apart to pieces, brought up to the surface, welded, and put down back into the mine again. This would mean a down- time of 1-2 weeks. We bring a welding machine and weld. Of course, first of all, a mine foreman checks to see if there is no methane, and we take precautions against fires. All the equipment at the mine is obsolete after several major overhauls. Our PPM-5, track-mounted mucking machine, was made in the 60s. The “mine face” is poorly ventilated; the fans blow exhaust air into the mine face, the temperature is no less than 40 degrees Celsius. That’s why you have to take off your work suit, which is wet from sweat. Each miner takes with him 2-3 litres of water per shift. Everything is coming out with sweat. There is not even any urine. Dust respirators are provided, but how can we work with them if there is no air? The one who asks questions should first try it himself. We are obliged to always have a “self-rescuer” on us. They should be worn on a belt across the shoulder, but they are cumbersome and keep us from working. That’s why we often leave them, even 100 metres away from where we work. Their benefits are doubtful. In case of necessity, 2-3 out of 10 get activated. The remaining ones are supposed to be functional based on the date, but in practice, they turn out to be out of service. They are all battered and look more like a visual aid for a safety engineer. In times of the USSR, heading drivers were smarter. Everybody knew what he should do at his place of work. Now, workers are not competent. There are few workers that understand

28 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

what they do. We, the old men, perform the role of shepherd. That is, we explain to a “green” heading driver the same thing several times. Sometimes it is of no use. They don’t want to learn. The younger ones are awfully spoiled. But if we leave, who can we entrust the mine to? In my opinion, the main reason for mine injuries is management’s request to speed up the completion of work tasks. The worker has to hurry and forgets about safety. You should also avoid loading machines above the norm and not overload the conveyor belts. It is important to replace equipment in time and not to constantly repair the old ones. Each worker should only fulfill his tasks and not the tasks of other workers upon the director’s demands.

What do you think about medical services in town? What kinds of changes have taken place in medical services over the time that you worked as a miner? Over the past 15 years of my work, medical services have not improved: it has become worse. Medical insurance does not cover all treatment costs, and each time we have to buy most medication by ourselves. For out-patient treatment, a doctor usually gives no more than five days, and then you either go to work or stay at the in-patient hospital. If a miner gets ill more than three times per year, he is offered an opportunity to restore his health at a local health centre during his spare time. But how can you combine treatment and work, moreover, in different shifts? Would I return from a night shift and immediately go for procedures? I would want to sleep. If you get ill often, the management tells you, “Look for another job.” That’s why with a minor ailment, you have to go to work until it becomes intolerable. The management does not welcome registration of injuries at the first aid station. I know several cases when a miner, who has sustained an injury, agreed to register it as a home accident, having been talked into it by the management. “We will pay for your treatment. You will get a vacation and a voucher to a health resort, and you will recover and work again.” This is how they persuade you. Only, not all of them recover and then bitterly regret about it their entire life. The difference in monetary award between disability pension owing to a work-related injury and pension owing to home accident is 10-20 times. MINERS

29 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

For several years already, I’ve been registered in the office of an occupational physician. There are symptoms of silicosis: I get short of breath at nights, cannot catch my breath, I have weariness. But doctors are not in a hurry to recognise it. They never even put bronchitis as a diagnosis, stating an acute respiratory disease instead. It has become usual practice that an occupational disease will not be registered without a bribe to doctors and the Medical and Social Experts’ Commission. Nevertheless, many managers who visit the mine occasionally have arranged maximum regress allowances for themselves a long time ago. Along with lifelong regress allowances on silicosis, one should receive a one-time allowance in the amount of 80,000 hryvnias. The doctors know about this and claim this particular amount as an award. But you are required to give this amount in advance and that means that miners have to find this money elsewhere.M ost miners do not have such savings. Doctors’ salaries are much lower than miners’, but look at what kind of cars they drive! The hospital yard reminds one of a car showroom at the world car industry premiers. When DTEK arrived, mandatory psychological tests were introduced. Some people want to pass them by themselves. If you don’t want to, they will mark that you are fit for 200 hryvnias. In the same way, you can pass an occupational health examination through doctors, but the amount will be about five times higher.

In your opinion, what can be improved about medical services, especially for miners? Every 2-3 years, I receive family vouchers at a discounted price to a recreation centre at the Black Sea for 10 days from the trade union committee. It is good, but it would be better to improve our health in a therapeutic health resort. But I place most of my hope on the restorative capacities of my body; the benefits of treatment in our hospitals are quite doubtful. Why do we avoid treatment at in-patient hospitals? What do you think? There are not even normal beds there. We go home for the night anyway. If there was a normal hospital, at least like we had in the USSR, we would be receiving treatment. And medical insurance is incomprehensible. The insurance provides medicine for one, but the other one has to buy it himself. I ask you kindly not to mention my family name as I need to work until retirement. If the mine management gets to know

30 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

about this, I will be fired and will not find any jobs at any of the DTEK mines as this company is a coal industry monopolist in our region. MINERS

31 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

VASYL KHOLOD 63 years old A RETIRED STOPE MINER AND UNDERGROUND MINER, WHO NOW HEADS THE NGO “UNION OF DISABLED AND INJURED MINERS”

Could you please tell us about yourself and your family? Where are you from? What is your life like in this town? I was born into a family of a military man. During the years of World War II, my dad was a senior lieutenant. After the fight inK ursk Salient, he was taken captive. After being released from captivity in 1945, he was sent to Krasnodon to help the national economy recover. He then got married and worked in the mines for his whole life.

32 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

How long did you work as a miner? What mines did you work at? I started to work at Molodohvardiiska mine just after graduation from school, and then I went to the army. After the army, I returned to that mine and worked there for four years. After that, I moved to Barakova mine and worked there until I retired. I worked for 20 years as a stope miner and for 20 years as an underground miner involved in the delivering process. I retired in 1991 after finishing my service term but still kept working, and in 2011, I completely left the mine. Now I work as a fitter in the Central Municipal Hospital and as the head of an NGO. Before there were 17 mines, now only 7 remain. So far, they say that before 2017 there will be only three left: Barakova, Sukhodilska-Skhidna and Samsonivska-Zakhidna.

Have you ever become ill or gotten injured at work? If yes, please tell us about the cases. Sure thing. Now I get 25 per cent regress payments for anthracosis and vibration. I gave up my health to the mines. Twice, I was looking into the eyes of death; several times I was underneath rubble. On 11 March 2000, there was an explosion at Barakova mine: as a result, 80 deaths. That happened at the end of the first shift, approximately at 12:45.M y partner and I were going to the bottom when we heard the rumble. That alarmed me, since there were no explosive works planned in this working zone. We went towards the sound of the explosion. We saw a crumpled metal door around 50 metres from the place it was supposed to be. “Maybe it was caught by a locomotive,” I thought. Soon we smelled smoke, switched on the self-rescue apparatus, kept on going until we saw the first two critically wounded miners.O ne of them was a guy for whom it was the first and last day of working. He survived but became disabled. And those who were closer to the epicentre all died.

What was the reason of the explosion? Grave violations of safety instructions. On that day, the oxy- kerosene cutter was used during repair work. In order to remove the regulator bearing, they were trying to heat it up. The hose of the oxy-kerosene cutter got disconnected, which directed the oxygen jet to the drum support bearing which was covered with oil, causing the fire outbreak.T he work zone was not even watered, fire extinguishers were not ready, MINERS

33 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

and those works were not even reported into the books. The coal dust blend went afloat and then exploded after being heated up to 560-600 degrees.A nd besides, the oxygen container was in the mine for at least a week, and that was a well- known fact. That is not acceptable at all.

What is your opinion regarding the safety methods at your work? Just after the explosion at Barakova mine in 2000, the safety regulations were followed more carefully and attentively for another two to three years. That was remarkable, as I kept working after the tragedy as well, and I know it. But after some time, the very strict requirements were not implemented as carefully. I am aware of the situation at all of the Krasnodon mines. And if the Technical Supervision Inspection performed the check and tests to the fullest extent, that would mean that all of the stems would need to be sealed. Here is the latest story. In a mine, a guy had his hand torn off by a cable. It is difficult to find the proper hoist cable at the mine; they all need to be changed. The employee started fitting the cable, caught the knot, and had his hand torn off. So who is guilty in this case, the equipment or employee? I was his advocate, and I managed to help him. Not a long time ago, the regulations allowed the Disabled Veterans NGO representatives to participate in MSEC hearings. The guy was supposed to assume 40 per cent of the guilt. The man had become a disabled person for life, and with that, the percentage of his regress payments would decrease to the minimum. After my intervention, his guilt rate was decreased to 5 per cent. And a lot of industrial injures are kept a secret. When a miner gets injured, especially not very serious ones, the only thing he hears from management are pleads to not register the injury. They all promise treatment free of charge, vacation and a voucher to a sanatorium resort, everything in order to keep the statistics on safety at a proper level. So far, these are the methods of management of the joint stock company Krasnodon Coal uses to improve the safety indices and decrease statistics on accidents.

And what’s the attitude of mines’ management and city officials to your criticism? I participated in the miners’ protests in 1993-1994. For my participation, I received threats at my home. I was frightened that my child would be harmed. I had everything…I have been around the block: I am not scared of anything anymore. But the truth is on our side. If required I can repeat my words to anyone’s face.

What is your opinion regarding the medical care in the city? I cannot say that there is no medical care. There is, but not enough. Lately I visited Kryvyi Rih. There, in every residential region, you can find two to three hospitals, which have good treatment and food. And what do we have? You have to pay for every healthcare cost, and it is not accessible to everyone. Insurance does not cover the actual expenses for the treatment, and the medications foreseen by insurance

34 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

are not effective. Either a small amount is foreseen for this in the budget or this money just disappears somewhere. Also, there is a big problem with medical staff. Gifted doctors are drained away to regional city centres, as the salaries and conditions are much better there. But we still have “heaven- born doctors” as well. For instance, a young but very smart and experienced surgeon, Tadevosian Artak Ashotovych. He is 29, but he is the head of the surgery department in the central hospital of Krasnodon. He is a very respected and valued person in this town. The mayor of the town provided him with a three room apartment close to the hospital in order for him to stay working in Krasnodon.

What do you think should be improved in the healthcare system to make miners’ lives better? It is necessary to get experienced and gifted professionals interested, for them to have motivation to stay in town. Our hospitals not only lack medical equipment but also beds. Last year I got humanitarian support from Germany and presented the hospital with four tilting beds. This is how we survive: the only hope is ourselves. Before doing something for the miners, it is better to ask the NGOs and trade unions about how to do it properly. MINERS

35 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE VOLODYMYR PROKHOROV 39 years old A STOPE MINER (The first and last names of the interviewee have been changed.)

Volodymyr, could you tell us about yourself and your family. Where do you come from? What is your life like in this city? I am from a family of miners. My grandfather, Ivan Petrovych, worked as a coalminer and mechanic in Krasnodon mines for all of his life. My father, Mykola Ivanovych, is retired now, but he still works as an underground electrical fitter at one of the enterprises. My mother, Tetiana Ivanivna, worked at the mine for many years, too. She was a fan operator, then a boiler room technician. She retired early because of health problems. My parents lived in Sukhodilsk, and I now live in Krasnodon with my family: my wife and two sons. We inherited my grandmother’s house. Unfortunately, our salaries are too low to buy real estate.

