By Tim Cocks and David Lewis
BAWDIE, Ghana, July 24 (Reuters) - A few years after coming as a teenager to this Ghanaian town to prospect for gold, Yaw Ngoha had made enough cash to marry his sweetheart and build a house with a porch, to which he would later add a flat-screen TV and satellite dish.
So when a town elder invited a doctor to talk to miners about the hazards of wildcat mining, "nobody listened," said the 36-year-old, sitting on a wooden bench on his porch in a lush banana grove.
"We needed money."
Since Ngoha started prospecting in the early 2000s, more and more people like him have helped Ghana grow into Africa's biggest gold producer. Across the continent and beyond, millions have turned to the trade. Few are deterred by the risks.
Ngoha's friends and family members started to sicken and die, but he told himself this had nothing to do with the amount of dust they'd been breathing in or the toxins – including mercury and nitric acid – they used to extract the gold.
One morning in 2016, Ngoha started coughing up blood. It felt like his airways were collapsing. His doctor treated him for tuberculosis.
The drugs didn't help, but he carried on working.
"I said to myself the symptoms were the result of a certain wrongdoing," he told a reporter during a visit in April. "Maybe someone has gone to a medicine man, or someone has gone to steal from someone, and we have all been cursed."
Ngoha was living in the town of Bawdie (pronounced Bor-dee-ay) in Ghana's Western Region. The area is a major producer of cocoa, rubber and palm oil grown by smallholder farmers – Ghanaian cocoa is used by chocolate-makers worldwide.
But cash crops are fickle, back-breaking, slow-paying, and hungry for land.
And the rocks here are laced with so much gold, they glisten.
Early colonists called this region the Gold Coast. The Ashanti people of southern Ghana have long made fortunes from what Ghanaians call "galamsay" (gather-and-sell) mining. Since 2008, gold prices have risen, digging equipment from China has become cheap and easy to get, and informal mining has mushroomed.
A 2016 report by researchers for the International Institute for Environment and Development estimated a million people in Ghana make a living in what some call artisanal mining, and 4.5 million more depend on it. Sub-Saharan Africa is home to almost 10 million such miners, according to a World Bank estimate: At least 60 million more are reliant on the sector.
As miners go for gold, they are poisoning rivers, farmland - and themselves.
Miners inhale fumes from explosives used to loosen rocks, and dust coming off crushing machines, which contains heavy metals such as lead. This weakens the lungs.
They use mercury and nitric acid, which also cause breathing problems, to leach precious ore out of sediment.
Then they toss the chemicals to the ground or into rivers.
Mercury is an especially dangerous poison. After long exposure to the vapour, cases of pulmonary fibrosis, restrictive lung disease, and chronic respiratory insufficiency have been reported in the United States. In Ghana, too, researchers have published dozens of papers documenting evidence of mercury-linked toxicity in the blood and urine of residents, as well as mercury contamination in soil, food, water and fish. Around Bawdie, in 2016, Ghanaian researchers in a University of Michigan-funded study found average mercury levels in the water were at least 10 times higher than international safety levels, or up to 86 times higher in one area.
Big multinational mining firms also cause pollution, but informal mines can be worse. A United Nations report published this year said artisanal and small-scale gold mining accounts for up to 80% of emissions of mercury in Sub-Saharan Africa.
It is hard to measure what harms result. One study, published by the Lancet in 2018, estimated that more than 10 million people in Africa are exposed to mercury by artisanal mining, cutting short by almost two years their expectations for a healthy life.
Even so, efforts by health and environmental experts to stop or clean up informal mining almost always hit the same snag: For people with few other options, there's too much money to be made in gold.
Vast amounts of gold from Africa's informal mines go to the United Arab Emirates, much of it smuggled. Since 2003, the UAE has reported importing about $10.6 billion worth of Ghanaian gold. No industrial miners send gold to the UAE, the companies have told Reuters.
Yaw Ngoha was 19 and had a basic school diploma when he followed his older brother Peter out of one of Ghana's poorest regions to Bawdie. He arrived in 2002, moved into Peter's shack with some other men and before long, was operating machines to crush ore into powder ready for panning.
"The machines produced so much dust," he said. "I was covered in dust and breathing in dust clouds all day."
The miners run water through the powder to separate heavier metals for collection, then mix in mercury, which bonds with the gold to form an alloy. Using tweezers, they pick out what look like little balls of tin foil and place them in a fire.
The fire burns the mercury, sending its vapour into the air.
Mercury poisons every tissue it touches.
Besides lung damage, it can lead to memory loss, irritability or depression, kidney failure, tremors or numbness, and discoloured, peeling or scaly skin. Extreme mercury poisoning can cause paralysis, coma, or insanity.
Even people who are not directly exposed absorb it through water or, for those near the coast, seafood. In a developing foetus, it can cause difficulties with mobility and learning. In the 1950s, thousands of people in the Japanese city of Minamata fell victim to mercury in the wastewater of a chemical factory.
