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Siyayinqoba Beat It! 2004 Episode 26 –

Wellness in the workplace

What can companies realistically do to accommodate the health and wellness needs of their HIV positive employees? What programmes should companies put in place to help address the impact of the HIV epidemic in the lives of their employees? In this episode of Siyayinqoba Beat It! we looked at what clothing and textile manufacturing companies were doing and the challenges they faced in trying to accommodate HIV positive workers. We also looked at what SACTWU was doing to assist companies in making a difference.

Jason Wessenaar: Dumelang reya ho amuhela mona hoSiyayinqoba support Group. {SeSotho} Hi, welcome to the Siyayinqoba Beat it Support group. My name is Jason. In the Siyayinqoba support group we are all living positively with HIV. Each week we get together to talk about issues that affects our lives from accessing Anti-retrovirals and quality care in our public hospitals and community care. USiyayinqoba nguhlelo lwakho loku phila kangcono neHIV. Uma uphila negciwane leHIV {IsiZulu} [Siyayinqoba is your quide to better living with HIV If you are living with the virus,] or you have a friend, a partner or a family member who is HIV positive this programme is for you. Joining us this week is Doctor Feroza Mansoor from Sactwu, South African Clothing and Textile workers Union, welcome doctor. Doctor Feroza is a National Director for AIDS project; she is here to talk to us about wellness programmes in the work place. Why do we need wellness programmes in the workplace, what other benefits? The siyayinqoba team visited Deriick Khati a worker living with HIV at Cotton King in Durban.

Where is the wellness?

Durban, KwaZulu Natal

Derrick Khathi: Ho Derrick waka Khathi. Ngithole 2003 ukuthi ngineHIV. Ngo 2004 ngaphathwa yiTB. Bangithatha bangiyisa eSANTA, ngahlala khona 4 months. Ngathi ngifika ngizoyenza iX-Ray bangitshela abodokotela ukuthi yiphaphu leli selidlekile yileli lakarigth Ngaqala ngomhla ka-nine June ngasebenzisa amapilisi ARVs. Hayi akushayisani, yikuthi kuphela anama-side effects wakhona kodwa ke ngiyazama. Eh, la siyenza iCotton Wool. Si supplyer ama-hospitals, clinics and izi nkampani izikhulu. Ngephela ngephela la ngisebenza nje, ngoba nakhu ayiko into ingingayenza, ngokwem’thetho ngedlela kungcole ngakhona, nangedlela kune dust ngakhona kodwa ayiko indlela enye ngoba u-cotton wool uyangcolisa, njengoba kubonakala la phansi uyangcolisa u-cotton wool. Lena ke yimask yami ngiyenzela i-dust, ayisebenzi, ayisebenzi imphela ukuthi ingangeni, kubalikuni mangiyisebenzisa le mask, ngiyifaka la, yikuthi iphaphu linye kubalukhuni mangidonsa umoya. Sometimes ngiyayifaka yona, mhlambe noma 2 minutes then ngibuye ngiyikumule ngidonse i-fresh air then ngiyibuyisele emulomeni ngoba kuyashisa kakhulu, kuhambisana nale dust lena. {IsiZulu} [My name is Derrick Khathi. I found out in 2003 that I’m HIV positive. In 2004 I got TB and they took me to SANTA, where I stayed for four months. When I went to do the x-ray, the doctors told me that my right lung has collapsed. As from the ninth of June I started taking ARVs. They have got some side-effects, but I’m trying. We are producing cotton wool, we are supplying the hospitals, the clinics and the big companies. I’m working here because there is nothing else I can do. It’s dirty and there is a lot of dust, but there is nothing I can do, cotton wool is very dirty. You can see for yourself there is a lot of dirt on the floor. This is my mask against the dust. It’s not working, really it’s not working. It’s difficult to breathe because I’ve got one lung. It’s difficult to breathe in and out, so I used to take it off for two minutes, so that I can breathe fresh air. It is very hot here and there is a lot of dust.]

Jace Naidoo (Cotton King Manufacturers): When he came back after the TB he was in an environment that had a lot of dust. We’ve actually taken him out and put him in an environment where he is which is more heat and less dust, which basically gives him a better chance in the work environment so he can perform with the disability that he does have at the moment.