36 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

For how long have you been a miner? What mines have you worked in? Please describe your work. I didn’t want to be a miner when I was young. I just didn’t like the job. But in Sukhodilsk, where I lived with my parents, there were nothing else to do. So I started working at Sukhodilska concentration plant, and then in our mine called Duvanna. I worked for half a year and then I left. You know, I just couldn’t do it. This is not my thing. So I trained to be a lawyer and worked for a couple of years. And then it happened so that I had to go back to mining. You can only steal or be a miner to feed your family and get a pension in our town. I started working in Samsonivska-Zakhidna in Slyva’s unit (a famous head of production unit). Then I moved to Barakova mine, had a little break, and now I’m working in Sukhodilska-Skhidna highwall mining. My job is to perform coal pulling. It includes cleaning, loading and transportation of coal, temporary and permanent timbering, roof caving, strengthening the roof with wooden prop stays, reinforcement of highwall mining roof rocks. It also includes setting props, flooring, stowing, conveyer extension and shortening, transportation of materials and equipment to the mining, stable holes mining, etc.

Can you describe the situation at Krasnodon Coal in general? What are you proud of? What is shameful? I think that right now the company is too much into populism. There’s so much said and written about safety regulations and labour health protection, but there’re too many violations, and it’s impossible to close one’s eyes to it. I don’t even want to start on wages. It’s so low, especially for underground miners, that it soon will be as much as a cleaner’s salary.

And salary is the most painful issue for miners, isn’t it? Yes, miners earn little. Of course, there are some well-paid units. For example, Molodohvardiiska is now active, and guys make around 10,000 there. But this is the only one! Most miners have low salaries and promotions are out of the question. Although we always hear that the metallurgy industry is now in bad condition and that production has gone down. To cut a long story short, we have to show understanding of the owner’s position. But who will feed our families then? And here is another ironic fact. You work for a month, but if the work plan is not fulfilled, there’s only 5,000 leftover for the payroll. The next month, we fulfill the carload andmetre plan, MINERS

37 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

but we just receive the same 5,000. So why work? Instead, you see on TV and read in newspapers that the average salary of a stope miner in Krasnodon Coal is 9,000, and a miner gets 5,000. I wonder where they found those figures. Actually, a stope miner gets 5,000-6,000, and an underground miner, just 2,500.

What do you think of safety measures at work? What about safety regulations? Do you violate any? Not in general, but all of the time in some minor ways. We ride on the belts not equipped for transportation of people.

Why? Isn’t it dangerous? Of course, but it’s better to ride a belt than walk 500 metres in knee-high water.

Any other violations? Well, let’s start with the fact that violations were included while drafting the documents. They intentionally used incorrect data for their calculations on how much coal could be obtained from “lava” under certain gaseous conditions. This is a widely known fact. And why is that? Because manufacturing staff has a monetary interest. And here is another one. How do we correct violations? The inspection finds out about them, gives an order, and we just report that everything was fixed.T hree months go by, and they find the same violations. It means nobody fixed them, and it starts all over again.

How do you know this? Everybody does! It’s not even kept in secret. Besides, how can they hide it if everybody sees it? So we are involved, too. We intentionally violate safety regulations. We ride; the gas protection system activates; we deactivate the alarm system and continue on. And then accidents and explosions happen. I think the reason is that “Move, move!” order. If you don’t obey, they will transfer you to the surface to work on a 1,500 hryvnia salary, and then even find a reason to fire you.

Aren’t you scared? Has it often happened that this “Move, move!” order has led to accidents? Yes, for example, last year we had an explosion in our

38 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

mine because of this. They just pretended not to see it and protection methods were neglected all of the time. Our former director cared only about output, and safety was just an obstacle. And fear. We got used to working like this long before. Nobody really cares now.

What do you think is a main reason for injuries in the mine? The already mentioned “Move, move!” thing, hurrying, and of course, the human factor. In most cases, miners violate safety regulations and get injured.

And what about individual protection measures? Well, we don’t have problems with our work suits. They’re okay and rather convenient. It’s good that it has a lot of pockets. Proper sizes aren’t always available, but this problem can be settled for a couple of chocolate bars. But the boots are horrible. It’s just impossible to wear them. In five minutes, your legs start hurting and your shift has just begun. They are very hard and heavy, and they tear along the crease lines.

And what do you do about it? Do they change the torn ones? Yes, they do. You have to sign papers, bring the old ones and get new ones. But what for? They will tear in a month. And your legs are so exhausted after your shift that they don’t return to normal even after you start your next shift.

Can’t you use other boots? Oh yes, we can! There are a bunch of boots of older design on the market. They cost 100 hryvnia. You can also exchange your yellow or green work boots for old, black ones. It will cost you 60 hryvnia. Almost everybody does this.

Haven’t you complained about this to the administration or trade union? Of course, we have. They say they don’t have any other boots. Only those.

Don’t you have problems with respirators? Actually, we don’t. There are enough respirators, but nobody likes the new ones. It’s really difficult to breathe while wearing MINERS

39 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

them. Maybe they have stronger filters, but your lungs can’t stand them for even a couple of hours. That’s why we take them off during the shift. And it’s not nice to breathe dust, either.

Do you have personal self-rescue devices? For now, yes. I can’t tell you anything about other mines, but we have our own devices.

Have you ever used them? Yes I have. I even had a situation when the device lasted for just a couple of minutes. It’s good I had time to find a fresh flow of air. Nobody can guarantee that the devices will work. And before, they were given to us every shift, so you had to use a different one every time. Workers didn’t care much about the devices and left them wherever they wanted. Now that they are personal, the attitude is very different. The situation with self-rescue devices is different. In our mine, we have to switch them on if there is a potential danger. And workers of Barakova mine get fined if there was no need to use the device. Administration can always blame the miner and say he didn’t estimate the situation correctly. That’s why people don’t use them.

And when you are at your workplace, where is the device? I’m not wearing it, of course. I take it off and hang it nearby. Before, we could leave them 20 or even 50 metres away, but then they started to discipline us, and now everybody knows that it shouldn’t be farther than the distance of your arm. Of course, it’s not always like this, but we try to do it most of the time.

What about your instruments? Do you have all you need? I wish we did! Problems with blades, not enough hammers and wrenches. We have to buy small items and bring tools from home.

Do you have alcohol checks? Yes, every time before going down. Just near the administrative office, and it’s always very crowded there. Everybody breathes into a tube. It’s not only degrading; they’ve also chosen a very bad place. It could be done at the assignment office without all

40 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

of that humiliation. And besides, what’s the point? Of course, they won’t let you work drunk, but a little bit of a hangover? No problem for 50 hryvnias or a bottle of Champaign. Medical workers are people, too. Although we have several that won’t give in to coaxing or even take money.

Have you ever fallen ill or been injured while working? If yes, please tell me about it. Of course I have. Once I was fulfilling the order of my boss and pierced my palm. Another time, I deeply cut my hand. Then, I was returning from the roadway, and when I came close to the pit shaft, I tripped and twisted my ankle; it was a serious injury where I ruptured ligaments. Injuries are a very painful topic. They are kept secret in 90 per cent of cases; small ones, 100 per cent. Serious injuries are, of course, more difficult to hide, but they manage to do it. Miners are forced to record injuries as off-the-job injuries in order to not spoil the statistics. I did it, too. And what should you do if they just make rather obvious hints? You plan on working here, so maybe it’s better to cooperate than lose your job? Thank God it didn’t have consequences for me. But when people have serious head injuries or fractures, and they are forced to lie, this is a completely different thing. Who can guarantee that there won’t be any consequences later? And here is another issue. My friend didn’t settle and recorded an on-the-job injury. In half a year they found a reason to transfer him to work aboveground, where the salary is lower than 2,000. So he had to quit.

So, you say that you are forced. How exactly? Different ways, starting with persuasion and ending with direct hints that you will get fired.A lthough they can also try to use money. Or organise unscheduled exams.

And what about sick leave? Is it fully paid? Yes, it is. There is another problem. People are afraid of sick leaves because they will say, “You are ill too often. You should leave.” Or they will force you to take exams, or put you on the “black list” as “unhealthy.” Although when it’s necessary, everybody just buys their way out of it. The price is well known, from 35 to 50 hryvnia a day depending on the illness.

How many days can you spend on your sick leave? MINERS

41 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

It depends. I don’t know why, but before, they kept you in the hospital for 12 days if you had bronchitis and now it’s only 7. But it’s not curable in a week. So you just have to go back to work with a cough. And then we wonder how we get chronic bronchitis. On the whole, a visit to the hospital only costs you your health.

And what do you think can be improved in medical care services, especially for miners? I think they must have separate hospitals. We have Ultramed, a diagnostic and treatment centre, so why not let them issue sick leave letters so that miners don’t wait in lines? And they also have to give people sanatorium trips to improve their health.

What else? Is it warm in bathhouses? Are there any water problems? A bathhouse is a whole new topic. We have a really dirty one. No stationary boxes for work suits, just welded cages instead. Clothes are not dried in them, and you have to wear them damp. You can imagine the smell. It’s getting colder, and we won’t have room for jerseys. Another problem is stealing in bathhouses. Even foot wraps are stolen sometimes. And bath attendants are not responsible for anything. Besides, we have a huge problem with drinking water. There’s none at all. We buy mineral water or bring it from home.

Is there a cafeteria? Yes! With ridiculously high prices. It must be 60 per cent higher.

What about getting to work? Do you go by yourself or is there a bus provided? Yes, there are buses. But we call them cattle trucks. They are in horrible condition. In the summer, you have no air to breathe, and in the winter, it’s freezing cold. Here’s another reason that we get sick.

P.S. Volodymyr Prokhorov: “There was a time when I didn’t want to be a miner. But today, when I’m older and have had some life experiences, I think that being a miner is a very honourable male profession. And if approached correctly, it can become even prestigious. It’s simple: provide people with what they need, offer them money, and they will take on the world for you!”

42 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE MARYNA OMELCHENKO

29 years old EMPLOYEE OF THE ORE-DRESSING PLANT (The first and last names have been changed.)

Can you please tell us about yourself and your family? Where are you from? What is your life like in this town? I was born here. I’m a native of this town. My dad worked in longwall mining, my brother was a miner, and my life ended up connecting with mine labour as well, in spite of the fact that I am a young lady. I am 29. I do not have a husband, and I am raising a child of school age. Before entering the ore- dressing plant, I had knowledge about a lot of professions: seamstress, plasterer, shop assistant. But I decided to go to the plant because of the salary when the coal enterprises started to pay in a stable manner, more or less. MINERS

43 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

For how long have you been working at the plant? Could you please describe your job? Just after being employed at the plant, I was assigned to be trained to become a machinist briquette maker for two and a half months. After that I had a two month apprenticeship. Since then, I have worked as a machinist of coal enrichment equipment. So far I have nine years of job experience at the plant. Among my duties is to supervise the operation of the conveyor chain. I check the level of oil in the gears, the connection of the gears to the ground, and for any discontinuities of the fence enclosing the revolving gears. In case of any failure or accident, I have to stop the line and inform the boss, who is then to inform the head of the shift. These kinds of situations are recorded in the record books of repairmen. If the line doesn’t have rubber fences, the coal spills over and then I have to use a shovel. There should be rubber fences on every line, but replacing them with new ones is a problem because there is no supply of rubber. This job is not easy. The chief engineer says that a woman has to shovel 7.5 tonnes of coal per shift. Not every woman can do that. That is why only the toughest stay here. The shift lasts for 12 hours, 2 working days, and 2 days off. I am lucky to have a good team. By the way, it consists of 30 women and 8 men, including an on-duty wireman, fitter, mechanic, dozer operator and four loaders. Using water emulsion, we sort the following types of coal: AKO (fist), AO (nut), AM (smalls), AC (seed), ACS (dust coal with seed). The emulsion is prepared by mixing the magnetite powder with water, which causes a rise in the solution’s density. During the emersion of coal into the emulsion solution, the solid sinks and the coal rises to the surface. That is how we divide the coal according to its weight.

