Here’s what trade unions can do to tackle HIV/AIDS

 

Lindiwe Dlamini is a worker at a clothing factory in Gauteng, South Africa.

She also sits on the National Executive Committee of the Southern African Clothing and Textile Workers Union (SACTWU), which is made up of over 90, 000 blue-collar workers, of which approximately 70 per cent are women of child-bearing age.

Globally, with HIV rates twice as high as in young men, young women are much more vulnerable to HIV/AIDS.

It not only continues to be one of the leading causes of death worldwide of women aged 15 to 49 years of age, but in low-to-middle income countries, nearly two out of every three pregnant women do not know their status.

In our union, a large percentage of our members form part of the working population hit hardest by the HIV/AIDS epidemic in South Africa.

And Lindiwe, who has been a SACTWU member for over 30 years, is one of them.

In 2003, Lindiwe’s only daughter Sibongile became seriously ill and died within weeks, leaving Lindiwe to care for her baby daughter, Nolwazi.

Sibongile only disclosed her HIV-positive status towards the end of her life, revealing at the same time that Nolwazi was also infected with the virus.

Had Lindiwe’s daughter been properly assisted when giving birth, counselled and advised to take a HIV-test; had she been treated for Prevention of Mother to Child Transmission (PMCT), Nolwazi would not have HIV today.

Although PMCT is highly-effective and affordable, in 2011, only 57 per cent of pregnant women living with HIV in low-to-middle-income countries received antiretrovirals (ARVs) to prevent new HIV infections among children.

For a number of years, as the sole breadwinner of her family, Lindiwe struggled to provide for her surviving children and sickly granddaughter. She spent many an hour queuing for assistance and filling out social grant applications but was unsuccessful.

But after disclosing her plight to the general secretary of SACTWU, Andre Kriel, he told Lindiwe about SACTWU Worker Health Program (SWHP) and encouraged her to confide in one of its social workers who immediately helped Lindiwe apply for grants.

Within weeks she started to receive financial assistance and soon after Nolwazi was able to start receiving treatment.

 

Quality healthcare for workers

Since launching in 1998, the SWHP has become one of the leading worker health programmes in the southern African labour movement, providing quality healthcare services to thousands of blue-collar workers.

At present, SWHP offers a successful, fully-integrated HIV/AIDS and TB programme, supporting workers and their dependents across South Africa. Our work reaches over 200, 000 people annually.

SWHP interventions address the key priority areas of prevention, treatment, care and support, monitoring and evaluation.

Particular emphasis is placed on primary and secondary infection and early detection.

This is done by adopting a holistic approach to managing the impact of HIV/AIDS on members and their dependents through workplace education and training; HIV counselling and testing; male medical circumcision; treatment; and care and support for those infected and affected by HIV/AIDS and TB.

But an important part of our work focuses on human rights and access to justice, including fighting stigma and discrimination.

Lindiwe was extremely anxious about how to talk to Nolwazi about her HIV-status and prepare her for the anticipated stigma she was going to be exposed to by her school peers, teachers and others.

Again, Lindiwe sought help from a SWHP social worker and together, they worked at disclosing and helping Nolwazi to accept her HIV status.

Due to her illness, Nolwazi was slow in meeting developmental milestones and suffered from learning disabilities.

The school that she attended offered no support for either Nolwazi or Lindiwe, but SWHP was able to help Nolwazi get an appropriate assessment in order to determine the severity of her learning disabilities.

They were then able to determine the schools that would offer Nolwazi the best opportunities and within a few weeks she was transferred to a primary school at which she has flourished.

 

HIV in the workplace

Central to our work is providing crucial support in the workplace.

Our social workers observe the daily routines of infected workers to see how the illness affects working women and men and how important it is to integrate labour logics in health interventions.

For example, SHWP allows workers to access health interventions outside of working hours so that they do not lose their leave days, and if they wish so, they can keep their HIV status confidential at work.

At the same time, the program pays a lot of attention to building partnerships.

For instance, SACTWU has negotiated with clothing and textile employer organisations so that shop stewards can get a minimum of two, fully-paid days off per annum to attend HIV training.

Employers also contribute a basic amount per member per month to an HIV fund.

This fund is invested in by SAWTCU for HIV-related interventions by the Worker Health Program. Both of the above negotiated decisions have been gazetted and are binding by law.

But what is of crucial importance is the buy-in, trust and support of workers, trade union members and leaders.

Over time, Lindiwe has become a strong advocate for individuals knowing their status, early detection and disclosure.

At union events, she addresses officials, shop stewards, members and their families, sharing the story of her daughter’s unnecessary death and the plight of her granddaughter who is still living with the virus.

Lindiwe talks openly to the Congress of South African Trade Unions’ million-plus members about the importance of wearing a condom and why women have the right to insist on this.

She encourages all members to know their status and to test regularly, she preaches the importance of PMCT, indicating that there is absolutely no reason for any child today to be born HIV-positive, and encourages parents in her audience to talk about sex and risk behaviours with their children.

Lindiwe’s story embodies the fact that HIV/AIDS prevention, treatment and care does not need to be the sole responsibility of a country’s health department.

Trade unions need to take a more proactive and fervent action, and encourage their members to do the same.

Not only in the fight to reduce the challenges faced by infected and affected workers but also in advocating the workplace as a key entry point for the prevention and treatment of HIV/AIDS.

The role of labour also needs to be better recognised at the national policy and programming level, including funding for worker and trade union driven interventions.

SACTWU’s program is an important example of a trade union HIV/AIDS initiative that is having a positive impact on workers, their families and their communities.

Although we are only able to help a small number of fish in a huge sea, our work demonstrates the impact of a replicable and scalable intervention within the labour movement.

On this World AIDS Day on 1 December, 2013, it is important to highlight the fact that addressing inequalities, promoting economic empowerment, obtaining decent jobs, and supporting workplace interventions with adequate programming and funding is a critical component of an effective HIV response.

It is therefore apparent, that labour itself, has a moral obligation to address this issue.