But the poison works slowly, making it hard to diagnose. And informal miners rarely take precautions. In Ghana, Ngoha and other miners said they would rip open sachets of mercury with their teeth, sometimes sucking it out and spitting it into bowls. They got it on their hands and didn't wash before eating. They inhaled the fumes.
In a good week, Ngoha could make as much as $300. A less productive week might yield $60. Rarely, when a mine failed to yield, he might take home nothing. But mining beat the $5 a week he could expect from a cocoa or rubber plantation.
A few days after Ngoha arrived in Bawdie he met Mary, a trader who sold soft drinks, snacks and other goods to the miners. They married the following year. He had no problem paying the $800 bride price demanded by her father's clan, or feeding the guests at their lavish wedding.
He bought land and built a two-room house, with kitchen and separate living space – rare in this part of Ghana. His gold money paid for a second-hand Toyota Corolla and school fees for all four of their children.
Galamsay penetrates all levels of society. Bawdie's town chief, Nana Kwaw Fobri II, makes rent from mining operations. He declined to comment.
But the trade's effects have long been a concern: In late 2005, another chief who also was in the gold trade summoned about 120 townspeople to a meeting. A surgeon he knew who ran a clinic in Bawdie was alarmed about the mercury the miners were using. The chief, Nana Boateng, wanted miners like Ngoha to hear about it.
At the meeting Dr. Frederick Sarpong, a tall, bald man with deep-set eyes, tried to explain how mining dust and mercury fumes make people more vulnerable to lung diseases, including TB. Half the adult population in rural Ghana have the TB bacteria in their throats, although most are resistant.
Even as the miners listened, Sarpong sensed them tune out: "When a doctor is speaking, even if they have their reservations, they will not come out and say so."
Miners started getting sick, often with symptoms that were similar. Broad-shouldered men with strapping muscles from digging and hauling rocks wilted into bony, hollow-cheeked starvelings.
Next came a hacking cough, bringing up puddles of red phlegm. They grew weak; many could not continue their work. Some, he diagnosed with TB.
Around 2008, miners started dying. In a single month, Sarpong recorded 30 deaths near Bawdie, all with the same symptoms. Bawdie's population is around 5,000.
A government study in 2013 had put the TB mortality rate nationwide at 7.5 per 1,000 cases. The numbers in Bawdie who failed to respond to treatment meant there must be more to this than TB, Sarpong concluded.
"They will come to the hospital ... coughing up blood," he said. "You might think it's tuberculosis, but actually this is mercury poisoning."
One night in 2009, Ngoha's brother Peter, then 40, started coughing uncontrollably. Blood was squirting out of his nose. The family rushed him to hospital. Hours later, Ngoha received a call. Peter had died.
In the years that followed, eight of his closest friends died similar deaths, he said. Boateng, the chief who had called the town meeting with the surgeon, said he had seen the same story with at least 50 miners.
Though doctors had warned that their mining practices put them at risk of just these sorts of health problems, the miners weren't blaming their trade. "We thought we had committed a sin against the gods," Boateng said.
He and half a dozen other miners visited the sacred oracles in the shrines of Ashanti deities. At each one, he said, the fetish priest "couldn't find anything we'd done wrong."
His own brother, Kwaku, 30, died at a mine further north. Kwaku choked to death on his own blood.
Sometimes death came more quickly. Boateng recalled a man who made so much money at a blast-site, people started calling him "Mr. Big Stuff." One day, friends said, Mr. Big Stuff just keeled over after inhaling a puff of smoke.
For years Ghana's government did little to curb illegal mining, but as concern grew, President Nana Akufo-Addo tried to crack down, banning all informal mining – even by miners who had licenses – between January 2017 and the end of 2018.
"Illegal mining has had a devastating effect on our environment," Environment Minister Kwabena Frimpong-Boateng told Reuters in the capital, Accra.
He said 80% of Ghana's waterways were polluted by miners stirring up sediment and dumping waste. The World Bank gives a similar figure. It says many of Ghana's waterways have been effectively blocked, causing flooding upstream, which destroys farmland or cocoa fields. Last year, the state-run Ghana Water Company temporarily shut down four treatment plants, citing pollution caused by mining.
Out walking near Bawdie, Dr. Sarpong paused next to a river turned sand-coloured by people dumping mining waste and stirring up river sediment to pan for gold.
"This is water people are drinking," he said.
The temporary mining ban was supposed to give the government time to register all miners and improve regulation. By the time it was lifted, however, fewer than 1,500 of Ghana's million or so miners had been vetted. The government declined to comment on why.
A short drive south from Bawdie, a shanty town ringed with illegal mines called Nsuaem-Top shows how hard it is to enforce the rules. Even while the mining ban was in force last year, the place was buzzing with illegal activity.
Stephen Ble owns a bar and restaurant that pumps out reggae music and feeds hungry miners. He said that in just over a decade, he had gone from being an impoverished school dropout to a gold trader – sometimes of 50 grams at a time – and investor in mines. He owns a Kia saloon car, a gold-coloured watch and a Samsung Galaxy smartphone.
"Look," he said, squeezing a twinkling puddle of mercury into his palm, "none of us has ever been harmed by using mercury."
He tossed it on the ground a few feet away from where his wife was cooking and their toddler playing.
In 2010, Boateng, the chief, got sick. Sarpong treated him for TB. By then, they'd both seen dozens die.
"It got to a point where people were dying who weren't even mining," Boateng said. "They were just traders working around the area where the mercury is dumped."
Boateng was lucky. He recovered, quit mining and went into cocoa and rubber farming. But now when he tries to warn young men off mining, he says they laugh at him. Some threaten him.
In 2011, Boateng took a job running Sarpong's mortuary. Now he records each body that comes in.
"The miners were seeing real money," he said. "They won't stop, whatever you tell them. They didn't care. They had a saying: 'with every job comes death.'"
Late last year, Samuel Essien-Baidoo, a researcher at Ghana's University of Cape Coast, studied the impact of mercury on miners in the Western Region. "Their kidneys were damaged, some extensively," he said. A number had skin rashes and most suffered from itchy eyes, hair loss and persistent headaches. Mercury was a problem, he concluded: Two-thirds of patients on dialysis at the Cape Coast teaching hospital were from the gold mining region.
Ghana's entire health budget for the next three years totals $850 million, so hospitals can't offer dialysis for free. The ones who can't pay "simply die," Essien-Baidoo said. Treatments to remove heavy metals are out of reach of Ghanaian wildcat miners.
Officially in Ghana, as in many other countries, mercury is a controlled substance. Ghana's 1989 Mercury Act allows miners to keep "reasonable quantities" for mining, but they can buy it only from licensed dealers. Ghana has also pledged to join a global pact named after the Minamata disaster to phase out mercury use in mining. Safer mining methods that have been proposed include burning off the mercury under glass to capture the fumes and condense them back into liquid. But the glass is fragile and tricky to handle. Another method requires a furnace and a source of energy, so it too hasn't been widely used.
In Ghana as elsewhere, mercury is smuggled in.
Selling mercury without a licence in Ghana is an offence that officially carries up to two years in jail. In a Bawdie gold trading shop, which offered mercury for 50 cedis ($10) for a thumb-sized ball and sold nitric acid in 35 kg containers, owner George Ansa, 36, said he had no licence. He got the mercury from traders at Ghana's ports, he said, and smuggled it inland using old Fanta bottles.
In a 2018 assessment, Ghana's government said official imports averaged just 11 tonnes per year. At the same time, it estimated that at least 45 tonnes of mercury were used annually in galamsay.
Some studies have suggested that much of the mercury used by miners like Ngoha originates in China, but it could come from many places. A former mercury trader in Africa told Reuters he used to import it from Slovenia.
A spokesman for Ghana's Minerals Commission declined to comment on its enforcement of mercury controls. Environment Minister Frimpong-Boateng told Reuters in 2018 that Ghana had trained about 4,000 miners to mine more safely, and plans to use drones to monitor mining. There are a number of initiatives in Africa aimed at producing ethical and environmentally-friendly gold, but they are not economically viable for now and run at small scale.
Solomon Kusi Ampofo, a natural resources expert leading Ghana's national mercury survey, said most miners would continue to use mercury until other practical methods are available.
Globally, the U.N. estimates informal miners spilled about 1,220 tonnes of mercury into soil and water in 2015 – 252 tonnes of it in Africa, and even more in South America.
WINNER TAKE NOTHING
Back in Bawdie in April, 16 months of TB medication had failed to heal Ngoha.
He stopped mining. Mary was struggling to feed the family and look after him. His Corolla, parked outside the house, had a 'For Sale' sign on it.
His cough was rasping, his thighs as thin as his calves, and a thumb and forefinger could practically encircle his ankles.
Sitting with him at the house, Boateng produced a photo of a recent arrival at the mortuary. The corpse lay on the ground, blood encrusted on the man's shirt, nose and the surrounding earth. A miner.
In turn, Ngoha pulled out an old photo. In it, he and Peter were sitting next to a rock-breaking machine in a gold-processing shack, with three friends standing around. All of them looked young and strong and healthy.
"They're all dead now," Ngoha said. "Everyone except me."
In early May, Bawdie buried another miner whose lungs had given out.
His name was Yaw Ngoha.
(Additional reporting by Ryan McNeill in London, Francis Kokoroko in Bawdie and Christian Akorlie in Accra Edited by Alexandra Zavis and Sara Ledwith)
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