Have you ever become ill or gotten injured at work? If yes, please tell us about the cases. I have never been seriously injured, but sometimes I got sick. And I get bruises and scratches constantly. This is because the passages are blocked as fitters leave their stuff in the way; for instance, the electric gear or some other equipment. One can fall down when visibility is limited at night time or when the lights go out. Once during the winter time, we were sent to move the snow and coal from the railway of the shipment area. Because of

44 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

the undercooling, I got the severe pyelocistitis. I was getting treatment in the municipal hospital for seven days; after that, I was discharged without being properly treated. These kinds of diseases do not pass in a week. This job is not for women who intend to have kids in future. We constantly have to bear heavy weights, which has negative impacts on our bellies and cause gynecological diseases: pelvic inflammatory disease and “descent of womb,” an illness every second woman has. We often get bronchitis because of cool drafts. I have no idea how dangerous magnetite is, but as far as I heard, this is a strong poison. Then, the mud emulsion is poured in the settling basins, each which is a few hectares in size. What is your opinion regarding the safety methods at your work? According to the safety system we must work with respirators, but women can’t handle that for long. We are using “petals” more often. Maybe they are worse in filtering dust, but it makes breathing easier. But for the last three months, there have been no petals at the warehouse. There are filters for the respirators, but no one uses them. As for me personally, I usually work without dust protection equipment. On the upper floors, where the “clutters” work, it’s quite dusty over there, but it’s not as dusty as our workplace. There people work wearing ear caps and special boots to protect against vibration. If safety system rules are followed, situations are approached consciously without panic, and timely equipment repairs are made, then there would be lower rates of accidents. If my boss commands, “Quickly, hurry up,” I do it the safest way and according to the rules. But not every employee can evaluate the situation correctly and as a result may be injured. In case of an accident, the same boss will tell the employee, “I told you to act faster but not to break the equipment.” In case the employee makes a mistake, he is called in for Thursday.

Could you please explain that? On Thursdays, the director, heads of shifts, bosses, and chief mechanic review offenses committed by employees. In case the employee is found to be at fault for breaking equipment, he is deprived of his bonus, partially or in full. There have been cases where the damage caused by the employee was deducted from his salary. If the employee happens to have Thursday as a day off, he has to come to the plant anyway. If MINERS

45 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

he doesn’t come, the decision will be made without him. So it’s better to come.

What is your opinion regarding the medical care in the city? Horrible. Even if doctors diagnose your illness, they do it not with purpose to help the person recover, but to make a profit on it. The attitude is negligent. I think that doctors should know my diseases, prescribe additional examinations, and treat every patient individually. Private clinics have absolutely different attitudes. For insurance, I pay more than I get. Under the insurance I don’t get all the medications, just a limited list of them and only local ones. We have to buy gloves, normal saline, and other materials by ourselves. When I get ill, I try to be treated in a day hospital in order to be back home by night time. When my kid is home alone, there is no pleasure to stay at a hospital overnight. In brief, I try to avoid any contact with our medical care system. If something serious happens, I go to Luhansk. Treatment there is better for the same price. Employees of our plant are entitled to revitalise our health once per year in the local health and recreation resort. But as for me personally, there are not even half of the procedures that I need. The voucher for the sanatorium resort is intended for us once per four years. We have to order them preliminarily, a year in advance, through the trade union committee. But employees of the office visit the seaside annually, as if their confining job in warm offices is extremely harmful. And the vouchers they get are not the cheap ones given to ordinary employees.

And what is your attitude toward the periodic health examinations? For me personally, it is important to find out during the periodic health examination as much as possible about my condition. But unfortunately, the doctors very often, without even looking up, ask, “Any claims?” Answering, “No,” they continue the same way without even looking at me and sign my periodic health examination forms. And those who have had diseases or had been staying in a hospital are classified into a risk group. Such employees have to visit the infirmary of the miner for three months before the start of each shift. He has his pressure measured, and if everything is ok, he gets his paperwork marked. Then he brings it to the office and can start working.

46 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

And what is the situation with uniforms and drinking water for employees? There is no drinking water at the plant at all. We go to mine with that understanding. People say it is clean, but if you look inside the tea-kettle, you’ll see lots of scum there. Maybe the filters are not changed. We get uniforms, but the sizes do not match. I receive a 52, but I need a 48. So we take it in or bring it to the tailor. We raised the issue with management but without results. But we have a new bathhouse! It is a great pleasure for us women. As a tradition for bath taking, we are issued household soap, 72 per cent, as if it was taken from the USSR strategic reserve, but we don’t use it in order to preserve our skin. We use this soap at home for household needs, and we take our own soap and shampoo to the bathhouse. The hot water is provided strictly according to schedule, 20 minutes and not a minute more. You snooze, you lose!

Are you satisfied with your salary? Now I get a net salary of 2,100 hryvnias. Five years ago, the salary was 1,600 hryvnias. Since then prices have risen by 50 per cent, so you judge if it is much or not. When DTEK entered the plant, the salaries were raised by 100 hryvnias. I wouldn`t stay here if there were other jobs available with the same salary. Moreover, I get coal to heat the house: this is a huge help. Employees who have gas heating do not receive coal. They feel upset that they do not get similar compensation.

Have there been changes in the health care system while you have been working at the plant? What do you think? No. At least not for the better. Moreover, they plan to close our region hospital. Then, it will be necessary to go to another city even to get medical notes.

What is your personal opinion as to the fact or action that can improve health care namely for the mine employee’s needs? First, bribery must be uprooted among doctors. It is necessary to catch them red-handed and lock them up. As far as I remember, under the constitution of Ukraine, the life and health of citizens is most valued by the state. And what is the reality? Life and health of the person, minors in particular, are nothing. And we are no one to the state. MINERS

47 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE Wives of Wives

48 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Zoia Ivanchykova,

A MINER’S WIFE AND MOTHER

The mining profession is often described as a job for brave people with a strong will. People who can conquer the earth’s depths and who can look danger in the eyes. Miners always have their honest companions near them: their wives. These are unique women whose tough character is just as strong as their husbands’ and whose resilience is something to feel envious about. They are well known for their dedication and patience.

Zoia Mykolaivna, tell us a little bit about your family. We have three members in our family: my husband, my son and me. I have been living together with my husband for 37 years, and my son is now 35. He has his own family, a wife and a daughter. We met at Donetska mine. Petia was a collier, working on hammers, and I was an estimator. We liked each other right away, dated for four months and got married after Wives of Wives Miners

49 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

that. Within two years, we had our son, Sasha. At first we lived in Honcharivka, five kilometres from Krasnodon, and then we got a flat in Sukhodilsk. Now we live in Atamanivka, in the Molodohvardiisk suburbs, located on the Krasnodon-Luhansk route. We’ve built a house here and gave the flat in Sukhodilsk to our son. He lives there with his family.

What is your husband’s job, and where does your son work? Petia is a shaft man, and my son is an underground miner in Samsonivska-Zakhidna.

Zoia Mykolaivna, is it difficult to be a miner’s wife? A mother? You know, I really think that a miner’s wife is the most difficult job ever. It’s emotionally difficult. I can’t even tell how worried you get sometimes, how much grey hair it costs you. You show him off to work and try to keep yourself busy and avoid thinking and worrying. And if you suddenly imagine yourself in the mine, you start asking yourself, “How is he? Has anything happened? What if he’s injured? What if there was an explosion?” You can easily get a heart attack. I was worried for my husband before. Now I think about my son, too. All of the time. I pray for them to come back home alive. I even sewed icons into their clothes for God to protect them. It gives me some peace of mind.

Your husband is a very experienced shaft man. A lot of things must have happened during these years? Yes, a whole lot. It’s good that we now have cell phones. He comes out of the mine, calls me and says, “I’m all right, don’t worry.” And before…I knew he had to be back from the fourth shift at half past nine, so I look out the window. It’s already time, so maybe the bus was late. Ten minutes go by, and I start worrying. It’s 10 and he’s not home yet, so I put some clothes on and go to my friend’s house because she has a phone that connects to the mine. I pray to myself. Minutes pass like hours. I call the office, and they say he’s there for one more shift. I calm down, and it starts all over again after the first shift. That’s how we live. And when he went to Kyiv, we couldn’t get in touch for weeks. They were on a strike for their rights and walked to Kyiv. And in several months, the wives followed them—on foot, too. I Wives of Wives

50 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

did as well. I hurt my legs badly. It was a hard time, almost no food. We didn’t know where to get anything, so we made semolina soup and fried potatoes. Oh, and salo was a delicacy. We even learned to make potato and cabbage chops and bean spread. You just add some “Gallina Blanca” spices and it smells like meat.

What did you give your husband for lunch at work? Baked potatoes. He didn’t take anything else because we didn’t have anything else.

Does he take it now? Of course, but now it’s way better than before. Salaries are stable now, so miners can be choosy about food. They don’t want to take salo. They prefer ham or pork. But they still take cucumbers, boiled eggs and a couple of sweets. If he takes the second shift and leaves early, he sometimes goes to the mine canteen. A complete lunch is 20 hryvnias. And you don’t have to pay in cash. They can just take it from your salary.

Does he take water? Yes, water is a problem. There’s no good water in the mine. He buys mineral water in the cafeteria, but it’s very expensive. The tea is also bad. He says he can’t drink it. The water is sweetened and coloured. In the summer, I made him a compote, which he took to work, and in the winter, I gave him tea in a plastic bottle.

What about injuries? How did you find out about them? Yes, he had minor injuries, although once he had serious emotional stress. He went for a shift in Sukhodilska-Skhidna, but didn’t go down and stayed on the surface. It was 9 June 1992. And there was an explosion, and all the men he worked with died. When a disaster happens, news spreads fast. So I heard there was an explosion, but no one knew how many people died, just that it had been a major one. Those are my most dreadful memories. You just lose your heart and want to scream, to pray to God and beg him save my husband. I don’t remember now what I was doing and where I was going. Finally I was in the mine. I only recollect that I was praying aloud. And when I found out he was alive, I just couldn’t get up. My legs didn’t move. It happens from joy sometimes. My hair went almost completely grey in three hours. Wives of Wives Miners

51 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Did your husband keep on working in the mine after this? No, he quit. He cried at nights. He worked for a month and then said, “I can’t. I just see the guys everywhere.” And left. There was a three year break, and that’s when we had a life without worries. And then he went mining again. Our son was growing up, and we didn’t have enough money. He’s still working now.

And what about salaries? Are they all right? You know, this hard work should be paid well. They give their health away, and get ridiculously low salaries. Petia’s salary is okay, of course. He is a very experienced shaft man, and he can sometimes get seven or eight thousand. Our son is a regular miner and gets no more than a thousand and a half. His wife doesn’t work because their daughter doesn’t attend kindergarten. How can you live with a family on this money? We help them from time to time, so they somehow cope.

Why doesn’t his daughter go to kindergarten? No places. Krasnodon Coal had its own department kindergartens before, and it was great. If a miner had a child, it was never a problem to find a place. But the company became private, and they got rid of all of the kindergartens. It doesn’t give them a profit, and young couples don’t have a place for their kids. Now we have some hope that the city will organise new groups of kindergartens, and maybe we will find a place for our granddaughter. You know before, Krasnodon Coal also sponsored cultural institutions, stadiums, and kindergartens, and now they gave up on all social programmes. Well, they help sometimes, but it’s just not even close to enough.

