The ILO/USDOL International HIV/AIDS Workplace Education Programme - Stories from the field
Approximately 650 workplaces in 24 countries stretching from Benin to China are now involved with in the workplace education programme known as SHARE (Strategic HIV/AIDS Responses in Enterprises). Overall, an estimated million workers benefit from the ILO interventions financed by the United States Department of Labor. These are some lessons learned from SHARE countries
Malawi: behaviour change in the workplace
Satemwa Tea Estate is one of the oldest and biggest tea factories in the southern region of Malawi with a workforce of 2,900 people. With high levels of absenteeism management was very keen to do something about HIV, but didn’t know how to make a start. The ILO began discussions with the company and ran a training programme for staff identified to be focal points in each division. Many issues came up in the workshops and as a result HIV committees have been set up and the first draft of an HIV policy has been developed for the company.
Management is already using this draft to start implementing HIV programmes and staff are getting information about the importance of prevention, particularly the use of condoms. Supervisors pass on messages about HIV during working hours; either while they are monitoring the tea picking or before work when employees gather for the distribution of tasks for the day.
Satemwa has developed a condom strategy called tolani nokha (help yourself); condom supplies are left at the reception and staff help themselves. “Now we don’t need to go to the clinic and request a condom, we just pass through the reception and help ourselves and we are not ashamed,” explains one of the many workers who are benefiting. The company has also developed a list of HIV services available locally in response to requests from workers.
HIV and the workplace: Reaching remote safari camps in the Okavango Delta
Desert and Delta Safaris is a tour company operating in the Okavango Delta in Botswana, where it has four up-market camps and employs about 300 staff. In a country with a high HIV prevalence, the company is concerned about how to protect and assist its workers. The tourist industry in this area faces particular problems as employees live in remote camps separated from their partners for three month periods and this often leads to other relationships. The camps can only be reached by small chartered aircrafts which makes it difficult to access health care and other social services.
In 2004, Desert and Delta Safaris started working with SHARE and one of its staff, Munihango Limbo, came to be trained about the ILO Code of Practice and the ILO’s behaviour change methodology. As a result he was instrumental in the development of the company’s HIV policy and programme and their adoption by both management and employees.
Limbo is now HIV coordinator for the company and leads a group of 14 peer educators and seven lay counsellors who live in the four camps. They provide information and counselling to the staff and there is a regular supply of condoms in the workplace, guest rooms and staff houses. The programme also reaches out to guests. “Because these camps can only accommodate a low volume of visitors, it is quite easy to build rapport with guests,” says Limbo. “Tourists are not only interested in the wildlife but also in the livelihood of the communities as well. We discuss a lot of social issues including HIV and we learn a lot from them just as they learn from us.”
A combination of Limbo’s leadership, top management support and employee commitment means the programme is performing very well. Almost all staff members know their HIV status. While the national uptake of VCT stands at 51%, 98% of Desert and Delta staff have been for HIV counselling and testing.
Covering the supply chain: ILO HIV/AIDS programme in India
Apollo Tyres Limited (ATL) is a young, dynamic organization with manufacturing and sales operations in India and South Africa. Apollo started its HIV programme working with truck drivers, and then initiated a comprehensive workplace programme in partnership with the ILO India project that covers its 7,000 employees in four locations.
The company uses a network of volunteers who are trained as HIV peer educators and master trainers to roll out the programme with colleagues. In recognition of their contribution, they are known as ‘champions of the cause’.
Apollo is now helping to initiate HIV programmes among companies in its supply chain, targeting small and medium-sized business partners. It began by setting up a sensitization workshop for all its suppliers, letting them know it had included issues related to HIV in its code of ethics. Compliance with the code is a key criterion for Apollo when selecting supply chain companies. As a follow-up to the advocacy event, it is targeting eight companies a year to set up workplace programmes, with the help of its master trainers. Apollo plans to expand its HIV initiatives to involve 4,500 retailers across India through its 120 sales offices.
Shielding young workers in Accra’s informal economy: ILO HIV/AIDS programme in Ghana
When a car needs attention in downtown Accra, the Odawna Light Industrial area is the place to go. One of the biggest garage communities in the country, literally thousands of operators live and work in a maze of small plots at Odawna, employing large numbers of young apprentices and keeping an extensive support economy of food vendors and other suppliers in business.
The various garages at Odawna have organized themselves into a consortium belonging to the Ghana National Association of Garages (GNAG), which has 40,000 members nationwide and 4,000 in Odawna itself.
A growing concern has been how to protect the workforce from the risk of HIV. Drug dealers and commercial sex workers operate in the area and alcohol is easily available. Most of the workers are young and poor, often living away from their families.
“When we first heard of HIV we practically believed it was a monster coming to swallow us up. Our population is overwhelmingly youthful and we believe this increases their vulnerability and the risk of contracting HIV,” says Alhaji Dakpo, Accra Regional Chairman of the GNAG. “Information and education was not reaching our garages and it was badly needed for our members.”
The garages’ consortium at Odawna linked up with SHARE, providing the project with an effective channel to reach the informal economy. It started in 2004 by running a survey among the garage workers, which confirmed a general lack of knowledge about HIV and its transmission. With ILO support, the GNAG identified 50 peer educators who went through extensive education and training on HIV issues. To encourage participation, workers received an allowance to cover the income they lost while carrying out HIV activities.
A network of focal points and peer educators now operates in 36 garage plots targeting garage workers and other small businesses such as food vendors. The key aim is to raise workers’ perceptions of their own risk of contracting HIV by creating an understanding of the connection between alcohol, multiple partners, casual sex and infection. The peer educators work early in the morning and in the evenings, when people have more time to talk, and they have so far covered about 2000 workers. Many have also been carrying out HIV education in their churches and local communities.
Sarah is a food vendor and peer educator at plot 10, Odawna garages. She believes strongly that the project has been highly beneficial to her and her colleagues. “Before this programme I did not care whether people had sex with a condom or not, but now I believe in the use of a condom. The information I learnt about HIV is burning inside me and I feel a need to share it.”
“In the past we could barely raise the issue of safer sex, condom use and VCT with our apprentices and workers because we felt uncomfortable,” explains Mr John K. Nimo, Acting National Secretary for the GNAG. “We believe the ILO programme has raised awareness of the risk involved and now people know they must look out for each other.”
Protecting young workers from HIV/AIDS in Cambodia
Twenty-one year old Huong Vuthy could not find a job in the rural province of Cambodia where she lived so she decided to come and work in the capital city, Phnom Penh. She had heard about HIV before she came, but thought it was only something that ‘bad people’ got and wasn’t her problem.
Since the first case of HIV was reported in the country in 1991, 94,000 people have died of HIV-related causes. Remarkably, Cambodia has managed to reverse the trend and has seen a fall in adult prevalence rates from 1.3% in 2003 to 0.9% in 2006 (UNAIDS, 2006); this is quite an achievement in a country that has emerged from over 20 years of violent conflict and which is still in the process of reconstruction. However, despite this success the Cambodian government is concerned to sustain and accelerate the national response to prevent a resurgent epidemic. Almost half of new infections are among married women.
Huong works in Cambodia’s booming garment industry which expanded rapidly in the mid 1990s and now employs an estimated 280,000 workers in over 200 factories. One out of five Cambodian women aged between 18 and 24 works in a garment factory; they are often single with low literacy levels, living away from their families and communities. Some supplement their income with second jobs at karaoke bars and restaurants.
On arrival in Phnom Penh many young women discover that they cannot be considered for a job in one of the garment factories without a medical check up. Their first port of call is a government health clinic where all workers must be examined before being given a health certificate attesting that they are fit to work. Concerned about the vulnerability of the young workers entering in the labour market, the Department of Occupational Safety and Health (DoSH) decided to set up the Friendly Education Centre which aims to provide HIV information while future workers are waiting to have their medical check-up.
Two educators from the DoSH visit the centre three times a week to provide information and advice about HIV prevention. There are plenty of visual and written materials available from the ILO and other organizations. The centre also shows video of HIV while workers are waiting.
The centre provides a valuable space for the young women to learn about HIV and the risks they may face. “I am here for a medical check up so that I can apply for a job in a garment factory,” says one hopeful rural migrant. “I have learnt more about HIV now by coming to this centre. I realise that it is important for me to learn about HIV so that I can protect myself. I also know now where I can go for other health services.”
This initiative from the Ministry of Social Affairs, Labour, Vocational Training was supported by the ILO SHARE Programme (Strategic HIV/AIDS Responses in Enterprises) financed by the United Stated Department of Labor.
The ILO’s SHARE programme ran from May 2003-August 2007 with a budget of US$483,883. It operated in the capital city Phnom Penh and Siem Reap province. SHARE worked with the garment factories, the hospitality industry and the informal construction sector where male workers often spend long periods of time based in camps away from home. In total 892 peer educators have been trained and 11,770 workers involved in a range of project activities in 15 workplaces.
These have joined the ranks of the 5,000 peer educators trained in the 650 workplaces partnering with ILO SAHRE world wide.
Building on strong occupational safety and health habits to address HIV/AIDS in Belize
Belize Electricity Limited (BEL) is the nation’s main power supplier employing 250 workers in 10 different locations around the country. The company already had a well-established occupational health and safety programme in place when approached by the ILO, and was open to integrating HIV education and risk reduction in its ongoing activities. Being part of a broader health and safety approach makes HIV work more economically viable for the company, and may make it easier to encourage worker involvement.
Employees from BEL took part in the ILO project’s baseline survey in 2004 and this exposed HIV risk behaviours among its staff. The most significant were regular alcohol consumption among male employees; a highly mobile workforce away from home for long periods; and a negative attitude towards using condoms.
Using this information BEL took action to protect its staff. The company instigated a ‘no tolerance’ policy towards alcohol consumption on the premises and limited alcohol availability at company social gatherings. It also moved away from giving workers long assignments in the field by building institutional capacity beyond head office, and developing short stint rotation systems. Finally, condoms are now readily available at the workplace and there is a back-up information campaign.
BEL has a network of peer educators and a wide range of HIV information and educational activities. The company offers financial incentives such as end-of-year bonus payments to boost staff participation in occupational health and safety programmes and events. BEL feels the HIV workplace education programme benefits everyone as the company achieves its productivity targets through lower staff turnover, less absenteeism and a return on capacity investment in staff. At the same time employees stay healthy and productive to the benefit of themselves and their families.
In 2003 the ILO and United States Department of Labor set up the first project to systematically target the country’s working population to protect it from the impact of HIV with a three year budget of US$452,518. BEL is one of 18 workplaces to become involved in the HIV workplace education programme which is active in five targeted sectors and reaches 4,614 workers.
Four years on, the foundations for a sustainable national workplace programme on HIV have been put in place, and the project is now being run by the Belize Ministry of Labour as the ILO’s involvement has ended. There is still much to be done – including a need for legislation to support national HIV policies - but the project’s interventions have shown that there is potential for action, and HIV is now widely recognized as a critical workplace issue in Belize.