A successful HIV/Aids programme in the workplace provides more than just anti-retroviral treatment. It also ensures that employees who have been retrenched have access to treatment.
This creates an environment of trust and care so that employees can openly declare their status and not feel discriminated against, says Nokuthula Matyeshana, a nursing sister at the DaimlerChrysler HIV/Aids clinic in East London.
Matyeshana says the provision of anti-retrovirals to employees is not the only component of DaimlerChrysler’s HIV programme. Constant advocacy and education of the workforce by peer educators are essential in dealing with the effect HIV/Aids has on employees’ daily lives.
It was because of this multi-faceted approach that the judges of Investing in the Future singled out the DaimlerChrysler programme for a special award this year. They praised its innovative methods of tackling the most relevant social issue of the day, in the process sometimes going against the current of government thinking.
DaimlerChrysler has 4 500 employees in three locations in South Africa. The company manufactures Mercedes-Benz passenger cars and Mitsubishi pick-ups for the local market and for export to the United Kingdom, Japan and Australia.
The company’s HIV/Aids programme covers all employees and their families — a total of 23 000 people. It is run as a public-private partnership with the German Economic Cooperation Ministry’s Technical Cooperation Agency; a comprehensive corporate HIV/Aids workplace programme was implemented in 1999.
A year earlier, the management of DaimlerChrysler had noticed that the majority of deaths among employees could be attributed to HIV/Aids. The number rose from about 8% of deaths in 1990 to 40% in 1997. In 2001 the HIV/Aids prevalence rate among the workforce was 9%.
‘At the same time the proportion of deaths attributed to unnatural causes — accident, suicide, homicide — had dropped dramatically,” explains Clifford Panter. He is an occupational health consultant for the DaimlerChrysler group in South Africa and is responsible for the continuous improvement of occupational health, employee wellness and employee assistance programmes at all business locations.
Panter says the decision to extend anti-retroviral treatment to retrenched employees was taken in December last year when government policy was directly opposed to provision of anti-retrovirals in the public health sector.
‘While there is no longer any in-principle opposition, anti-retrovirals are still not available in the public health sector. An employee who loses membership of the medical scheme through retrenchment and who happens to already be on anti-retrovirals is now assured continued access.”
Panter says DaimlerChrysler is the first company in the manu- facturing sector in South Africa to ensure universal access to anti-retrovirals for all employees.
‘We actively manage [the programme] in partnership with our trade union partner, Numsa [the National Union of Metalworkers of South Africa]. It provides a platform for the company to tackle HIV/Aids as a development problem through the community involvement component of the programme and also through our advocacy work in South Africa and globally.”
The programme ensures a continuum of focus from prevention, care, support and treatment through to community involvement. It has reduced the number of HIV-positive babies born to mothers who have used the company’s prevention of mother- to-child-transmission services.
Of those who have participated in the anti-retroviral programme since 1999, ‘97% are still alive, with 95% of patients still at work in normal jobs”.
For Panter the success of the programme cannot be measured by a decrease in the rate of HIV prevalence, but by the fact that 75% of employees have been tested for HIV over the past three years. Currently 45% of employees are using on-site occupational health services, while 30% use their own doctors.
‘In a successful HIV/Aids programme, prevalence should not decrease but [rather] the number of people becoming newly infected must decrease year on year with prevalence remaining stable. We will only formally repeat a prevalence survey in 2005,” says Panter.
Matyeshana says the success of the programme is directly linked to the 150 employees who are trained as peer educators to deal with problems their colleagues have in relation to HIV/Aids.
‘These peer educators can counsel their colleagues on stigma and discrimination, and also talk about compliance with anti-retroviral treatment,” she says.
From the time employees are diagnosed HIV-positive, they are given pamphlets and education about treatment, even though they may not need it for many years to come. The local community radio station partners with DaimlerChrysler, and peer educators present an hour-long weekly programme on living positively.
To increase awareness, the programme has launched ‘info islands”, computer touch screen kiosks, supplemented with permanent poster displays and pamphlet dispensers in recreational environments. The kiosks’ multimedia content is available in Afrikaans, English, isiXhosa and isiZulu.
The company also rewards employees who have a zero absenteeism record by giving them a chance to win a motor vehicle if they have not missed a day at work for the year. Each month there is an opportunity to win a TV, video recorder or stove. This has resulted in a reduction in absenteeism from 4% to 2%.
Currently the company trains and supports African traditional healers in first-aid treatment and in dealing with sexually transmitted infections, symptoms of tuberculosis and HIV care and support. It also trains domestic workers and has funded five mobile clinics for ‘Trucking against Aids” projects. The peer educators work in mosques, churches, schools, social clubs and sports clubs.
Matyeshana says more advocacy is needed for people to ‘come out” and live openly with HIV. ‘We give them information about living positively with HIV and they take this information to the community.”
She says that DaimlerChrysler does not operate as an island, but has extended its programme to the community. ‘This programme is distinctive because we do not just focus on our employees, but the community as well.”
For instance, Matyeshana visits schools in the area to give talks on HIV/Aids, well aware that ‘these children are the future of the company”.