You live in Atamanivka where two mines have been closed. Do you think they pollute the environment a lot? Oh, this is a painful issue. Our village is located between two mines, and both of them have waste piles. Two years ago they started to bulldoze a pile by Horikhivska mine. The air was full of dust. It was even lying along the windows, and you couldn’t hang your laundry outside. People would only breathe normally through respirators. In Simeikyne, where the waste pile is even closer, people hung wet clothes on their windows, but the coal dust was still in the air. And why? Because the technologies and processes were not properly followed. You Wives of Wives

52 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

have to do moisten the waste pile at first and nobody did that. Krasnodon Coal promised people a gas pipe to calm them down. It’s been two years, and the pipes are still being constructed and no one knows how long they will take. This year, they started to bulldoze a waste pile by Talivska mine, and everything started all over again. And Krasnodon Coal is hiding again, saying they don’t damage the environment. I wish they came to Atamanivka and lived here for a couple of days: they’d have a completely different opinion.

Do miners have any benefits? Did you feel the effects of the law, “On prestige of miner’s labour”? Benefits? Gas compensation of 60 hryvnias. With tax deductions, 50 hryvnias. A ridiculous amount. In the winter, we have to pay over 400 hryvnias for gas. The law on prestige helped our son get a scholarship to a university. He wanted to study, and the law says that it must be provided for free. That’s it. This year, we were told that they adopted some regulations, and that chevaliers of “Miner’s Glory” will receive a monthly pension. But nobody receives it.

And where do you rest? On weekends, we try to walk more, go to the countryside. We also go to the sea every year because the trade union provides us with trips. We went to Koktebel before, then to Mykolaivka, Saky, Feodosiia, and now it’s Yalta. I like it, but my husband says we won’t use the mine’s programme again. He says you work with the same people for a year, and then you go to Crimea and all of the faces you see are familiar. Same talks about work, mining machines and salary. Petia had a trip to a sanatorium in Odesa, and he loved it.

Do the mines have resorts? Yes, they do. It’s by the Siverskyi Donets River. But it probably lacks financing because the conditions there are really bad. Cottages are half-destroyed, no windows, no tableware, old rotten matrasses, abandoned beaches. It’s not very nice to rest there. Besides, the guards are very rude. But our son likes going there. Every summer they spend a week there. You know, miners have to rest as much as possible. They work so hard, and they are so often humiliated. My son is always so deeply insulted and says, “Why should I slave away, listen to swear words, and be called a moron for two and a half Wives of Wives Miners

53 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

thousand?” He says he will quit, but then he goes down back to work. He understands that there’s nowhere else to work in Krasnodon. That’s why he studied: to earn more. You know, a lot of people are now not very happy with Krasnodon Coal. The owner knows that there are no other jobs and he doesn’t pay enough money. Everybody has kids and loans. You have pay for it. So our husbands are on the hook, and they can’t jump off. There are some good points though. At state mines, they sometimes hold onto your salary. We don’t have such problems. And in general, we get work suits, trips to the Donets recreation resort, different sanatoria. My husband says they invest in safety now, and this is good too. And there is also a special medical service where you can get examined for free.

How do you celebrate holidays? Miners’ day? Oh, we have fun. We meet friends, men drink vodka, and we have wine and sing songs. But it’s the second year in a row when celebrations and holidays have been rescheduled due to work schedules. I don’t know who celebrates then. I guess, the youth. And before, when it was always on Sundays, we took our families to the central square, watched concerts, met friends, and had something to drink. It was really nice, somehow festive. Wives of Wives

54 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE Wives of Wives Miners

55 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE OLEKSANDRA PODOLSKA

A WIFE OF MINER (The first and last names of the interviewee have been changed.)

«Самое тяжелое – не иметь возможности просто услышать голос»

“The hardest thing is just not being able to hear his voice.” The mines have affected Oleksandra’s life since the very beginning. Her father, a native of the city of Kharkiv, found out about mines opening up in Sverdlovsk and decided to go there to earn some money. From Kharkiv, the family moved to the small mining town. And the move turned out to be forever as with most families in similar situations. Thus, Oleksandra grew up in Sverdlovsk, graduated Wives of Wives

56 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

from vocational school, and married a miner.

Oleksandra, please tell us about your family. My husband Ivan and daughter Ksiusha—this is my family. My husband is 30 years old; I am two years younger. We married eleven years ago, and at that time, Ivan was already a miner. At the Sverdlovsk vocational mining school, Ivan got a job as an underground electrical fitter, and ever since has been working at the mine for almost 13 years now. Ksiusha is in fourth grade. As for me, in autumn this year, I had to quit my job just because there is nobody to pick up our daughter from school and educate her. Our parents cannot help because of their age and health and because my husband works on a shift schedule. There was no other way, so I had to quit.

Has the financial situation of your family changed after you stopped working? Are you satisfied with your husband’s salary in general? I wouldn’t say that it has changed significantly for the very simple reason that my salary cannot be compared with the salary of my husband. However, this is only in comparison of his salary with my salary. I believe that the work of miners, in particular, the work of underground electrical fitters should be better paid. Let’s say, it shouldn’t be twice as high, but at least 30 per cent higher. The money he earns now is only enough for a family of three people. But not more than that. Going to a health resort for 24 days to truly improve our health and not just to get some treatments, we could not afford it. A car or apartment? That’s out of the question.

As we’ve started speaking about recreation and health improvement, there are health resort and recreation centre vouchers for miners… Frankly speaking, we’ve attempted to receive such a voucher before. The first time we spoke about it was last summer, at the end of June. By that time, it turned out that the only remaining vouchers to a sort of health resort or preventive treatment centre. But there is neither a river there nor a lake. Anyway, you want to rest somewhere by the water, as it’s hot and again we have a child. And if it’s like that, is it a holiday? As my husband says, vouchers are distributed at the beginning of spring, no matter whether they are available or not, everything is decided in advance. And it’s based on seniority: Wives of Wives Miners

57 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

first the very top managers choose, then supervisors, and what remains are for others. It’s not fair. People who sacrifice their health for the mine should be compensated by the mine. It’s clear that it’s not possible to improve everybody’s health at once. That’s why it’s necessary to have a well-established and objective procedure so that vouchers are received by those employees who really need them. At present such a procedure does not exist.

Has your husband’s health significantly worsened during the time he has worked at the mine? Chronic diseases, injuries perhaps? He does not get ill often, but when it happens, it’s very severe: his lymph nodes get inflamed and he gets a high temperature. The biggest problem is with his back; he damages it very often. And here we are. There’s no one to turn the soil over in our vegetable garden because he has damaged his back. They were lifting pipes at work in a very narrow space where it wasn’t possible to straighten up so then he jerked on the pipe and damaged his back. And I’ve also noticed one thing: when he works without a break, he doesn’t cough much. Well, from time to time. But as soon as he takes a vacation, in 4-5 days, the cough will start for sure. And he is coughing out black stuff. It might be dust coming out. It should have a source, right? Does it mean that there is something already wrong with his lungs? But my husband, as all the other miners, pass regular medical examinations, which includes photofluorography, and it looks like everything is in order. It might be true that the equipment has not detected it yet, or that there is nothing there. Everybody knows that it is common practice to classify all occupational injuries as home accidents. It is becoming absurd. Even if being injured in a particular way simply isn’t possible within the civilian context, they would still write “home accident” in defiance of common sense.T hey can do everything. Thank God Ivan has not had any serious injuries, so we have not had to face this practice ourselves. Once he stripped his nail. He came back to the surface, the machine operator said, “Go home, visit a hospital, rest for three days and come back.” No sick leave was given. We spent those three days as a weekend, and that’s it.

And what are his usual working hours? Does he have time to rest before his next shift? Wives of Wives

58 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

He usually works during the first maintenance shift. We get up at 4:30. After 5:00 he leaves the building in order to catch the bus to work. By the time he reaches the mine, receives his work order, changes his clothes, and descends in to the mine, it is already 8:00 or 9:00. As a rule, around 15:00, he has already finished his work and the same actions are repeated in reverse order: return to the surface and change clothes. He comes home after five in the evening. Altogether, roughly, from 6:00 to 6:00 for 12 hours he is not at home. Of course, he gets tired. It’s good when everything works as an alarm clock. And when there is an emergency, something has broken or stopped, you should do something. But there are no resources for that. It’s time, time, time. And then, of course, haste, nerves…

That means he works only during the first shift? Yes, these are his usual working hours. If somebody takes a vacation, it happens that Ivan takes the shift of that person. Then, the schedule is different: three second shifts and a day off, three third shifts and a day off, three fourth shifts and a day off. It’s a bit easier that way. Also because those who work during the maintenance shift like him are more often left to work during the second one. I remember a case when Ivan stayed in the mine for three shifts, one after another. I could not imagine. How? To have a bite to eat or at least a drink of water? And the eyes, they get tired. Well, as they say, when a new shift descends, workers are informed on the surface that there is somebody in the mine staying for a third shift. Some guys would give him their miner’s lamp, while others would give him some water or a bag lunch. So you won’t be left alone, but it is not pleasant at all. By the way, I asked my husband, “For how long do miners’ lamps stay charged?” It turns out that it’s only enough for one shift. That’s why they try not to waste the charge. Sometimes they move with their lamps switched off. Sometimes they work without a light. It’s good when they work in pairs. In such cases, they use one of the miners’ lamps, while the other one is spared.

They say a man gets used to everything. Have you managed to get used to the specifics of your husband’s job? Those emergencies, second shifts? It seems to me that I will never get used to them. Nothing has changed for almost 11 years already: he leaves, and my daughter and I begin waiting for a call. Ivan phones Wives of Wives Miners

59 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

immediately after he takes a shower and changes into his clothes. It cannot be earlier as his phone remains with his clean clothes. In terms of time, it is about 4:00 in the afternoon. Sometimes he calls at 3:30. I ask, “Why are you so early?” Well, we were hoisted and replaced. Sometimes it’s half past five. Why did you take so long? We already thought you had left for the second shift! It turns out there was just a failure. How is it possible to get used to this? I cannot get used to having to wait permanently either. When it comes closer to four, I don’t part with my phone anymore. I put it close to me and wait. I wait, wait, wait. Or it happens that we prepare something tasty with my daughter for the evening and dress up to meet father in a festive way. We sit. There is no call on time. It’s all right. Perhaps, they left later, and something got broken at the last minute. We sit. Half an hour later, there is nothing. Perhaps he was late, and the bus left without him? We sit. In another half an hour, everything is clear, and it looks like it is the second shift. It is half past nine, and we still sit. The little one whines, “Mama, when will Daddy finally come?”A nd she doesn’t go to bed until Daddy arrives. At a quarter to 11 there is finally a call. We seize the phone simultaneously; Ksiusha snatches the receiver, shouting, “Hello! Daddy! Daddy, where are you?” She hands me the receiver, and I get full of tears. It is both joyful that he is coming back, and it hurts that it’s so late. We were doing our best, we were getting prepared. “I’m sorry,” I say. “Dinner is already cold. We will not be meeting you dressed up. But anyway, we are waiting. Come quickly.” You cannot get used to it, when on the weekend they ask you to come in for a fourth shift. Or when we celebrate holidays without him. And we always worry. You can’t escape from these thoughts, especially with accidents happening in the mines all the time.

Waiting and worrying, are these the hardest things for you associated with your husband’s job? The hardest thing is…Perhaps the hardest thing for me is that it is not possible to get in touch with him when you want. Those who work on the surface can be reached by phone, but not him. It is already 7:00 in the morning when he cannot be reached. Until that very moment when he calls himself. And this can be 16:00 or 22:00. For this long stretch of time, the person does not exist. It’s not possible to ask how he is, whether everything is all right. Just to hear his voice. To get to Wives of Wives

60 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

know why he is late, whether he was left for the second shift or if something happened. Sometimes he calls directly from the mine through a dispatcher in order to warn us, but only when he is close to the phone. In other cases, we are to guess ourselves. And we worry, what, how.

You talk in the plural form. Yes, my daughter worries as well. And she also misses her daddy a lot. She waits for him, and he comes home so tired that he falls asleep over his plate. She misses the care, she misses the communication. And I think it is like that in all miners’ families.

