PRIESKA, South Africa (AFP) — Robert Devenish has resigned himself to an agonising death of asbestos-induced cancer, a silent but cruel killer stalking mining communities in South Africa's Northern Cape province.
"Nobody wants to die suffering, but we don't all have a choice," said the 64-year-old former mine employee who was diagnosed with mesothelioma last December and given months to live.
Mesothelioma is a non-curable cancer of the lung lining that can take up to 40 years from asbestos exposure to develop. It condemns its victims to a painful and breathless end, usually about 18 months after diagnosis.
Devenish is one of tens of thousands of South Africans, most of them in small Northern Cape towns, who contracted asbestos-related diseases (ARDs) -- a hangover from the country's heyday as one of the world's top producers of the substance believed as far back as the 1920s to pose serious health risks.
Asbestos mining stopped in South Africa in the mid-1980s, but people are still being diagnosed with ARDs like mesothelioma and asbestosis on a regular basis, while many more continue to be at risk from unrehabilitated sites.
Several uses for asbestos, once a popular insulator due to its heat resistant properties, have been banned around the world.
And foreign-owned mining companies have in the past six years paid out tens of millions of dollars in settlements from which an estimated 10,000 South African victims of their asbestos extracting activities have benefited so far.
Mesothelioma sufferers like Devenish got 28,000 rand (just over 4,000 dollars, 2,800 euros) each, small comfort for a dying man.
At a time that he should have been welcoming retirement, Devenish is instead packing up house with his wife, Anna, and moving from the remote settlement of Marydale to a smaller home in a bigger town where she can remain after his death.
"The doctors said the life expectancy is between six and 18 months without special treatment," explained Devenish, who is following an expensive but hopefully life-prolonging course of chemotherapy.
Prieska doctor Gideon Smith said his longest surviving mesothelioma patient died two years after being diagnosed. But some are known to have lived for five years.
Smith told AFP he diagnosed five to 10 cases of mesothelioma per year in the town of about 20,000.
"Every time somebody comes to me with a lung ailment, the first thought is asbestos. It is almost always the case," said Smith.
One of his patients, 68-year-old Petrus van Nell, has taken to bed with mesothelioma without much hope of rising from it again.
Like many others, he grew up on asbestos mines and worked as a youngster at crushing stones for pocket money.
"I am short of breath and tired. Extremely tired. I have a lot of pain," Van Nell said as he battled to sit upright in his bed.
In a small house nearby, mesothelioma sufferer Magrieta Esau, 52, is on a permanent course of morphine. She grew up on asbestos mines, later worked on one, and lost both parents to ARDs.
"The asbestos was everywhere, even our homes. But nobody ever warned us," she said. "As children, we played on the asbestos mine heaps. And we were sometimes paid small change for helping to crush the stones.
"I am angry. It is hard to make peace with the fact that the rest of my life will be full of pain."
Studies have put the prevalence of ARDs in Northern Cape mining areas as high as 50 percent of the population.
Yet piles of raw asbestos fibres are still to be found dumped and uncovered, while rehabilitation work has yet to be done on several mine dumps that threaten communities within a 100-kilometre (62-mile) radius with wind contamination.
Some secondary roads in the province contain asbestos fibres visible to the naked eye, and many schools and homes in towns like Prieska still have asbestos in their frames.
"If this was Europe, huge areas would have to be evacuated. They are not safe for people to live in," said lawyer Richard Spoor, who has represented dozens of ARD sufferers in court.
In a provincial budget speech in June, Northern Cape environment minister Pieter Saaiman said rehabilitation of derelict, ownerless asbestos mines was progressing well.
"However, secondary asbestos pollution remains a matter of concern," he said, without proposing a course of action.
Anti-asbestos activist Sol Bosch watched his father die cruelly over three years of the lung disease asbestosis.
Bosch is bitter over what he perceives as mining companies' past callousness and the current government's inertia.
But on a personal level, fear of sharing his father's fate is never far from the surface.
"I am too scared to go for an X-Ray," he said. "I would rather not know."