Addressing the risk HIV/Aids poses to your company is a requirement of current labour legislation in South Africa, says Sandile July, a director at law firm Werksmans.
The legislative framework is provided by the Employment Equity Act and the department of labour’s Code of Good Practice on Key Aspects of HIV and Aids and the Technical Assistance Guidelines. Legal considerations aside, it makes good practical business sense to develop a policy on HIV/Aids and implement a workplace programme.
Active management of HIV/Aids risk will improve productivity and staff morale. This is true even for a small company with under 50 permanent employees, such as Max-Wezie Civil & Building Contractors in the Eastern Cape.
The owners, husband-and-wife team Max and Wezie Zondani, who started their company from a one-roomed house in Qunu, had seen the impact of HIV and Aids on productivity in the construction industry. The couple realised a workplace programme would be to the benefit of their fledgling company.
They approached the South African Business Coalition on HIV and Aids (Sabcoha) for help. How do you create a successful workplace HIV and Aids programme?
Pat Mhlongo, project manager: Sabcoha small to medium enterprises Capacity-Building says buy-in is key: “The first and most important element is to set up a committee through which discussion and consultation can occur. The members of this committee will include representatives from all levels of the organisation, from shop stewards through to management. This assists to allay fears or doubts that employees may have in terms of why a policy is being implemented — for example, is it a witch-hunt to fire all employees with HIV?”
Sasol group community affairs manager Pamilla Mudhray says it’s essential to have the whole hearted commitment of management: “We’ve been very lucky with our leadership,” she says. “[Chief executive] Pat Davies is very vocal and very visible.”
But it’s also vital that there’s buy-in throughout the business, from trade union representatives to people on the shop floor. If the programme does not permeate the company culture, it will become top-heavy (driven by management and resisted by staff) or bottom-heavy (driven by peer educators and dismissed by management).
When Sasol set out to create a programme over seven years ago, the obstacles were greater than they are now. “We had a very good understanding that people were fearful — there was stigma, misinformation and political resistance,” Mudhray says.
More social openness and political will to fight the disease have allayed some of these fears, but it remains critical that a programme addresses employee concerns, says Mhlongo, including ensuring:
- That the people living with HIV are treated fairly by all;
- That confidentiality is maintained;
- A safe working environment;
- Protection from discrimination;
- Protection of employee benefits; and
- Protection of promotion and training opportunities.
Within these policy parameters, it’s up to the individual company to decide the extent of a workplace programme. A massive company such as Anglo American, with 11 000 HIV-positive employees enrolled on its eight-year-old HIV disease-management programme, has the resources to offer all the bells and whistles, from education and awareness to condom distribution and disease management (through access to both antiretroviral drugs and treatment for the opportunistic and related diseases that make people who are infected ill, for example, sexually transmitted diseases and TB).
A small company such as Max-Wezie may not be able to afford such extensive support, but even much smaller interventions — often focused largely on education, awareness and encouraging voluntary counselling and testing (VCT) –can be very effective. Max-Wezie has employed a full-time HIV/Aids co-ordinator to manage its programme.
Although staff are encouraged to test regularly for HIV, management realised that HIV by itself is not the cause of absenteeism, but rather the concomitant infections and conditions that make people ill, so every quarter the company holds a ”wellness day” to test for TB, high blood pressure, diabetes and other diseases.
Effective programmes
“It’s most important to understand who you want to serve through your programme and what you want to achieve to be able to deliver something of value to your employees,” says Mudhray. The committee should set goals right at the outset. Those goals should encompass both prevention of future infection and catering for the needs of those who are already infected, to manage the impact on the workplace, says July.
The most effective programmes are multipronged. They start from a base of education and awareness through provision of information, aimed at both prevention and empowering infected staff members to lead healthy lives.
The second prong is either the provision of VCT in the workplace, or the encouragement of VCT outside the workplace.
If VCT is to be offered on site, it is absolutely essential that employees have total faith in the confidentiality of their results. A culture of trust combined with support for those infected and affected should be actively created and nurtured.
A company-wide sense that employees who are HIV-positive will be supported is very important, says Mhlongo. “A system of trained peer educators needs to be put in place to ensure that those infected with HIV are offered psychosocial support by colleagues on the shop floor.”
Mhlongo points out the importance of respect and support — through regular debriefings — for the peer educators, too: “Being a peer educator is voluntary; the emotional baggage they carry from their colleagues should not impact on their contracted day-to-day responsibilities at work.” (Sabcoha is currently planning a national conference for peer educators, which will be aimed at sharing knowledge and best practice. For more information, visit www.sabcoha.org.)
The third prong is a wellness or disease management programme, ranging from the sort of intervention offered by Anglo or Sasol to the ”wellness days” at Max-Wezie.
In addition to this, companies should put some thought into conditions in their communities that impact on employees — and the impact of the company and its employees on the community in turn. So, for example, knowing that one of the critical factors in the spread of HIV in the construction industry is the high mobility of employees who are posted far from their homes and families, Max-Wezie has encouraged staff to bring their families to live with them on site.
Companies such as Sasol and Anglo are deeply involved in communities — Anglo, for instance, is working with local authorities to improve health services in the rural areas from which their staff hail. Part of Sasol’s community involvement involves extending support into the families of people living with Aids: “We’re living through the ‘full-blown’ stage of the epidemic,” says Mudhray, “so we need to deal with the psychosocial impact.”
Family members should be prepared emotionally and practically — employers might need to have conversations with people who have disclosed their status, about issues such as providing for children who may be orphaned.
Finally, the company does need to think about how it will measure success. This could be in terms of enrolment in a disease-management programme or comparing the results of anonymous testing at intervals (some big companies with active programmes have seen prevalence fall) through KAP (knowledge, attitude and practice) surveys that show whether employees are putting the education to work, or through feedback from staff.