Oleksandra, please tell us, do you as a mother worry about the ecological situation in Sverdlovsk? You know that the work of miners leaves conspicuous “traces” at the surface. Yes! Terricones (mine waste piles) are awful and “worry” is not the right word. We live quite close to a terricone. You can neither open the windows nor hang clothes outside for drying. Window sills are always black. I bring my daughter to school, along with other children, and a truck passes by, and that’s it: all of them are covered in red dust! It is horrible to imagine that we breathe this dust, that our children breathe this dust! Where should health come from, how do we protect them? Author: It is not the first question of our interview without an answer. Oleksandra stopped waiting for it a long time ago. You cannot say that she has become completely desperate. She is rather afraid to hope. In Sverdlovsk, where everything depends on the mines, there is a lot to be afraid of, especially to lose a job and fall from grace. There is nowhere you can go to get away from the mines, and there is no way back for dissenters. It is better to keep silent and be patient if you can’t choose anyway. Wives of Wives Miners

61 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE LIUDMILA KARHALEVA-TEMYR A MINER’S WIFE, A DOCTOR

“I can understand miner’s bad habits. Because it’s scary to descend down there.”

However you slice it, you won’t manage to stay away from a coal mine in a miner’s town. Liudmyla Leonidivna Karhaleva- Temyr, born in Rovenky, was raised in a construction worker’s family, but became a miner’s wife—and a doctor who treats miners among other patients. Wives of Wives

62 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Liudmyla Leonidivna, did your life change after becoming a member of a miner’s family? When we got married, Serhii had already been a miner. He has been working in a coal mine since he was 18, and his father was also a miner. I can’t say that my life changed a lot after this. I grew up in a one-parent household during Soviet times, so I got used to difficulties. My mother raised me alone. My father is a person with a disability. He got ill when I was studying in first grade. It’s good that education was free then. It’s the only reason why I finished secondary medical school. I received my diploma with honours, so I was sent to the institute. It was easier back then as I had a letter of referral. There are no such letters now.

What coal mine has your husband been working at and for how long? Serhii is a labour protection shift leader at the Rovenkivske mine administration. He started as an underground miner and a hoist man. He completed his higher education after we got married. He has 22 years of work experience. But in labour protection, the length of service for working underground is not considered as it should be. He has to work a few more years before he can retire.

Did he change his place of work? He did, but his destiny always makes him return to mine administration. It all happened because of one miner’s superstition Serhii told me about one day. A person who descends into a coal mine for the first time receives a mentor for some period of time. So Serhii’s mentor once noticed my husband drinking water in the coal mine and asked, “Why do you drink? You won’t be able to stop working at this coal mine!” And it happened so! He came to this coal mine, and since then, he has been working there. He moved to another one, but that one was quickly closed and restructured so he returned to his first place of work.

And does he often tell you about his work? Yes. Our town is small. We know many people, both his co- workers and colleagues. He always tells us if something happens. It’s a tradition in our family: we all share news. His mother and sister are both doctors, so we can freely discuss both medical issues and news of the coal mine. He Wives of Wives Miners

63 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

understands me. And I just have to listen to him.

Do you have time for conversations? I assume that your husband has to work shift to shift. He really works from shift to shift, but we have time.

A difficult working regimen, right? Sure, it’s difficult to work shift to shift. And it’s impossible to get used to this even if you have been working for a long time. There is a biological clock, and if a man has to sleep at night, it is very hard to make his body not only wake up but to work as well. Moreover, it’s always dark underground. The eyes close by themselves, and if he didn’t have good night’s sleep…

Does it have any impact on his health? Maybe his sight has worsened, or maybe he has gotten an occupational disease? No, he has good sight, and no occupational diseases. Thank God there were no injuries. It’s clear that work leaves its imprint. But again, some illnesses are typical for miners, others for intellectual workers. There are no good diseases at all. And whatever illness your family member has, it’s always unpleasant. We didn’t have any particular problems and managed to cope. Well, there were colds, micro-injuries. He stumbled, he sprained. This is life after all; there is no insurance for such events. On the other hand, he entered the institute for this purpose, as risks are lower for a job that requires more qualifications.

Do you worry when you see him off for work? I mean, there are risks, after all. Any wife, whenever she sees her husband off—a driver to a run, a miner to a coal mine—still worries and waits for him at home. And she wants him to return alive and safe. We can’t say that only miners’ wives get worried. Moreover, now it’s just scary to go out!

And, certainly you wait for him to return from his shift. Sure I do. And how could I not? Perhaps, waiting is the most difficult. What else does a woman need for composure other than her family to be close by?

You mean you sometimes worry about him? Wives of Wives

64 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Well, first, he left me phone numbers to contact him. If he stays too long, we know that we must call the lamp room and find out whether his number came up or not. If it didn’t, it means that he has left for a second shift. The second telephone connects us with his unit, where we can find out where a worker is, what duty he has.

Do you use these telephones often? Not really. He manages to notify us in advance if he is going to be late or if he will come home in time. In general, we’ve never had any problems with finding out where he exactly was at work. The control there is good; they wouldn’t lose a person.

Do you cook him something for lunch to bring to work? No, Serhii does not take food to work. He keeps a healthy lifestyle. I cook healthy food for him, and he only has meals at home. He doesn’t even drink water at the mine. He doesn’t take a cup with dirty hands. Before, when his work was more difficult, he took some food with him from home. But then it had an effect on his health. He noticed this himself, or to be more correct, he felt it. He gained weight. It became harder to breathe. Finally, when it became difficult for him to move through the mine, he decided to change his lifestyle. Now he does physical exercises and lifts dumbbells. Our dream is to buy a stationary bike or a treadmill.

And what about rest and recreation? Is it possible to get trips from your coal mine? We adjusted our working schedules to make our holidays coincide and took a trip to a recreation centre. Certainly, we could have chosen a sanatorium, but at that time, we had no such problems that would require us to improve our health. That’s why we asked for something during the family holidays.

Does your family consist only of you and your husband? We also have a daughter.

Would you like her life and work to be connected with a coal mine? She still goes to school, but it’s already seen that she has no inclination toward the technical sciences. She is the creative person in our family. And, moreover, it’s still early to raise the Wives of Wives Miners

65 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

question about the choice of her future profession. And when the issue is brought to mind, life will change it somehow, too. We hope very much that the mining law will work and that our daughter will receive the benefits of an education as a miner’s daughter.

So, if we talk about finances, I have one question. Liudmyla Leonidivna, in your opinion, is the pay for a miner’s work enough considering the conditions and risks? Cognition comes through comparison. As we have no possibility to work and earn at other enterprises and considering the background of other regions, we look okay. But when you face this every day, the cost of treatment or the prices for food, they are more expensive because salaries are higher. It is clear that mining is one of the most difficult professions in Ukraine. And I would like miners’ work to be appreciated properly. If not by salaries, then in some other way.

What do you mean by some other way? Again, not all regulations of the mining law work here. For example, families of miners living in private apartments receive coal. And what about us, workers who live in state apartments? We get nothing. Why can’t they compensate our gas expenditures, for example? I’m sure that there are other ways.

You are a miner’s wife but also a doctor. Can you give any advice on how to improve medical care for miners in this town? First of all, hospitals must be provided with staff.H ospitals could have all the equipment at its disposal, even the most modern devices, but there are always people who need to operate them. But if the staff potential is absent, what can we discuss, who will perform the work? Young specialists come, but there are so few of them. And why must medical care be improved only for miners? We are all closely connected, and we need each other in the same way. Why did it happen that the Luhansk region is the only one without a rehabilitation centre? In the town of Krasnyi Luch, only patients with occupational injuries are treated. And what about others? It’s so close to me, and it’s so painful because I went through this myself. My father was a construction worker, and he suffered from a stroke and stayed home for 14 years. He received no support at all. And is Wives of Wives

66 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

his profession required any less? Where will the miners live if the houses are not built? I consider that it is necessary to increase the common level of medical care. It will be the best and most reasonable way.

Perhaps it is better to keep a healthy lifestyle, for example, as your husband does, in order to seek medical attention as rarely as possible? Of course, that would be perfect. But I can understand miners’ bad habits. Miners often come to my office, I talk to them, especially with the youth, and I understand that it’s scary to descend down there. Any man, whatever his age, would not complain. And he would never cry after a long working day like women sometimes do. And the stress is always there, so this is how they get rid of it. And they can be understood here as well. Wives of Wives Miners

67 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE SVITLANA SHMYHOVA

AN OCCUPATIONAL PHYSICIAN, CHAIRMAN OF THE OCCUPATIONAL HEALTH EXAMINATION COMMITTEE

«Мы располагаем хорошим ресурсом специалистов, но хотелось бы улучшить материальную базу отделения профосмотров» MEDICAL

68 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Please tell us about yourself. Where are you from? What is your life like in this town? I’m a native of Sverdlovsk. In 1993, I graduated from the Luhansk Medical Institute. I’ve been in medical service for 19 years, including 6 years as a general practitioner and 13 years as an occupational physician. At present, I work as an occupational physician, and I am the Chairman of the Occupational Health Examination Committee. I have “first grade” qualifications.

Please describe your job. What is it about? The medical service is based on disease prevention. The main objective of my work as an occupational physician is to identify occupational pathologies at an early stage and send people to specialised departments for additional examinations. As the Chairman of the Committee, I control the quality of occupational health examinations. Occupational health examinations are organised on the basis of the Occupational Health Examination Department of the Central Municipal Hospital No. 1. Besides, for big enterprises of the town, occupational health examinations are carried out by mobile teams at Dolzhanska-Kapitalna, Kharkivska, Sverdlova and other mines. It is very convenient for enterprises to have on-the-job occupational health examinations of workers. However, considering the specifics of our work, not all of the enterprises are capable of arranging proper working conditions for us. Occupational health examinations are carried out in accordance with a planned schedule. First, we develop a schedule of occupational health examinations for enterprises. Before each visit, a briefing for specialists participating in the occupational health examination is organised. All of our specialists have received training on occupational pathology at the Luhansk State Medical University. Such trainings are carried out regularly. The enterprises have different profiles, thus the factors causing occupational diseases can differ. That’s why before each visit, it’s worth reminding the doctors what they should pay attention to. For each enterprise, the sanitary and epidemiological service provides us with a statement of groups selected on the basis of harmful factors that they face. For instance, for a stope miner and a sinker, the harmful factors are as follows: coal dust, occupational noise, from 81 to 99 dB, local vibration, lifting and manual MEDICAL WORKERS

69 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

movement of heavy weights, and restricted body movement of the knees, squatting, etc. For other mining disciplines, there can be other harmful factors. Committee members’ conclusions are registered in the occupational health examination record and should be signed by all doctors, the Chairman of the Committee and the employee. The occupational health examination record is stored in the employee’s out-patient medical record and the enterprise is provided with a photocopy. The Occupational Health Examination Department has an automatic digital photofluorography machine made in 2005, in operation since 2006. One month before an occupational health examination, there are organised photofluorography examinations, as well as instrumental and laboratory examinations. It means that when the Committee arrives, the doctors are already equipped with primary examination

data. This photofluorography machine is used not only for enterprises, but also for individuals, for instance, rural inhabitants. We cannot treat separately miners’ medical needs and the needs of other inhabitants of the community. It is the same as fighting against tuberculosis, which is equally dangerous for everybody. It would be good to buy for Central Municipal Hospital No. 1 one more, perhaps more modern, automatic photofluorography machines, as the one we have often causes problems when we connect it to rural electrical networks.

