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Episode 19 - Farmworkers

An alarming 35 to 40% of farm workers living in South Africa are infected with HIV.  Conditions prevalent on farms are conditions that contribute to a high rate of HIV infection. On farms workers are often forced, in the absence of alternatives, to live in crowded compounds far from their families and isolated from HIV/AIDS interventions.

Shalom Ncala: Sanibonani babukeli, siyanamukela kuSiyayinqoba Beat It! Lolu uhlelo lwanoba ubani ophila negciwane lesandulela ngculaza abathandiweyo babo, yimindeni, abangani nabasebenza nabo ngisho phela nabasebenzi bezempilo. Samkela ithimba elesekelayo. Namhlanje sikhuluma ngabasebenzi basemaplazini. Lena yingxenye yemiphakathi yethu exhaphazekayo futhi izikhathi eziningi ayinakiwe. Izinga lokuthelelana ngesandulela ngculaza alifani kuzo zonke indawo. Amaqembu athize emphakathini abuthakathaka futhi azithola ebhekene nalengwadla okwedlula amanye. Enye ingxenye ethintekayo kakhulu yilabobantu abafuduka beyofuna imisebenzi emadolobheni basengozini enkulu yokuthola igciwane lesandulela ngculaza. Namhlanje sihanjelwe ngu Antoinette Ngwenya uzosabela ngolwazi alutholile ngokusebenza nabantu basemaplazini, siyakwamukela Antoinette. Akhe sihambe siye e Hoedspruit eLimpopo siyohlangana nengxenye yabasebenzi basemaplazini (IsiZulu). Hello and welcome to Siyayinqoba Beat It! The programme for everyone living with HIV, their partners, family, friends, colleagues and health workers. Today we are talking about farmworkers. Farmworkers are one of those vulnerable groups that are often forgotten. The rate of infection is not the same everywhere. Some people are more vulnerable than others. People who have to move from one place to another to look for work are amongst the most vulnerable. With us today we have Antoinette Ngwenya who will share her experience of working with farmworkers. Welcome Antoinette. Let's go to the Hoedspruit in Limpopo province to meet a group of farmworkers.

Support Group: Hi Shalom!

Antoinette Ngwenya: Thank you Shalom.

Tumi: (SeTswana) Today we're at Mohlatsi farm in Hoedspruit to talk to men and women about STIs and VCT.

Farmworkers: Hi Siyayinqoba!

Christine Du Preez: (Afrikaans) Every Monday we have what we call an outreach to all farms. We tell them about HIV and STIs and that they can test afterwards. Then we allow them to ask questions and give them an opportunity to come for VCT. When they come for VCT, there's a counselor and a nurse that does the VCT.

Lady in worshop: This shows that the person is ill. Do you remember we talked about sores? Do you see the sores? This is the results of the people having unprotected sex.

Guy 1: Sex workers want us to use condoms, but we paid for sex with them. Do we still need condoms?

Lady in workshop: We'll ask Antoinette to comment on this.

Antoinette: It would be sad to engage in unsafe sex. You're putting yourself at risk of contracting an STI. It is always better to use condom during any kind of sexual intercourse. Does that answer your question?

Guy 1: Yes it does.

Antoinette: With us today we have Lucy, Rifa and Constance who are counselors. They will conduct HIV tests for those who want to be tested.

Jaco Fivas: Even if they're positive or negative, we don't know it and we are not allowed to discriminate.

Christine: (Afrikaans) Yesterday we were at Mohlatsi farm and tested 27 people for HIV. 12 of them tested positive which means it's 40% of them that tested HIV positive. The farmer, Jaco, took the twelve HIV positive workers to Hlokomela Wellness Clinic for their CD4 count test. Our funders "Right To Care" says we can start patients on ARVs at a CD4 count of 250. So we start people for example those who tested yesterday with a CD4 count of less than 250, we start them on ARVs. But not immediately because we first teach them about adherence. We are very strict with that because it's an important life long commitment. We can't just give it to anyone, but we do give to those who need it as soon as possible. The farmers of Hoedspruit are amazing. They are very optimistic, and we've worked with the farmers for a whole year on a HIV policy for the farms. They help us implement the policy. They transport people to the clinics and give them leave. Everybody is optimistic. I'm very pleased with the farmers in Hoedspruit.

