Health and wellness

Our approach

Our proactive, risk-based healthcare service provision aims to ensure employees are fit to work, lead healthy lifestyles and retire at a physiologically appropriate age. Robust medical surveillance enables active case finding, and early disease detection and treatment, in support of our four-pronged healthcare strategy:

1. Education, awareness and health promotion
2. Disease prevention and risk management
3. Clinical intervention (treatment programmes)
4. Continuous employee health risk profiling

The strategic intent is to build resilience and empower our employees to proactively manage their health and wellbeing. Our electronic integrated health management system is aimed at providing a holistic view of each employee’s health status on a digital platform. This platform collates occupational and non-occupational health data for our management teams to make informed decisions for safe production. It is the foundation of the digital transformation of our health strategy.

FY23 PERFORMANCE AND FOCUS AREAS

Occupational medicine and hygiene

We aim to prevent occupational health incidents to protect employees from experiencing serious health implications and Harmony from financial liability and reputational damage.

South Africa

In South Africa, our key health concerns are occupational hygiene stressors (silica dust, noise, radon gas, heat, diesel particulate matter, welding fumes and harmful vibrations). Although we have seen a significant decline over the years, noise-induced hearing loss (NIHL), heat-related illnesses, and occupational lung diseases (OLD), particularly silicosis, remain our major risks.

Addressing occupational lung diseases (OLD), silica dust exposure presents a major risk as it causes silicosis, an occupational lung disease that increases susceptibility to TB, particularly among HIV patients. We address this through an integrated HIV/Aids, Silicosis, and TB (HAST ) policy and programmes. We submitted 115 (FY22: 108) silicosis cases for certification and possible compensation by the Medical Bureau for Occupational Diseases (MBOD). The MBOD certified 62 (FY22: 184) silicosis and silico-TB cases.

Our focus is on improving our performance towards the 2024 industry milestones:

• The elimination of occupational lung diseases (OLDs)
• The reduction and elimination of NIHL
• The prevention of TB and HIV/Aids.

The first milestone requires that no new cases of silicosis should occur among previously unexposed individuals (those who entered the mining industry in 2009). There were two certified cases of silicosis among previously unexposed employees noted at Target Mine in 2013 and 2015.

Target Mine is used as a case study to showcase a comprehensive and focused approach to risk, enhanced preventive controls, quality assurance strengthening and improved outcomes since 2019. No new cases have been noted since.

Our goal is to meet the TB milestone (the TB incidence rate should be at or below the national TB incident rate). The number of TB cases diagnosed was 262 (FY22: 267), indicating a TB incidence rate of 604 (FY22: 590) per 100 000 employees tested. COVID-19 hurt our TB programme, consequently, there was a slight increase in TB cases for FY23. However, we have implemented a turnaround strategy to address the TB surge for us to meet the industry milestone.

Extensive work happens via the TB/HIV programme to attain the HIV/Aids milestone: 100% of employees are offered HIV counselling and testing (HCT) annually and all eligible employees are linked to an antiretroviral treatment (ART) programme.

Papua New Guinea

The significant occupational hygiene stressors at Hidden Valley, where we use large mining and earthmoving equipment, are NIHL and exposure to diesel particulate matter and respirable crystalline silica dust. Masks are also worn while high rainfall is a natural silica dust control in our mining areas. Our robust noise monitoring programme addresses NIHL by ensuring employees wear appropriate hearing protection devices.

Hidden Valley has a comprehensive occupational hygiene programme to mitigate known health risks across the operation. The programme and work comply with international hygiene standards and practices.  These are periodically audited by Aspen Medical as part of the Health Governance Programme. Independent consultants also periodically undertake training and third-party verification audits.

Non-occupational healthcare

Using our electronic health management system that supports follow-ups, Harmony’s integrated lifestyle programme addresses communicable diseases like HIV/Aids, TB and Covid-19, and non-communicable lifestyle diseases, including increasing mental health-related conditions. In FY23, 2 355 (FY22: 2 494) employees participated in this programme.

South Africa

In South Africa, non-communicable chronic lifestyle diseases, like hypertension, heart disease and diabetes, remain significant challenges for employees. We also manage challenging communicable lifestyle conditions like HIV/Aids and TB.