What do you think should be improved about medical services, especially for miners? We have good staff, but we would want to improve the resource base for the Occupational Health Examination Department. The Medical Council submitted a request to target financing from the municipal budget for 2013 in order to carry out a full range of instrumental examinations in accordance with the Order of the Ministry of Health No. 246. At present, beside the photofluorography machine, we badly need a spirography machine in order to examine external respiratory functions, an audiometer, without which we cannot determine a degree of a person’s hearing disorder, and a mobile electrocardiography recorder or electrocardiograph machine. As there is no audiometer, we have to send patients to the Luhansk out-patient hospital to be examined by an MEDICAL

70 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

audiologist. Since the beginning of the year, there have been six identified cases of sensorinerual hearing loss as primary occupational diseases, but these patients have not been given any appointment cards to doctors after their occupational health examinations. It’s very important to approve occupational health examination plans on time. The planning schedule should be approved in January. In such cases, we would have more time for occupational health examinations and thus for examining each employee. To have enough time for examinations also means better quality of occupational health examinations as well. In 2012, occupational health examinations were supposed to cover 11,490 people, including 8,599 miners. During nine months in 2012, occupational health examinations were passed by 6,079 people. General pathologies were identified

among 312 people, including 41 women. These people were recommended to find another job with acceptable working conditions. Occupational pathologies were suspected among 184 people. They received appointment cards to visit an occupational physician. If our Occupational Health Examination Department continues to provide services to DTEK, it’s high time to start thinking about strengthening the resource base. Then, not only the miners, but the whole city would win!

На фото: прохождение профосмотра перед трудоустройством на шахту. MEDICAL WORKERS

71 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE IRYNA VLASOVA

A HEALTH POST NURSE AT ONE OF THE MINES (The first and last names of the interviewee have been changed.)

«Спросите любого шахтера и он вам ответит, что при обнаружении какого-либо заболевания его просто уволят с работы» MEDICAL

72 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Iryna, tell us about yourself, about your family. Where do you come from? I’m 59, and I was born in a town called Uralo-Kavkaz. It is 10km away from Krasnodon. My mother worked as a nurse in a local hospital, and I didn’t know my father. When I was a child, I decided to become a medical worker, too. I actually wanted to be a doctor, but it just didn’t happen. So I trained as a nurse, and I have been working in medical care for all my life.

For how long have you been living in Krasnodon? And what’s your life like here? We moved to Krasnodon with my husband about 29 years ago, and before, we lived in Molodohvardiisk. I always worked in hospitals. At first, it was in a urology department.T hen I moved to surgery and worked in an ambulance. Later I was a nurse in a kindergarten for a few months, but then came back to the hospital and worked in the vaccination room. My total experience is 39 years; 10 years with coal mining enterprises.

How would you assess the level of medical care in Krasnodon? A little bit better than satisfactory. Let’s start with ambulances. There’s no financing. Cars are breaking down all the time. No gas. Sometimes there’s only one car available because all the others are broken. It happens that ambulances arrive after 40 minutes to an hour. Two years ago, the town bought four “Nyva” cars and one mobile intensive care unit. And Krasnodon Coal has also recently bought two new cars for a local ambulance station. Krasnodon lacks medical care workers, starting with ward attendants and including even doctors. There are no specialists. If we are fortunate, there’s one ORT, an optician, an urologist and a cardiologist. Not enough physicians. To understand the situation, you just have to visit a hospital once. There’s a line of 30 people to every room. People get angry and argue. And I can understand them. They not only feel bad, but also have to stand for a whole day in the hospital.

Stand? Aren’t there any benches? Yes, there are, but just a few chairs. In most cases, people stand close to the rooms.

And what about medical equipment? MEDICAL WORKERS

73 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

For complex examinations, people travel to Luhansk from Krasnodon. They also go there to get treatment because here in Krasnodon, we don’t have the equipment or specialists.

The medical profession is very popular right now. A lot of graduates enter medical universities. Why do you lack so many people? Because salaries in Krasnodon are low. Graduates try to find jobs in the capital or somewhere else in the region, almost nobody wants to work in our hospitals. How can you keep a family for only 1,500 or 2,000 hryvnias? And sometimes there are delays, especially at the end of the year. This is the answer. Nurses’ salaries are just a little bit more than the minimum. It explains bribes, and the fact that doctors get commissions for medicines sold so they prescribe only the most expensive ones.

MEDICAL

74 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

When did you start working at Krasnodon Coal? Why did you decide to work at the health post? I retired after years of employment. But I didn’t have enough money, so I started working at the health post of the mine. I worked at different mines, so I could see where it was better and why.

Does the health post belong to the mine? Not now. We were transferred to Ultramed medical service, which protects miners’ health. And before, the whole staff of the post belonged to the mine.

What is Ultramed? This is a medical service owned by Krasnodon Coal. Its staff includes health post nurses and doctors, who carry out health

examinations of miners. The service has all the necessary specialists.

The town lacks specialists while Ultramed has them all, right? They work under a contract, their salary is good, and so the staff is full. Citizens often go to Ultramed. But while miners are given treatment for free, citizens have to pay.

Let’s talk about health examinations. How often are they organized? How well? Examinations at mines are carried out once a year. There is an approved schedule, according to which Ultramed specialists go to the enterprise and examine workers. And if we talk about health examinations in general, they are necessary, of course. Another problem is miners’ attitude, they are scared like hell.

Why? Every medical examination aims at finding diseases early on, doesn’t it? The reason is that our men take examinations the wrong way. The very fact is hated. But people were actually made to fear them. Ask any miner and he will tell you that he would get fired if they found that he had any diseases.T hey are ready to pay a lot just to pass this examination.

And do the doctors take money? MEDICAL WORKERS

75 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Yes, they do. From 250 to 350 hryvnias.

So, examinations are just part of a formal procedure, aren’t they? Sometimes. In most cases, doctors just ask questions. But the worst thing is that miners refuse to get examined. It seems to be a great opportunity to have your health checked by all of the specialists for free, to detect diseases early on, get treatment and be healthy again. But in fact, it’s just the opposite. In 50 per cent of cases, miners just pay to get a “healthy” mark. And there’s a reason: people don’t want to lose their jobs. It’s quite absurd sometimes. One of our workers didn’t want to see a cardiologist because he was afraid that they would send his health records to the mine. And if so, they would first register him, then transfer him out of the mine, and then they would fire him. He has two kids. You just can’t lose your

job and stable income in such a situation. We managed to persuade him to see at least a private doctor. He received treatment and his heart stopped bothering him. But he also had to go to Luhansk to be sure that Krasnodon Coal medical workers wouldn’t find out about his disease.

What else are they afraid of? Taking blood pressure. A lot of them have a so-called “white robe syndrome.” Once they see a doctor, the pressure goes up. And now you just can’t go into the mine when your blood pressure is high. That’s why people are scared. Those who are on a medical register have to come to a health post before going down, where the nurse takes the pressure and gives him permission to work. If the pressure is a bit high, she gives him a pill; if it’s too high, she sends them home.

Are they often on sick leave? Rather often. But Krasnodon Coal isn’t very happy about it. If you are ill for too long, then you shouldn’t be a miner. If you take more than five sick leaves a year, they start watching you. All sick leave letters are signed by the director or his deputy. If you seem suspicions, they can make you take a medical examination. It sometimes happens that miners go back to work before they are actually cured. Mainly colds and bronchitis.

How would you assess miners’ health? MEDICAL

76 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Bad. After 10 years in a mine, most of them have chronic diseases. One out of two has back pain, and one out of three has problems with his joints. Half have bronchitis and blood pressure issues.

What do you think of underground safety measures? What damages their health so much? Is it only bad working conditions? Of course not. Lifestyle and emotional state as well. Most miners smoke and drink alcohol; you can’t say they care about their future. And regarding their emotional state, people are often stressed just before going down. Here’s one example. There was a lethal accident in one of the mines recently. They made a video clip and played it during every shift. But I wish they’d only shown the reasons, told them about the violations and so on. No, they also filmed shots of a cemetery,

crying relatives, kids who were left without their father. Can you really show this before a shift? When you see a person you used to know dead in a coffin, who wouldn’t have high pressure and heart problems? Are we talking about safe working processes after this?

Did you hear complaints from the miners? Well, those weren’t complaints. Several people came and asked for a headache pill or validol. And of course, they told us why they felt bad. My personal opinion is that you shouldn’t get miners worried before work. They need all their attention and concentration. If we’re talking about their health, the problem must be solved comprehensively. Let’s start with the buses. They are in horrible condition: they are too hot in the summer and freezing cold in the winter. Here’s one reason for illnesses. Then they come to work and get cursed at and humiliated a couple of times a day. The result is predictable: miners get anxious. Then they come to the office and are demeaned again by having to take the alcohol test. They go down into the mine feeling upset and work hard for six hours. How can you stay healthy?

And what do they think about alcohol tests? They are more or less tolerable now, but still, there are a lot of complaints. At our mine, the test is done in front of the office before each shift. Other mines don’t do it regularly.

Do miners come drunk to work? MEDICAL WORKERS

77 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

It happens sometimes. Of course, we send them home. Sometimes they come with a hangover and practically beg on their knees to let them work. I don’t take responsibility for it, but I know for sure that there were cases when nurses ignored alcohol test results for money.

Let’s go back to health posts. How well are they equipped? Do they have all you need? We have everything we need to apply first aid: IV lines, different solutions, bandaging materials.T he situation is worse with regular aspirin and medicines. The head of the health post keeps the pills, and she can give not more than a pack per shift, though we didn’t have such problems before. They also promised us a defibrillator, but we don’t have it yet. And there are no drug-containing substances here, only mine rescue brigade (MRB) doctors use them.

Aren’t there any delays of mine rescue brigades? No. Though enterprises are located rather far away, mine rescue brigades always come in on time.

And where do you keep medicines? In the fridge. Actually, not all health posts have working refrigerators. For example, mine has been out of order since June, and I keep medicines in the cabinet.

So, the temperature control isn’t correct, is it? No. It’s hot in the summer and of course, there is no air conditioning. If there’s no refrigerator, you can’t guarantee that medicines have not spoiled.

What about underground health posts? Do you consider them useful? Yes, of course. When it comes to health, it’s seconds that matter. An underground nurse can make injections on time, relieve pain and shock and apply first aid. Underground posts have everything you need to provide medical aid. And everything is modern. Besides, now all production units have special sets of medicines and first aid materials.

Have you ever had lethal cases? Yes, I have. The first man died inside of the mine.T hey called MEDICAL

78 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

me from the unit and told me that someone was feeling bad. I started to ask about his condition and they told me that he wasn’t breathing anymore. Heart disease. The second case was on the surface during the night shift. It was a young guard, 23 years old. He knocked on my door, I opened it, and he was already lying there on the floor. He died from acute pericarditis.

Do injuries often happen? Do people come to you a lot? What are the reasons for injuries? Yes, there are a lot of them. Mostly they happen because of rushed work and violation of safety instructions. But injuries are kept secret. Miners are forced to record injuries as off-the- job injuries. Heads of production units get reproached for industrial injuries and lose their bonuses, so they put pressure on the miners. But we always tell the miners to think. Light

and serious injuries are completely different things. Nobody can guarantee there won’t be consequences.

You have been working at the health post for 10 years. What changes in medical care services have happened during your work? I would like to point out that medical care is now receiving attention. I mean those underground health posts appeared, and the other ones on the surface have all the necessary medicines. All medical care workers completed special courses in first aid.T hey were organized for all of the miners, especially to prepare those working underground.

What do you think can be improved in medical care, especially for miners’ needs? You know, we can’t consider the miners’ and town’s medical needs separately. Everything is interconnected because Krasnodon Coal is such an integral part of the town. Thus, miners are treated in city hospitals. And they lack equipment and professional doctors. That’s why we have to improve it comprehensively. I think we should start with promoting healthy lifestyles. Miners must care about their health, only then would it be effective.