Shalom: Ngibonga kakhulu for the kind of work that you're doing out there. ...for abantu abasebenza emafamini. And sibathathela as if bangabantu nje who just bring us the next pair of fruit. Njengoba kuhleli ama fruits la phezu kwalelitafula sazi nje ba ngabantu abazositholela lama fruits lawa but badlala indima enkulu kakhulu in terms of i-economy ye country yethu as it is. But I'd like to know how deep is the problem emafamini? (IsiZulu) I'd like to say thank you for the kind of work you're doing out there. In as much as we tend to think less of farmworkers. We see them as people who will just bring us our next pair of fruits, and we only think of them as fruit harvesters. But they play an important role in the economy of the country. But I'd like to know how deep is the problem on the farms?

Antoinette: Firstly, thank you Shalom. Secondly, there is a general perception that farmworkers are inferior. In January 2008 an HIV/AIDS prevalence survey was conducted amongst farmworkers. The study commenced in 2003. Nobody knew about the HIV/AIDS prevalence levels before this study. So one of the results was that the HIV/AIDS prevalence level was 28%.

Busi Maqungo: ....if ba yi 28% e Hoedspruit kuphela and zingaphi ilantuka amaplasi okanye I farms esinazo apha eSouth Africa? (IsiXhosa) So you can imagine, if this statistic of 28% in Hoedspruit is accurate, what is the prevalence on the rest of the farms in South Africa?

Antoinette: There is evidence that this programme is helpful in Hoedspruit. The provincial government is proud of this programme. It would be to the advantage of the whole country if the National Department of Health would support these kinds of initiatives. These are the people who are often marginalized and these are the people who are feeding the nation. It means we are full today because of them.

Victor Lakay: From the insert we can see that out of the 27 people that tested, 40% were HIV positive. (Afrikaans) Why are seasonal farmworkers more vulnerable?

Antoinette: One of the reasons farmworkers are more at risk to contract HIV/AIDS is because they are highly mobile and many are seasonal workers. But it also affects other migrant workers, those working in construction, mining, fisherman and those in the trucking industry. They are all vulnerable because they are always away from home. There are a number of contributing factors such as, they usually have multiple sexual partners, they have unfavourable or very poor accommodation and they don't have easy access to health facilities.

Victor: How did this programme get so many people to test that particular day?

Antoinette: Many workers decided to test because they noticed their friend and family members dying from HIV related illnesses. So there's no much demand for HIV information anymore. Everybody wants to test for HIV. They'll say "we heard enough about HIV, we want to know our status".

Busi: Actually sis Antoinette I think le programme yenu yoku educator abantu and thereafter they come for ilantuka for itest it's also working towards the NSP goals... (IsiXhosa) Your programme of educating people about HIV/AIDS and thereafter testing them, is also working towards one of the NSP goals. People now get to understand the need to know their status. So by 2011 we would've reached the goal of 75% knowing their status.

Shalom: Ninganyakazi, sizobuya khona maduzane. Siyanamukela futhi kuSiyayinqoba Beat It! Namhlanje sikhuluma ngesandulela ngculaza kubasebenzi basemaplazini. Akhe sibheke okulandelayo ngabasebenzi basemaplazini besifazane. (IsiZulu) We'll be right back. Stay where you are! Welcome back to Siyayinqoba Beat It! Today we're talking about HIV amongst farmworkers. Let's take a look at our next story about women farmworkers.

Tumi: (SeTswana) we are in Arcornhoek speaking to Rifa. She tells us how she disclosed her HIV status in the community and how female farm workers are treated in Hoedspruit. Did you test for HIV, and why did you feel the need to test?

Rifa Molekane: (SeTswana) I was very ill, I went to the clinic and I was tested for HIV. I tested HIV positive with a CD4 count of 9. I was advised to start on ARVs because my CD4 count was 9.

Tumi: (SeTswana) Do people here know about HIV and that they need to test to know their status?

Rifa: No. Many of them don't take the HIV test. When they fall ill, it's easier for them to say they are bewitched. They don't even want to go to the clinic or have contact with a nurse. If they do go to the clinic, they'll say it's for a headache. They are very scared to ask for VCT.

Constance Ngobeni: (SeTswana) I work for an organization Hlokomelo Home Based Care as a counselor and a caregiver. Women in rural areas are economically disadvantaged. When they seek work, the supervisors expect them to have sex with them before employment is secured. The supervisor may be sleeping around with 15 to 20 women at the same time, putting them all at risk of contracting HIV. None of these women know his HIV status. It's a fact that most men on farms don't want to test for HIV/AIDS.

Rifa: (SeTswana) My opinion is that women are afraid to test. People that are HIV positive are said to be suffering from "mafulara". But some of us know it's not true. We know its HIV/AIDS. Most of them don't test for HIV. Those who are HIV positive believe they are bewitched. That isn't true.

Tumi: (SeTswana) so they don't test? As you said, you worked on farm. Are women treated differently to men?

Rifa: (SeTswana) women are ill treated and exploited. Generally women on farms are suffering economically. They are responsible for the well-being and livelihood of their families. That's why they are under pressure to seek employment to earn a living.

Nokubonga Yawa: Once ndandikhe ndasebenza eplasini, I think kwakungo 2002. Phaya wonke umntu kuba imali incinci efunyanwa phayana uyayazi uzothi kuze ubenemali imali yakho ibeninzi funeka uqale ulale nemaneja kuqala. So uyayazi kengoku na bana imali yakho soze ingabi ninzi ba ukhe wamtswebela yabona. Ingaba abantu esebe testile bayanda na aba positive okanye liyahla inani labo, ingaba ngotata aba positive kakhulu okanye ngomama?(IsiXhosa). I once worked on a farm, I think in 2002. We were paid low wages. Many women would opt to have sex with the supervisor or manager for better wages. In your view, is the statistics of men living with HIV higher or lower than that of women?

Antoinette: According to the survey done in January this year, the highest numbers of people testing for HIV/AIDS were women. 32.5% of the women that tested were HIV positive, compared to 20.9% of the men. More women test than men because they are at higher risk of contracting HIV. The women farmworkers are vulnerable and they experience gender exploitation. Most of the women are breadwinners and most of them are married. They are not educated so they get jobs on farms. And to secure employment, the supervisors expect sexual favours. Yes.

Busi: Ne-promiscuity kuma supervisor? (IsiXhosa) Promiscuity from the supervisors?  Disgusting.

Shalom: Akhe sithathe ikhefu sizobuya khona manje. Siyanamukela futhi kuSiyayinqoba Beat It! Namhlanje sikhuluma ngesandulela ngculaza kubasebenzi basemaplazini. Akhe sihambe manje siyohlangana no Armstrong ongumsebenzi wase plazini ophila negciwane lesandulela ngculaza. (IsiZulu) We're taking a quick break. Be back now. Welcome back to Siyayinqoba Beat It! Today we're talking about HIV amongst farmworkers. Let's go now to meet Armstrong who is a farmworker living with HIV.

Tumi: (SeTswana) Today we're in Hoedspruit speaking to Armstrong. He's going to tell us about his HIV status, and how he works with the other farm workers. When did you go an HIV test and why did you decide to go?

Armstrong Khoza: (SeTswana) I was feeling very ill, and I discussed my health situation with my boss. He advised me to go, and he accompanied me to the clinic. I was tested and they said my blood samples were to be sent away for HIV testing. Days thereafter, we fetched the results, and I tested HIV positive.

Nurse: Binne kaant. More Armstrong, hoe gaan dit? Nee goed dankie. Het jy gekom vir jou pille?  (Afrikaans) Come inside. Good morning Armstrong. How are you doing? I'm good thank you.

Armstrong: More miss. Goed en jy? Ja...(Afrikaans) Good morning miss. Good and you. (SeTswana) I take 2 tablets in the morning and 3 at night, and I take vitamins.

Tumi: (SeTswana) How are you feeling now?

Armstrong: (SeTswana) I am okay. I don't have any health problems.

Tumi: (SeTswana) What are duties on the farm?

Armstrong: (SeTswana) I'm the foreman. I delegate and supervise every worker's daily tasks.

Tumi: (SeTswana) Do you encourage workers to test for HIV?

Armstrong: (SeTswana) One of the problems faced by these farm workers is illiteracy. The workers cannot read and write. If I put up a "no entry" sign most of them don't observe it because they can't read it. And in my view, their understanding of many issues related to health care is poor.

Tumi: (SeTswana) So in other words, it's difficult to encourage them to test for HIV?

Armstrong: (SeTswana) Yes, the common remarks made by workers about HIV testing is that, if you were to test positive, that will lead you to commit suicide. So it's better not to know their status because it will have a negative impact on their lifestyle.

Tumi: (SeTswana) These farmworkers are immigrant workers, they don't live with their partners on the farm. How do they deal with the separation, specifically their sexual needs?

Armstrong: (SeTswana) They cheat. But they do use condoms.

Tumi: (SeTswana) They practice safe sex?

Armstrong: Yes, we set up condom dispensers. These condom dispensers get refilled from time to time. Workers help themselves. Learning from my experience, I encourage people who are not feeling well to go for an HIV test. It is done at the clinic.

Victor: Antoinette, I just have a comment about more women testing than men. My feeling is that we've been socialized very differently as men and women. Women have to take responsibility for their bodies, they have to take responsibility for sex, they have to take responsibility for the children and their families, and I feel that men, we're not socialized to take responsibility in that way. So it's not good enough for us to say that more women test than men, that's just the way it is. I think our programmes need to talk particularly to men's sexual health and men's reproductive health issues so that men too can take responsibility.

Antoinette: At the start of our discussion I didn't mention programmes Hlokomelo offers. One of the 7 programmes we have addresses gender inequalities. The gender coordinator targets men. The gender programme addresses issues that affect men. Since we started in 2005, we have about 30 gender advocates. Armstrong is one of them. He was trained in reproductive health, sex and sexuality, anything to do with sexual education. For Armstrong as a supervisor to disclose his HIV positive status and that he's on ARVs is a good indication and maybe it'll encourage other supervisors to follow his example. It's not Armstrong alone, it's just that maybe he's bold to disclose his status. There are some supervisors who are on ARVs but they're not willing to disclose their HIV positive status. It's coming up slowly. And I think maybe by 2010 we'll see more men testing.

Victor: I think it's a very good programme in terms of providing treatment, care and support. But how comprehensive is the approach to include prevention strategies and behavioral changes?

Antoinette: Concerning behavioral change communication, most of the gender advocates developed murals on the different farms. The murals communicate about HIV/AIDS, women's right, human rights, VCT, gender based violence, and for men and women to share responsibilities. We noticed that male condoms are not as popular, they prefer female condoms. Our biggest challenge is to secure female condoms. It's encouraging to hear women calling out for female condoms during our site visits. They say to us "You promised us female condoms. Where are they?" From January to date, we have sufficient supply of female condoms. This part of our prevention strategy.

Shalom: Izindawo eziningi ezweni lethu, lapho abantu ababuthakathaka kakhulu baphila emiphakathini enezinga elikhulu lokuthola igciwane lesandulela ngculaza zilitshelwe futhi azinakiwe. Abasebenzi basemaplazini badinga ukuvikelwa futhi bakwazi ukuthola ukunakekelwa kwezempilo nolwazi lokwelatshwa. Singajabulela ukuzwa kini. Nakho ke sibhaleleni kule likhele elivela kumabonakude wenu. Sizobuya neveki elizayo, kuze kube ngalesosikhathi. Zivikele, uvikele nabanye. Salani kahle emakhaya! (IsiZulu) In many parts of our country, some of the most vulnerable people who live in communities with the highest rate of infection are completely forgotten and neglected. Farmworkers need protection and access to health information and treatment. We love to hear from you! Contact us at the details on your screen now. Until then. Protect yourself, protect others. Goodbye to you at home!

Support Group: Bye!