Derrick Khati: Akumunandi, ngeke ngisho ngisho ukuthi kumnandi ngoba nabaphathi bayo ifirm akubona abaphathi okwazi usebenzisane kahle nabo. {IsiZulu} [It’s not nice. I can’t say it’s nice, because the bosses of the firm are not sympathetic towards us.]

Jace Naidoo: Derrick is employed here primarily as a boiler attendant, he works in an environment that’s quite hot, so he does, from time to time, work under constraints that I would consider for normal people to be very difficult. But I think, as you’ve seen today, that Derrick, even with his HIV status, is reasonably healthy even under those circumstances.

Derrick Khati: Iboss ephethe lekhaya mina yangitshela emakaleni yathi ngangi ngeko ngakathi uthola leHIV yakho, ngangingeko, so ngifuna umshini wami uhambe, kusho ukuthi ngaleso sikhathi bengiphethwe yikanda kakhulu, ngahamba ngaya eKing Edward, i-ambulance yafika yangithatha la ebusuku, ngangiyenza inight shift yangithatha i-ambulance ngasasa kwabuya iphepha lalikombisa ukuthi fanele ngekhokhele leyo mali, yayithi R150. Mangi thatha leli phepha ngiyoba khombisa I management ukuthi nanti iphepha le ambulancefanele likhokwele bathi hayi abayikhokheli bona. {IsiZulu} [The boss told me he was not there when I got my HIV. So he wants the machines to keep running. At the time I had a severe headache, I went to King Edward Hospital. I was working night shift and the ambulance came to pick me up. In the morning I received an invoice for R850 to pay the ambulance. When I showed this to management, the amount that had to be paid they said they are not going to pay it.]

Support group

Anthony Fernandes: What happens to his future, and how much of a gamble is it when he says: “There isn’t better work or a lighter work for me”, and the company can’t accommodate him. Does he just get dismissed and go back and looking for a new job? Or is it the company’s responsibility to help him find a solution to accommodate his HIV?

Dr Feroza Mansoor (National Director, SACTWU AIDS Project): I think it’s good for companies to have a policy whereby they do provide reasonable accommodation and do try to accommodate somebody who’s got HIV. Obviously when someone’s got HIV we want them to be productive for as long as possible and that’s the key aim. If we can keep them in employment for as long as possible, it’s far more beneficial to someone who has HIV. So, for a company, it is better for them to try and see if they can give them what’s termed lighter jobs, which would be something that would be less of a health hazard to them, which this particular company is attempting to do. So, if companies can keep that as a policy it will definitely help them save costs in the long-term as well, because it saves them from re-skilling people, spending money on training people to get skills that this particular individual actually has.

Anthony Fernandes: And yet, in most factories that we know, lighter work doesn’t really exist. There’s only one job really applied to accommodating the company. What happens then?

Dr Feroza Mansoor: It is a difficult problem because most companies have certain job descriptions and when you approach a company saying: “Is it possible to give somebody lighter duties?” the answer usually is: “It’s impossible, because there is no such thing as lighter duties.” You go from one job, that’s just as difficult, as the next job. The other problem also one has to factor in is if they give you a lighter job, it could affect salaries. So somebody who could be in a more skilled job, if they’re given a lighter duty, it might require lighter skills as well, and therefore would cut their income, which doesn’t quite benefit the individual concerned. So it’s a really difficult problem that companies face.

Busisiwe Maqungo: I think izamu affector lomntwana and I think inoba noya i-effect kwi CD4 count yakhe and at the end uDerrick a- end up anga perfomi kakhuhle and this is not what we want, sifuna abantu ukuba mabaqubekhe,maba perfume well. {IsiXhosa} It will affect him and have an effect on his CD4 count. He will end up not performing well and this is not what we want. We want people to get better and perform well at work.

Anthony Fernandes: And I wonder if the wellness programme is a part of educating employers. We have to educate people who’s negative about HIV, because they don’t know. It’s not just a disease they can’t see they think is something. What is the role of the wellness project then?