Is this promotion organised now? Yes, but only in some aspects. For example, Krasnodon Coal has a very developed sports infrastructure. Every year we MEDICAL WORKERS

79 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

have inter-mine sport competitions in different kinds of sports. Everybody can take part. Krasnodon Coal has its own stadium where they hold football matches. Enterprises have their own football pitches and gyms. This year, more than 3,500 miners and their families participated in sporting events. Miners go to the swimming pool. Trade unions give us money for miners and their families to use them for free. Swimming is rather popular here. But here’s another problem. The swimming pool is the town’s property, but they do not have a budget to maintain it. Krasnodon Coal gives us some money, but it’s just not enough. As a result, this year the pool wasn’t open in the summer and autumn, and nobody knows when it will be opened again. On the whole, I would like to say that we have to change the way of thinking and get people interested. Probably a new program called “It’s cool to be healthy” should be initiated on the state level, and coal enterprises and local authorities should help implement

this programme at the city level. The more promotion we have, the better results we will get. MEDICAL

80 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

MEDICAL WORKERS

81 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

OLEH VATANSKYI

DIRECTOR OF ULTRAMED MEDICAL SERVICE OF KRASNODON COAL

«Наша главная задача – выявить заболевание на ранней стадии и своевременно назначить лечение» MEDICAL

82 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Oleh Oleksandrovych, tell about yourself and your family. Where are you from? What is your life like in this city? I was born in 1961 in the city of Luhansk. My mother was a medical nurse and is now retired. My father was a Soviet Army officer; unfortunately, he is no longer among us. I spent my childhood and teenage years in Luhansk. In 1985, I graduated from Luhansk Medical Institute. I had my internship at City Hospital No. 4 and was sent to work at the Sukhodilsk city hospital. I worked as a sector doctor and later became the head of this service. In 1993, in Krasnodon, I was invited to work at the Ultramed medical centre. Initially, it was planned as a medical centre for Chernobyl veterans, but they later decided to make it a medical centre for mine workers. I have been the head of Ultramed since 1998. Now Ultramed is a subdivision of Krasnodon Coal. Medical services include a diagnostic centre, 2 prophylactic sanatoriums, and 13 health posts throughout the enterprises. It employs 215 people.

What does Ultramed do? The main function is to conduct preventive examinations. The miners’ health and diagnostic of diseases at early stages are our main tasks. Before, professional health examinations were performed at the central city hospital. Since 2000, this task has only been performed by Ultramed. We try to reduce the time of examinations as much as possible. Medical teams go to the enterprise to examine as many miners as possible in one day. Our doctors have different express equipment at their disposal: portable fluorography, urine and blood express analyses, portable cardiographs, humalyzers for biochemical analyses and audiometers. There are two ultrasound examination devices, portable and fixed, as well as a cardiac ultrasound machine, and endoscopy equipment. In general, we examine approximately 14,000 people per year. Last year, Ultramed moved to a new, separate building. There is a small clinical laboratory here to perform necessary analyses. The staff consists of professionals who are continuously improving their education. We take part in all seminars conducted in the region.

Does Ultramed perform health examinations only for Metinvest enterprises? MEDICAL WORKERS

83 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

We never refuse if other enterprises address us. We sign an agreement and organise examinations in the name of Krasnodon Coal.

Are diagnostic procedures free for miners? All diagnostic and treatment procedures are free for employees of Krasnodon Coal. But citizens have to pay. Another issue is that miners are scared of medical examinations. There is no such term in medicine, but here at Krasnodon Coal, the majority of miners have a syndrome of hiding their health conditions.

What is this? From whom and why do the miners try to hide it? It happens because they don’t understand the purpose of medical examinations. A doctor’s task isn’t to make a man lose his job, although many workers think so. Our main task is to reveal a disease in its early stages and to prescribe a respective treatment on a timely basis. After having received this treatment, a man will

MEDICAL

84 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

recover. Unfortunately, a lot of miners who are scared to lose their jobs, look for different loopholes in order to avoid being sent away from the coal mines due to health reasons. “How will I provide for my family if I am sent away from the coal mines?” This is their motivation. And they can’t imagine leaving their families without a breadwinner.

Tell us about how professional medical examinations are conducted. If any illnesses are revealed, do you send the patient to a hospital for additional examinations? Of course, it is rather difficult to assess the patient’s health condition at once, so we accumulate the information. All the primary information about the enterprise, such as sick leave letters and visits to a doctor, are collected at the health post. A doctor organises and examines the information to decide whether this patient requires health improvement or

stationary treatment. During health examinations, doctors already know what to pay attention to. If a disease is suspected, a patient can be included into the “first” risk group.T here are three of them: the first group, where a disease has been diagnosed for the first time; the second group, where miners are under medical care and have their blood pressure measured before each shift; and the third group, where miners require treatment and are transferred to work aboveground or have their contracts terminated.

After the disease is diagnosed, where does the patient undergo medical treatment? Ultramed mostly deals with diagnoses. Our main job functions are disease prevention, early diagnoses and recovery. Miners receive medical treatment at the city hospital. Most frequently, they suffer from acute respiratory diseases.T he second most common ailments are general injuries, orthopedic injuries, skin diseases and cardiac diseases.

What about insurance? We are open to all insurance companies. Everyone receives the green light.

Tell us about health posts. What are the duties of medical nurses in underground posts? We have 13 health posts: 10 aboveground and 3 underground ones. The fourth underground health post will be opened at MEDICAL WORKERS

85 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

the Barakova coal mine by the end of the year. I would call an underground health post a base of medical staff from where medical nurses treat injured people as necessary. Considerably reducing the time to apply first aid can save a miner’s health and sometimes even his life. Let us count: miners work as far as 30 to 90 minutes into the mine, plus it takes about 23 minutes for a mine rescue brigade to arrive, plus 10 minutes to descend. And a nurse who is underground can provide first aid much faster. The underground health posts are equipped with special bags containing everything needed for first aid.T here are also vacuum braces, mattresses, and special dismountable stretchers. In addition, there are special fillings at all mine workings. These are cases containing everything needed for first aid.

So if an injury happens, what does a nurse do? How does

she know where to go? There is always notification about injuries. A dispatcher receives the information and tells a nurse at an underground post to go and provide first aid. After this, the injured person is moved aboveground.

What are the qualifications for a staff member working at a health post? All staff members are trained. We have our own training classes where all medical workers have been trained. Now the best three medical workers conduct trainings for all of the employees at Krasnodon Coal. We have already trained 4,000 mine workers beginning from April of last year. We will cover 100 per cent of the company’s workers. Our training classroom is equipped with modern dummies, defibrillators, and cushions designed to imitate injuries. I would like to mention that we already have seen the benefits from our staff training today. People are not afraid to apply first aid.T hey already know how to apply a tourniquet, how to use vacuum splints, and how to use stretchers correctly.

If a person was injured while working and needs hospitalisation, what hospital would he be taken to? To the Krasnodon central city hospital, but we are now trying to arrange it so that a patient won’t be transported through the whole region and taken immediately to the hospital where MEDICAL

86 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

he will receive the most qualified aid or to the closest one. For example, if we are talking about Samsonivska-Zakhidna coal mine, it is much more convenient to take a patient to the hospital in Luhansk.

How do you assess the city’s health care? The highest class specialists and best medical workers work in the Krasnodon central city hospital. Another issue is that this hospital lacks good equipment. But the city takes active part in multiple programmes for attracting investment. Recently Metinvest bought two new ambulance cars, and the children’s hospital purchased laboratory equipment.

Is there emphasis on promoting healthy lifestyles? I think that it is one of the most important and at the same time most difficult work directions in medicine. In my opinion, it is necessary to create a school of professionals, who will be able to persuade people that it is easier to prevent a disease than to cure it and then they would be able to defeat this syndrome of distrust of medical workers. In general, I would like to note that the majority of coal mine workers have serious health problems. And it is another confirmation of the fact that treatment must be started at the stage of its conception.

What about the provision of water? Unfortunately, the issue of providing miners with drinking water is still not solved. But Metinvest is developing a major programme in order to provide mineral water in Tetra Paks. This water will be mineralised especially for miners. MEDICAL WORKERS

87 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

MEDICAL

88 Photo: Kostiantyn Strateliuk, Ultramed VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

YEVHEN SKLIAR

CHIEF OF SURGERY AT THE CENTRAL CITY POLYCLINICS

SERHII DEMYDENKO

AN OCCUPATIONAL PHYSICIAN

OLEKSANDR SUKULENOV

CHIEF PHYSICIAN’S DEPUTY MEDICAL WORKERS

89 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

“If the level of medical care improves, the whole city will enjoy the benefits.” Miners say that one out of a million tonnes of coal takes WE LACK one human life. And how many injuries this million tonnes results in is never even mentioned. It’s widely known that PEOPLE MOST the mining industry has one of the highest injury rates. What injuries happen, where and how treatment and rehabilitation OF ALL are organised, and what things still need to be acquired, we talked about these issues with the head of surgery of the Rovenky central city hospital, Yevhen Borysovych Skliar (YS). As health examinations and professional diseases are a very prominent problem among miners, occupational pathology specialist Serhii Borysovych Demydenko also participated in the conversation (SD). Deputy Chief Doctor Oleksandr Oleksandrovych Sukulenov (OS) applied the finishing touches to the picture of medical care for miners. His remarks were regarding technical equipment of the city

hospital, rehabilitation issues, sanitation and miners’ health improvement in general.

Yevhen Borysovych, please tell us about yourself. Where are you from? Why did you choose medicine? Where did you start working, and what was you first position? YS: Rovenky is my home town. I was born here. I have worked in medical care my whole life, though this profession was chosen by accident. I’ve been a doctor since 1997. I started my career as an ambulance paramedic, and I then worked as a physician’s assistant in the Soviet Army. After the Army, I entered Luhansk Medical University, graduating as a traumatologist and working in the hospital departments of traumatology and orthopedics. Ten years ago, I was assigned as the head of the surgery department of the central city hospital for adults. Simultaneously, I provide medical aid as a traumatologist at the hospital’s injury care centre.

What injuries do miners usually have? How often? YS: All of them. We have all kinds of visitors. Even impossible things happen. In fact, you can break any part of your body. And since it’s a miners’ district, it’s no wonder that miners represent 70 to 80 per cent of all patients.

And if we count only on-the-job injuries? YS: The ratio of on-the-job and off-the-job injuries is difficult MEDICAL

90 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

to tell, but off-the-job ones prevail. If we have 10 home injuries, there will be only around 3 industrial ones. And those are fractures most of the time. The parts you use while working are most commonly broken, which are the arms and legs.

And speaking about the three-to-one ratio, please tell us, is it always possible to tell the difference between on-the- job and off-the-job injuries? YS: We can’t be sure here because we believe the patient. If a person says he got injured at home, we have to record it that way; same with on-the-job injuries. Sometimes even conflicts occur. We are often blamed for hiding industrial injuries. But there’s no personal interest for us here. We cure everybody, not depending on the type of injury, with the same methods. The patient is the one who cares because in case of an on-

the-job injury, he gets money for treatment from the social accident security fund but for an off-the-job injury treatment he has to pay by himself.

What injuries can you cure by yourself, and when do you have to send patients to a regional clinical hospital? YS: Concerning this matter, I’d like to point out the help from our Luhansk colleagues of the traumatology and orthopedics departments. If we have any diagnostic and technical problems, we get in touch with them by cell phone in just a couple of minutes and they come here. They bring equipment, metal ware, etc. This is so well organised and convenient, especially for the patients, that we perform 90 per cent or surgeries here instead of going to the Luhansk regional hospital. And we don’t have to move the patient, which is also very good.