HIV/Aids

The scourge of HIV/Aids in South Africa continues to impact employees and their dependants, despite progress in raising awareness, prevention, and the availability of ART. Harmony is concerned that HIV/AIDS and opportunistic infections contribute to absenteeism and related productivity and skills losses, which negatively impact our sustainability. Motivating employees to disclose their HIV status remains challenging (this is worsened by the stigma and confidentiality), so we focus on encouraging positive behaviour.

In FY23, 29.3% of our permanent workforce was HIV-positive and 8 934 employees (FY22: 9 595) received ART and participated in our HIV/Aids programme. The prevalence at Harmony is higher than the national average because the Harmony environment is closed and controlled, compared to the rest of the country.

We distribute a Dolutegravir-based regimen, and other smart drugs, which accelerate viral suppression. We saw fewer side effects for 82.0% (FY22: 78.0%) of employees. These drugs support South Africa’s achievement of the United Nations Programme on HIV/Aids (UNAIDS) 95-95-95 targets. Harmony’s HIV/Aids programme aligns with this global campaign. Tshepong was the first operation to reach and surpass the new 95% target with Doornkop also reaching the 95% target in the recent financial year (FY23).

Harmony’s HIV Status %

Target 95%	FY23	FY22	FY21
of people living with HIV will know their status	89	85	76
of people with diagnosed HIV infection to receive sustained ART	90	89	86
of people receiving ART to have viral suppression	82	78	78
Employees on voluntary counselling and testing programmes	83	92	***

*** Figures were not monitored

Employees continue to receive pre-test counselling and voluntary testing through ongoing initiatives at our healthcare hubs. Note that in numerous instances, employees will test more than once in a financial year. In FY23, 71 563 (FY22: 67 035) employees received voluntary counselling and testing, and 59 372 (FY22: 61 565) confirmed their status. TB screening was offered to 7 054 employees and 5 936 were tested. We also identified and began treating 24 new positive cases.

Mental health

Supporting an inclusive and caring culture, employees participated in renaming our mental health and psycho-social programme to Khethimpilo (Zulu for “choose life”). We officially launched the campaign in March 2023, focusing on suicide prevention and substance abuse. We encourage employees and their families to use the service, (ongoing hybrid, on-site and telephonic counselling by resident social workers and Reality Wellness therapists). This programme is crucial to mitigating emerging risks, and disease outbreaks due to the economic climate and other factors that induce stress. By year-end, we recorded 9 620 consultations addressing substance abuse, family problems, work-related challenges, and other mental health concerns.

20 865 employees were reached through awareness and promotion campaigns:

• Zero tolerance to violence at work and home environments (6 900)
• Suicide prevention (3 800)
• Substance abuse prevention (1 779)
• Programme rebranding and awareness of services (8 346)

Papua New Guinea

TB and comorbid HIV/Aids as well as lifestyle diseases, such as hypertension and diabetes, are the main reasons for off-site referral for further checks and failed pre-employment medical examinations.

Given the humid climate, upper respiratory tract infections and TB are our main medical concerns. We effectively manage TB with digital X-ray, GeneXpert and other medical laboratory equipment to accurately diagnose this chronic disease as well as tropical diseases. In FY23, Harmony treated 2 456 (FY22: 1 545) employees for respiratory ailments. Good hygiene practices (regular hand washing, sanitising and wearing masks when experiencing symptoms) are emphasised regularly to reduce contagion.

Responding to disease outbreaks

Vulnerable employees are sent off-site for active disease management, including malaria and other endemic tropical diseases like typhoid and diphtheria. Outbreaks of dengue, filariasis, and Japanese encephalitis did not affect our employees.

While rampant in Papua New Guinea, malaria does not affect our Hidden Valley operation because it is at a high altitude. Cases recorded at Hidden Valley are typically contracted off-site with symptoms presenting when employees return to work. Employees, contractors and communities in lower valleys, and at Wafi-Golpu, are at greater risk of contracting this disease. In FY23, at Hidden Valley, our malaria cases decreased by 29.0% to 90 (FY22: 127).

At Wafi-Golpu, our employee and contractor-focused malaria management programme includes awareness and education campaigns, and mosquito net distribution. We encourage both groups to take nets home to their families.

Mental health Increasing mental health issues are challenging to assess as most patients do not disclose necessary information. Our on-site medical team addresses this issue with continuous health promotion activities, including a topic of the month and campaigns that encourage regular health checks.

As exercise is among the recommended treatments for mental health conditions, we have a gym and undercover sports facilities for employees at Hidden Valley.