Dr Feroza Mansoor: Some managers, I find, are very good, in that they take the information and it actually hits to the human part of them, which is what we want to do through an education programme. And when we say sensitise, we mean making someone more sensitive, so we we say sensetising management that is exactly what we want to do, we want to reach out to beyond rands and cents, to get to a point where, if you had HIV today, how would you like to be treated.

John Vollenhoven: Coming from the Western Cape, from Atlantis, there’s a lot of factories there and they ask, I’m a TAC volunteer, to help them implement a policy: how you should treat workers what to do with a person living with HIV, and all that stuff. So that the workers next to the person who is HIV can even assist him. And that’s not happening there.

Dr Feroza Mansoor: There’s some companies that have a policy, it’s just not working because it becomes a paper document, and that’s the reality of the situation. Ideally, we should have a policy in place negotiated or discussed by a multi-layered committee comprising management, shop stewards, workers, all those people it would affect. That policy should then be spread out, people should be aware of it, it shouldn’t just be a document kept in the HR manager’s office. It should be something that’s obvious, that everyone’s aware of.

Jason Wessenaar: In a company where they don’t have a policy, what is SACTWU’s role? And how do you make sure that these policies are monitored? Beacsue I think one of the compenets of the policy, is that a policy nees to be monitered and updated all the time.

Dr Feroza Mansoor: It’s difficult to say that we are actively monitoring policies in workplaces. We basically go on requests from factories, where they want us to get involved. We’ve got over 1000 factories nationally to cover, with 110 000 membership to cover. Unfortunately at this point, I don’t have enough resources to dedicate to that component.

Vuyani Jacobs: I used to work especially with clothing industries in the Western Cape when I started giving education with Busi and we used to spend time during the lunch time, and most of them in the Western Cape are women, and we used to talk about the MTCT programmes when we were mobilising for mother-to-child-transmission. And we were given time at the lunch when everyone wants to have a smoke, everyone wants to have a tea, they want to have coffee, they want to have a conversation. When is the right time? And how is it to negotiate it?

Dr Feroza Mansoor: We initiated our programme based on what we have, which is we’ve got half an hour. It’s not that, we need three hours, otherwise we do nothing. We’ve got half an hour so what can we get done in half an hour, and that’s how you should go forward one day we are going to get through. For me, if somebody takes home one message from a half an hour talk, or one fact, they’ve gotten an education. If I could affect one person’s life for one night, where they would use a condom, in one sex act, I’ve done my job as an educator in a factor.

Jason Wessenaar: We will talk more about AIDS in the workplace after this short break. Stay tuned.

Jason Wessenaar: Mohe reya ho amuhela mona hoSiyayinqoba Support Group. {SeSotho} Hi, welcome back to the Siyayinqoba Beat It Support Group. The programme fro anyone infected and affected by HIV. The Siyayinqwoba team visited Doctor Mansoo to talk to her about SACTWU HIV/AIDS programmes for workers in the clothing and textile industries. Lets see what they find out?

Wellness in the workplace

Durban, KwaZulu Natal

Dr Feroza Mansoor: I’m Feroza Mansoor, I am a Nationa Director of the SACTWU AIDS project. Today we’re visiting a company called Ninian and Lester. The company has elements of a wellness programme in partnership with the SACTWU AIDS Project that presents a good example of what companies should be doing on the HIV/AIDS issue.

Ben Gama (Human Resource Manager, Ninian and Lester): My name is Ben Gama; I’m the Human Resource manager at Ninian and Lester. The division employs about 694 people. And we came about with the HIV/AIDS policy based on the fact that we knew, and we accepted that there was this pandemic and everyone had to do something about controlling what was happening.

Dr Feroza Mansoor: So Sonita, tell us, how’s the training programme going?

Sonita Naidoo (Training Manager, Ninian and Lester): Since our last meeting Feroza, the training programme has gone very well. We have completed the shop floor people’s training. We’ve also done people from the packaging department, the dispatch, and the office staff. Our peer educators are very good at what they’re doing at the moment, cause we’re also encouraging the staff to come into training. We’ve had a lot of reluctance initially from the black males in the dispatch area, but since the peer educators have been talking to them in their tea breaks, they’re now quite comfortable to come into training and sit down at the back, and they also get the same message that other people are.

Sister Lindiwe Mthambo: I’m sister Lindiwe. I’m the occupation health nurse in the company. My main emphasis is on HIV and AIDS awareness. Keep counselling people on a daily basis, and refer them as they need to go for testing.

Ben Gama: We have since, after training, embarked on voluntary counselling and testing, whereby we send our people to SACTWU offices where they undergo the counselling and testing, and this is done during working hours and we pay them for that.

Sister Lindiwe Mthambo: More and more people are coming now we’ve done the HIV Awareness Programme which we covered earlier this year. So from the knowledge they had there, they began to understand why is it important for them to be tested. So I get more and more coming for testing.

Dr Feroza Mansoor: What do you do when somebody is HIV positive?

Sister Lindiwe Mthambo: The company has given me permission to give them multivitamins, vitamin B-Co, Bactrim, as a primary point of care.

Ben Gama: The company is strongly considering having its own antiretroviral rollout, and there has been a budget allocated for that. But again, we wouldn’t go on that on our own, we want to go hand-in-hand with the assistance of SACTWU.

Dr Feroza Mansoor: I have just seen sister Lindiwe and I’m now after Volten Hall to get tested, this is the diver provided by the company for this particulary visit.

Sister May-Rose Dlungwana (SACTWU Nurse): Abasebenzi abaningi banenkinga yokuthi baze la eclinic bazo tester ngoba abanaso isikhathi, kodwa eh, emseni uyenwe ngu Ninian & Lester ukuthi adedele abantu bakhe kusukhela ku2 beze bazo tester aba transporter abathethe ngezimotho zakhona bese besuka la eclinic yami bese bayagoduka, kwenze umehluko ukuthi abantu beze bazo tester zakhuphuka inumbers zami. {IsiZulu} [Many workers have a problem to come to the clinics and get tested, they don’t have time, but now that Ninian and Lester provide transport for their workers to come to the clinics after two o’clock to get tested and then go home, it makes a difference to those who come and test and the numbers are increasing.]

Support group

Busisiwe Maqungo: From what we saw in this insert compared to the previous one, I think these guys are doing an excellent job, because we saw nurses and they also mentioned the VCT thing, but I think it’s a bit inconvenient if the workers are going to be transported from the working place to the VCT site which is miles away, it might even lead to workers not testing. Do you know, this testing thing it’s not an easy thing: “Okay, you guys, get inside the bakkie we’re taking you to”, no, it doesn’t work like that. I think it would be more convenient if you guys had VCT site on the premises.

Dr Feroza Mansoor: In terms of the voluntary counselling and testing, that is something that I’ve been offering to companies since last year. In terms of building a partnership with companies, so I will go to the company and say we as the SACTWU AIDS project do voluntary conselling and testing we provide it Bolton Hall Clinic which is the clinic you saw in the end May-Rose Dlungwana is employed by the project and she does the testing confidentially in a clinic setting, but it runs separately they don’t belong to the clinic It amost a stand alone site in a clinic setting and it helps in that anyone can just say they’re coming to the clinic, they don’t have to say why.

Busisiwe Maqungo: You also asked a question about after testing, what are they doing? She mentioned Bactrim and other stuff. She didn’t mention the treatment of the opportunistic infections if they appear, she didn’t mention about the support group, because it’s not like you get tested and you go back to work again and you’re fine. I think the support group is the most important thing in this whole thing. What are you guys doing about that?

Dr Feroza Mansoor: The first one is a closed support group run by the nurse. So she knows whoever HIV positive is when she makes the diagonis they’re referred into an HIV positive support group. That’s the first step.

Jason Wessenaar: Is that in the workplace or outside?

Dr Feroza Mansoor: Outside the workplace. We will encourage that in workplaces as well, but we’re not at that level yet where we’re starting to disclose that openly in factories. So for now, when we have disclosure in the clinic setting to our nurse, she refers to our HIV positive support group.

Vuyani Jacobs: We have not been able in this country, with SACTWU, with many other unions, to actually come up with workers who are openly living with HIV. It’s either been the way we do things, or the way we give the education. Because I think openness is a preventional method to prevent new infections, to promote a familiar environment and to promote openness amongst people as a way of saying HIV is there and it’s treatable, it is working, and this is how you can live with HIV. Either you are on ARVs, or you’re not on ARVs, but it’s a way of moving forward. We haven’t been able to go through that.

Dr Feroza Mansoor: In terms of workers who are living openly with HIV and AIDS, my experience in the industry is that there’s still, even though they’re open to the department and I will find lots of our workers and they will say they are HIV positive, we know them, they walk in and out from our department on a daily basis without a problem. You find still there’s difficulty for them to disclose at factory level. There’s just one or two where I know they’re happy to disclose in the factory. And that’s the reality of where we are.

Jasson Wessenar: Don’t away we will be back after this short break with Doctor Mansoor and the Support Group.

Jason Wessenaar: Welcome back to Beat It Support Group we are talking to Doctor feroza Mansoor form SACTWU about HIV/AIDS wellness programme in the workplace.

Lihle Dlamini: I’m concerned because I heard the guy saying, for Ninian and Lester saying, that they’re looking at giving ama-antiretrovirals to their employees, and we all know that the protocol says that a person has to go under education for about four to six weeks before one takes antiretrovirals. And one has to attend an adherence classes, and what will happen if the companies are not prepared to give time off for the employees to attend those classes. And you’ll find out that those people will not end up being adherent to the medications.

Dr Feroza Mansoor: Putting people on antiretrovirals ensures that they are productive for a longer period of time. It saves money. The company does not have to retrain. The company would not lose skilled individuals, the company would not have to deal with somebody who is nursing a dying husband at home. If antiretrovirals are provided and provided across the board to every person that needs and requires it, so, by government coming forward and saying that they are going to provide antiretroviral, that’s an absolutely important step that was taken. It has huge impacts on how we as a trade union, what training programmes we run. Now, it’s very, very important that every worker understands what it means to be on antiretrovirals.

Vuyani Jacobs: Companies have made enough money at some point and of course there are problems including industry. But companies are still making money and they’ve made money, they have an obligation to actually treat their workforce in such a way. I don’t want VCT to only go and measure the response of the company. I want VCT, educational, preventional method to be there, I want VCT to be there, there’s possible there should be opportunistic treatment of opportunistic infections, there should be access to antiretroviral drugs, because some companies can really afford it. And in the situation of the worker become retrenched and there are problems, the government have the constitutional obligation to every individual, and the way to enforce, SACTWU should take it to the street. Don’t you think we must take it to the street?

Dr Feroza Mansoor: What we need to do and is see how we can help government do their job because ultimately, government should be taking care of the health of the people in this country. They are struggling a little bit because of the impact of HIV and AIDS and we as HIV/AIDS activists..

Busisiwe Maqungo: Because they took too long to implement...

Dr Feroza Mansoor: Yes, we know that the problem is if we started ten years ago giving ARVs, we won’t have the problem now of orphans who are around, of people who are still dying, who can’t access ARVs because it’s too late. So, the impacts of not providing treatment early are with us, which we’ve gotta deal with. We’ve gotta fix that, we’ve gotta get them into a culture of treatment. Treatment is available, treatment is the focus of a comprehensive programme, and then it reduces whatever resources you put towards orphans, cemeteries, everything else.

Jason Wessenaar: Siyabulela Doctor Mansoor, the Support Group nababukeli ekhaya. {IsiZulu} Thank you Dr. Mansoor, the Support Group and the views at home. Things to remember are:

1. All workplaces should have an HIV/AIDS policy to protect their workers.
2. Companies and employees both benefit by keeping people with HIV and AIDS at work for as long as possible.
3. Employers should allow their employees to be part of the wellness programme.

We hope that you have enjoyed the show and are feeling the Siyayinqoba Spirit that together we can Beat It. If you have any questions or comments please contact us on the numbers on the screen right now. Join us again next week on the Siyayinqoba Beat It support group. Till then, stay healthy and remember that we can Beat HIV. Salani kahle {IsiZulu} [Goodbye]

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