When talking about financing, we would like to know how well first aid for miners is and how quickly they are transported to you. YS: Mine rescue brigades are most commonly sent in case of industrial injuries. They have all of the modern equipment. They don’t have limits in financing, and the situation is getting better year by year. Starting with pain killers, they even stopped using opiate analgesics, which is great, and ending with transport immobilisation aids. From the moment the brigade picks up the injured person and until they get MEDICAL WORKERS

91 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

to the hospital, the patient gets the whole set of measures that he needs. They use transportation splints, new types of stretchers, special bandages, which are inflated and affix to your neck and body, infusion therapy and anti-shock WE CAN ONLY measures. All I can say is good job! SUSPECT A Yevhen Borysovych, you emphasized that mine rescue brigades have no financial problems and that they can PROFESSIONAL afford to provide high quality medical aid. But do you face financial problems as a city hospital doctor? DISEASE YS: Let’s start with the fact that there’s no limit for perfection in medical care as well as in any other area. Medical science develops new methods, technologies and equipment. Of course, I am just like any other doctor: we want to have all of this. Most often, we can only dream about it. We are financed from the city budget, and of course, it can’t satisfy all of our

needs and wants. OO: On the other hand, we received money from the city budget to buy a new tomography computer. It can confirm any diagnosis or the locations of fractures. And it works for all citizens for free. The only thing you have to pay for is tape, which is 60 hryvnias. YS: And believe me, those costs cannot even be compared to what they have to pay in the Luhansk region. There’s no other price as low as in Rovenky for spiral computed tomography.

If possible, let’s talk more about your wishes for the hospital. What does the hospital lack in the first place? YS: People. A long time ago, our government decided that we didn’t need doctors of particular specialties and implemented a programme under which family doctors had to examine patients. That’s why for the last five to seven years we haven’t had even one traumatologist. And doctors are people, they get old. The average traumatologist’s age in the city is 40. It means that they are about to retire and have to give their knowledge and experience to young specialists. It has to be, needs to be, and can happen. We just don’t have anybody to give this knowledge to.

So, people are the first point. And the second? YS: Secondly, everything is getting more expensive and our instruments and metal ware are not exceptions either. In fact, we use different types of them. But in most of cases, if the MEDICAL

92 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

person can’t afford the metal, we have to pick cheaper metal ware. OO: If it is a work-related injury and a person needs this metal ware, there are no problems whatsoever.

How’s the situation with the equipment in inpatient departments? Are there functional beds, orthopedic anti- decubitus mattresses? YS: In 2008, thanks to Rovenkiantratsit, which paid attention to injured miners’ problems, we carried out a major European- level repair of the traumatology department. Now, instead of common patient rooms—and some of them were for 18-20 people—we have small, comfortable ones. Each has a sink, a fridge, air conditioning, and split systems. There are some multifunctional traumatology beds, which has a control device to change body positions. There are also orthopedic beds, not in every room, but not every patient needs it there.

So, can we talk about changes for the better? YS: Positively. There are changes, and they are for the better. And they keep happening. For example, now we are discussing this new digital x-ray apparatus we are going to get thanks to our partnership with DTEK. Besides, one of the latest DTEK initiatives is carrying out independent health examinations by their own specialists or contract brigades. Serhii Borysovysh, here is a question for you as an occupational pathology specialist: is there a necessity to do this or are your capacities good enough? SD: I think our capacities are not bad. Initiatives of DTEK are their own concern.

How are health examinations organised in Rovenky now? Who is responsible? SD: Health examinations are carried out by the department of preventative measures of the central city hospital for adults. We have a special department, a head of the department, a head nurse and all of the doctors, who participate in the health board. Every year, there is an order issued and board members are discussed, as well as locations and schedules of work, a list of examinations is defined according to order #246, jointly issued by the Ministry of Health and the State MEDICAL WORKERS

93 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

Service of Mining Supervision and Industrial Safety. The workers receive special forms, come to our hospital, register and get examined. There is even a special building for it.

Do you have all the necessary medical equipment? A A CITY REHAB helicograph, an audiometer… CENTRE IS A OO: We have a portable automatic screening device, again, financed from the city budget, which is transported to the DREAM enterprise building according to previously developed schedules. We have a helicograph, but the audiometer is out of order right now. We should buy a new one because now we are forced to send people with hearing disorders to examinations in the regional clinical hospital.

What are other reasons to send a person for an additional examination?

SB: We can send the patient if, let’s say, we have a suspicion of radiculopathy. In order to check the diagnosis, we have to conduct an electroneurogram, which can only be done at the regional hospital. And there are also neurosurgeons if we need any consultations. We send people there if they have sensorinerual hearing loss connected to work activity. And people with pneumatic hammer disease should also be examined again at the regional hospital.

What occupational disease of miners is most common? SD: Now it’s chronic bronchitis originating from dust. The second is pneumoconiosis and silicosis.

So, bronchitis is the most wide spread cold-related disease, isn’t it? SD: I think the most common are acute respiratory disease and acute upper respiratory infection. And only then, acute and chronic bronchitis.

Do doctors always diagnose bronchitis? Miners often complain that their lungs are almost out of breath and they still are diagnosed with acute respiratory disease. SD: There are certain instructions of when to confirm bronchitis. In particular, if the bronchitis is chronic, the criteria are the following: a person coughs for three months in a year for two years in a row. And this is recorded, which means a person saw a doctor. If he comes and says, “I’ve been coughing MEDICAL

94 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

for ten years,” but he has never been sent to hospital, we only have his words to believe. We only make a diagnosis once a person has sought medical aid, received treatment, and had his bronchitis symptoms recorded by a doctor.

Is this an occupational disease? SD: Not necessarily. If the diagnosis is established and the person wonders if it is connected to his occupation, then it’s time to consult an occupational pathology specialist at the city or regional level. Then, they study his occupational history, sanitation data and dustiness of his work place, where he worked, for how long he worked, etc. They also study medical documents, out-patient medical records, data on ambulance trips or hospital stays. But again, we can only assume an occupational disease. The decision is made by at least the Luhansk department of occupational pathology. In general,

several hospitals deal with it: Luhansk, Donetsk, Kharkiv and Kyiv. Only they can confirm an occupational disease.

Nowadays you could easily face the following situation: an occupational physician diagnoses a miner with an occupational disease, which requires medical attention. But the miner is scared of receiving treatment for the disease because he might be transferred out of the mine or he might get his salary cut. Or that he might even be fired. What do you think can be done about this problem? SD: This is not a problem of our patients, but the absence of alternatives: alternatives for jobs and for a decent income. And if this question is to be asked, then you would be better off addressing staff sectorial doctors of DTEK. They send miners suspected of having occupational diseases to the occupational pathologist. And if they are right, they send the patients to Luhansk. After consultation and additional examinations there, it can be said whether a person has an occupational disease or not. And this procedure, of course, might uncover diseases that would affect his prospects for a job in the future. OO: I think this is a rhetorical question. While the general situation in the country and region is not improved, the problem will still be there. Besides, where can a middle-aged or soon retiring miner find another job? Unfortunately, you have nowhere to go in this town except for the coal industry. And a decent salary is not even worth mentioning. MEDICAL WORKERS

95 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

So, right now there’s only one way out: to care and improve your health and working conditions and exercise. And what is the situation with sanatoriums? The sea is always the sea, but some miners really need to go to sanatoriums from time to time. YS: We recommend people to go to special sanatoriums as necessary. We have specialised sanatoriums to provide treatments; for example, in cases of respiratory diseases, musculoskeletal system problems.

Okay, so you recommend them to go. Do trade unions follow your recommendations and the wants of miners? YS: Yes, they try to send workers to recommended sanatoriums. The other problem is that not all miners want to go to sanatoriums. OO: There’s a special committee for sanatorium treatment. We

issue certificates, and in general, there are no big problems with such trips. If a person wants to go, he does. SD: Of course, there are a certain number of unsatisfied people. Those who wanted to get into one sanatorium and got into another. That we can’t explain right now. But in our city, in general, it is rather well organised. There are no big problems, and I don’t remember complaints like, “I wanted to go but they didn’t let me.” At the very least we have a local health and recreation resort called Shakhtarski Zori. It’s no problem to get in there.

And how is the base? Are procedures varied and effective enough? YS: Our resort is one of the best in the country. It even has Crimean mud. And we can organise the full course of balneotherapy plus spa therapy without leaving the Luhansk region. Within 18 kilometres from town, we have our own little Crimea. Those who we convince to try Shakhtarski Zori refuse to go anywhere else after. It’s even economically reasonable. Why would a person travel through the entire country if he can get everything right here?

Can miners have rehabilitation there after suffering an industrial injury? YS: For industrial injury rehabilitation, we have a special regional medical rehabilitation centre in Krasnyi Luch. Those MEDICAL

96 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

who need medical rehabilitation are sent there at the expense of the Fund. But I should point out that it only applies for on-the-job injuries. It’s convenient for both doctors and the injured because Shakhtarski Zori cannot always be used for rehabilitation needs. We can only send a person there if he has vacation. Or we also have enterprises where the workers are allowed to stay there without discontinuing work, which is also great. OO: So, if a person has sick leave, we cannot send him there. And a rehab centre in Krasnyi Luch allows him to do it. And if the person has a new injury and needs rehabilitation treatment; for example, we cure the fracture but there is a problem with flexion function, we send him there.

If only your town had such a rehabilitation centre. YS: Well, we can only dream of that.

Yevhen Borysovych, how much time does it take to rehabilitate someone after an injury? YS: There’s no single proper answer to this question. All people are different. I was taught that in every situation there are three of us: a doctor, a patient and his disease. If the patient takes the side of the disease, the doctor will never cure it. He is left alone. And vice versa: when a patient is with a doctor, they can overcome any disease together. If a person becomes paranoid about the illness, it gets really complicated. And if there is full contact between a patient and a doctor, everything will be alright.

So, no more questions about rehabilitation and health improvement. But still, how can miners protect their health? Not only the working conditions, but the ecological conditions and bad personal habits contribute here too, right? YS: We should recollect a well-known formula from an international health care organisation. It says that medicine can only improve health by 10 per cent, while 90 per cent is from the environment, working conditions, water, and food. OO: That 90 per cent is a reason for all of the problems. Miners must have modern individual protection devices and safety regulations against dust and fumes that have to be followed in the mines. Of course, a person should understand too, that health is health, and if he smokes two packs after he leaves a MEDICAL WORKERS

97 VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE

“stoping face,” it won’t do him any good. Same thing with using alcohol to reduce stress. Yes, the environment is not very favourable, especially in our region. And of course, it has consequences. If you take a pocket light outside at night, you will see the air is full of dust. And this is what we breathe in. YS: But one can’t just blame the environment for deteriorating health and the emergence of chronic and allergic diseases. For some reason, we always move the country’s socio-economic situations to the backstage, but one should look for the roots of the problem right there.

Are there swimming pools, stadiums, and gyms in town? Do miners have any place to work out? OO: There are swimming pools in the centre and in Dzerzhynka. And gyms. Everything works and is maintained by DTEK.

To sum up our conversation, please tell me, do we need to improve medical care for miners or for all citizens? OO: I say this: if the level of medical care for miners gets better, everybody will win. We can’t analyse the situation only for coal miners. This system might work only if the enterprise buys equipment for its own health posts. It’s clear that a person from the outside will not get into it. It’s just like in our Shakhtarski Zori health resort; not only miners are allowed to go there. For example, doctors of our hospital got presents for Medical Worker’s Day, a chance to go there at a reduced price. As far as I know, members of miners’ families can go there as well. I mean, of course, if the level of medical care for miners improves, everybody will benefit: the whole town. VOICES OF MINERS

IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE