Contribution to the characterization of environmental health risks in artisanal mining in South-Kivu, DR Congo: participative epidemiology and health resources dynamic

Abstract Background: environmental health issues are associated with artisanal mining in DR Congo, particularly when it is practiced informally or with limited material and technical resources. This paper argues that the adoption of positive practices involves socio-economic and administrative aspects that may limit artisanal miners' adherence and access to the means of health risk prevention practices. There is a need to mobilize trans-disciplinary interventions and research to co-produce the conceptual framework on the feasibility of reforming artisanal mining practices linked to health risks in DR Congo. This case study aimed to co-construct with actors in the Luhihi artisanal gold mine, in South Kivu, their perceptions and the importance they give to health risks as well as to describe the dynamics of resources to prevent health risks that actors in the mine mobilize or think they are able to mobilize.Methods: a " socio-anthropological” qualitative study with "transdisciplinary methods" was conducted. The data collection tools and methods used included an exploratory survey, semi-structured interviews, and focus groups mixed with proportional piling to support the open-ended interview discussions. The actors interviewed were selected by “convenience sampling” and the saturation principle indicated the size of the sampling. A total of 67 people was interviewed at the Luhihi and we organized 5 Focus Groups (FG) with 5 to 10 mining actors. The data were triangulated to ensure their veracity and an “inductive thematic data analysis” was applied. Results: the key findings are the role of actors involved in the system of interest at the Luhihi artisanal mining site; a description of a participatory health risks epidemiology at the mining site; presentation of the perceived importance given to health risks by actors, the constraints in the organization of healthcare services and the sources of medical care resources; and opportunities of collective action to prevent health risks at the mining site.Conclusion: the results are translated into a grid of powers and interests in relation to the mobilization of resources for the prevention and treatment of health risks and the contribution to the dialogue for change regarding the ignorance of the actors in the mine of exposure to chemical risks such as exposure to mercury, silica, carbon monoxide, and cyanide. Also, an analysis of whether artisanal mining actors in DR Congo would be able to organize health risk prevention services in the mining sector.