My phone vibrated violently on the desk.
I saw Wang Maoxia's name flashing on the screen. I knew it was bad news.
She was crying. "Song Dengfa, he is dead," she said, addressing her husband by his full name as some Chinese do. "He died at seven this morning."
I knew nothing I could say would comfort her.
Song, all of 36 years old, was the fourth gold miner I had photographed who has died since I started this project documenting a few of China's millions of pneumoconiosis sufferers 17 months ago.
Typical among those dying of this occupational disease in China today, Song was a sole breadwinner from an impoverished, remote, rural part of the country and leaves behind a young wife and child—Wang, 26, and their son Jingtao, 5.
Just a week earlier, another one of his fellow gold miners, She Faxue, 38, had died, at his home atop a hill where no cars or motorbikes can go.
Winter is the season these silicosis-stricken miners most fear. Their lungs, weak from the debilitating fibrosis wrought by the silica dust they inhaled working in the gold mines years ago, are extra vulnerable in the cold that seeps into their drafty, spartan earthern-walled homes.
Every winter, the list in miner He Quangui's notebook gets longer. It is a list he keeps of all the silicosis patients he knows in his area who have died. He has had to add She's and Song's names to the list this winter—numbers 34 and 35 respectively. Even as he fights for his own life, he hopes he doesn't have to add another.
Pneumoconiosis, China's most prevalent occupational disease, is a slow, silent killer. China's mine explosions and accidents hit the international news headlines every now and again. But in recent years, pneumoconiosis has killed at least three times as many miners as accidents have, according to Chinese state media.
More commonly known as "black lung disease," pneumoconiosis is an umbrella term for a group of similar diseases in which a worker's lungs are gradually overwhelmed by the dust they breathed in up to 10 to 15 years earlier as they worked in gold, coal or silver mines, or stone-cutting factories. The variant that befalls coal miners is black lung, named after the color of the fluid that comes out of their lungs when they have "lung washing" treatment, or a lavage. Among gold miners, it is silicosis, named after the silica dust that gets lodged in their lungs and causes those organs to eventually become stone, suffocating them.
Doctors say the disease is most potent among gold miners, compared to coal or silver miners or other types of workers in stone blasting industries. Gold miners get ill after a shorter period of exposure to the dust and also die more quickly.
They typically work until they feel ill with a serious flu, start coughing and are out of breath. Workers of state-owned mines who get regular health checks are likely to be diagnosed early and get treatment—lung washing—which prevents their lungs from deteriorating too quickly. Migrant workers, who usually work with no contract with the mine owners and have no insurance, often find that they already have stage 2 or final stage pneumoconiosis—too late to even do lung washing. They usually die within a few years, often barely out of their 30s.
Chinese official statistics show that pneumoconiosis is the most prevalent occupational disease in the country—making up over 90 per cent of all work-related illnesses. There is no solid recent official data on the number of victims, but NGOs and experts estimate that there are millions of workers in China with pneumoconiosis, the vast majority of them migrants from impoverished parts of the country, with limited access to good medical care and legal aid.
China is now the world's leading gold producer, outstripping South Africa in 2007. With its penchant for bling bling, China is also a leading gold consumer in the world. The unseen cost of gold is the slow death of these silicosis-stricken miners.
Silicosis is irreversible and there is no cure—apart from a lung transplant, which is rare and hugely expensive in China—but it is preventable.
For a disease as deadly as this, prevention methods—such as using water when drilling, better ventilation and using good face masks—seem reasonable enough, but were just not practiced in mines like the ones where Song, She and He had worked. Working conditions have, in theory, improved somewhat since, but in one gold mine I managed to get into last year I saw miners wearing only cotton masks, even when they were drilling hard rock in a tiny cave.
As scores of men have started to die from silicosis in villages across rural China, leaving wives without husbands, children without fathers, mothers without sons, there is a growing awareness of the disease. Still, it is not well-understood. One villager, who was a neighbor of a silicosis patients, asked me, "Is it contagious?"
For widows like Wang Maoxia, the disease had been a daily presence since Song was diagnosed with it in 2008, after working in gold mines as a driller and stone blaster for five years. Now he is gone; she doesn't have to sit by him to feed him and help him use the commode, but she is struggling to come to grips with it.
"When he was around, I was stressed. It was hard physically and mentally. But now he's gone, it is even harder. My head feels heavy and all messed up," she tells me when I visit a month after her husband's death.
As we speak, her young son tries to slide down the slope where his father's grave is.
Looking at the boy, Wang says: "You think he's too young to understand that his father is dead but the other day he asked me 'Mummy, are you cooking for daddy too? He is lying out there on the hill by himself.'"
My phone vibrated violently on the desk.