Addressing GBV in the DRC

20141125_123725To commemorate the International Day for Elimination of Violence Against Women and the beginning of the 16 day campaign against gender based violence, SWHAP in the DRC held a network meeting to build capacity within steering committees to address populations considered at higher risk of HIV infection. These groups include women, Lesbian Gay Bisexual Transgender and Intersexed (LGBTI) individuals and men who have sex with men (MSM). According to the UNAIDS Gap Report, young women and adolescent girls are disproportionately vulnerable to HIV infection, being twice as likely as young men to be living with HIV. There are many reasons for this including culture, biology, economics, unequal power relations between men and women and gender based violence (GBV). Women who fear or experience violence lack the power to ask their partners to use condoms or to refuse unprotected sex, and fear of violence can prevent women from learning and/or sharing their HIV status and accessing treatment. Women who face intimate partner violence are at a 50% increased risk of acquiring HIV (UNAIDS). Stigma, discrimination and fear of violence also means LGBTI persons and MSM are at higher risk of contracting HIV. Laws and social customs in many countries condone discrimination against these groups limiting their access to health care services.

During the network meeting a human rights and gender specialist from UNAIDS explored the link between gender based violence and HIV with the participants. Testimonies from MSM and LGBTI persons also addressed misconceptions and provided confidential hotline numbers for additional information and support. SWHAP considers workplaces an important entry point for raising awareness on the sexual and reproductive health rights (SRHR) of vulnerable groups.

SWHAP, ILO and COTU Seminar for Building and Construction Sector

The construction industry in Kenya is one of the key drivers of the country’s Gross Domestic Product. Growth in this industry has attracted many foreign and local workers. However HIV and AIDS continue to be major challenges in this male-dominated sector with ignorance on the transmission of HIV contributing to the spread of the virus. Against this background SWHAP in Kenya partnered with the International Labour Organization (ILO) and the Central Organization of Trade Unions (COTU) to raise awareness on HIV and AIDS and occupational health and safety in the Building and Construction sector.

Workers’ representatives from the sector were challenged to advocate for structured HIV and wellness programmes and to encourage members of their respective unions to undergo Voluntary Counselling and Testing. Of the 16 workplaces represented at the forum only one had a policy on HIV and AIDS and only two companies had conducted awareness and VCT sessions. These companies will now be supported through a mentorship programme to develop policies on HIV and AIDS, whilst a national policy for the sector is also developed.

Promoting healthier drivers and safer roads

Drivers’ general health impacts on their ability to do their jobs. Additionally, sexually transmitted infections including HIV, are a growing concern in the transport industry and long distance truck drivers are especially at risk. In order to promote good health amongst this group SWHAP partners in the transport industry hold targeted campaigns addressing their HIV and general wellness needs.

In Zimbabwe, Scania dealer Scanlink in partnership with SWHAP, ILO, the National AIDS Council and the Ministry of Transport set up a wellness and HIV screening campaign along a busy highway. While motorists participated in VCT and wellness screening, Scanlink technicians provided a bumper to bumper check of vehicles issuing defect sheets where necessary. Peer Educators from Scanlink and Ericom lent their support to this initiative, handing out information, male and female condoms and encouraging truck drivers and motorists to get tested.

IMG_5962

On November 29, Scania South Africa used the Southern Africa Regional Finals of the international Scania Driver Competition to offer free VCT and wellness screening to competition participants and spectators. The competition attracted over 700 skilled bus and truck drivers from the region with 38 drivers from Botswana, Namibia, South Africa and Tanzania making it to the finals. Drivers were judged on three factors: safe driving skills, economical driving and environmental impact. Lawrence Nkwinika from South Africa won Best bus driver, whilst Nicolaas Kallie Truter from Namibia won Best truck driver. Congratulations to Scania for a campaign that puts driver health at the heart of safety.
Scania driver competition 2

International Human Rights Day

Human rights are linked to the spread and impact of HIV, with lack of rights exacerbating the impact of the disease. Issues such as gender inequality, discrimination, poverty and social injustice contribute to and increase the impact of HIV.  The protection and promotion of human rights is essential in the global response to HIV and the realisation of human rights means access to education, information, care, treatment and support for individuals affected or infected by HIV and AIDS.

SWHAP supported workplaces are working towards healthy working environments where the human rights and dignity of all people including those living with HIV or other medical conditions are protected and respected. Workplace HIV and Wellness policies recognise HIV and AIDS as a workplace issue and ensure, the provision of education, information sharing, confidentiality, access to medical treatment and support services for all employees. HIV positive employees are accorded the same rights, facilities, benefits and opportunities as those with other serious or life threatening illnesses.

Sandvik East Africa

Workplace policies are also taking in to account the gender differentiated vulnerabilities to HIV and are attempting to address the biological, socio-cultural and economic reasons that make women more vulnerable to the disease. Workplace programmes include spouses of the predominantly male workforce, encouraging shared confidentiality especially partner notification and support income generating projects for spouses.

The slogan for this year “Human Rights 365”, reminds us that every day is Human Rights Day and that we need to keep pressing on to ensure the fulfilment of human rights for all.

World AIDS Day 2014

The Swedish Workplace HIV and AIDS Programme (SWHAP) joins the rest of the world in commemorating World AIDS Day 2014. The theme for this year, “Closing the gap”, focuses efforts on empowering and enabling people everywhere to access the HIV prevention, treatment, care and support services that they need, ensuring that no one is left behind.

UNAIDS has set bolds targets for the elimination of the AIDS epidemic as a global health threat by 2030. These targets relate to zero discrimination, reduction in the number of new infections to 200,000 amongst adults by 2030 and 95-95-95 for treatment (95% of all people living with HIV knowing their status; 95% of all people diagnosed with HIV receiving treatment and; 95% of all people on treatment achieving viral load suppression).  According to UNAIDS “without scale-up the AIDS epidemic will continue to outrun the response, increasing the long-term need for HIV treatment and increasing future costs.”  Scaling up will result in a 15-fold return on HIV investments, preventing 28 million HIV infections by 2030 (13 million in sub-Saharan Africa) and 21 million deaths. Scaling up now would also mean USD 24 billion saved in future treatment costs. (http://www.unaids.org/en/resources/campaigns/WAD2014)

 As SWHAP has shown, workplaces are an important arena for addressing the causes and implications of HIV and AIDS. All parties in the workplace have a vested interest in ensuring that no one is left behind. Investment in workplace programmes has been shown to make good business sense for companies, by reducing absenteeism and improving productivity. On a macroeconomic level it is estimated that the HIV and AIDS epidemic reduces economic growth by 1% annually in some countries in sub-Saharan Africa (www.avert.org), inaction is not an option. Trade Unions are an important partner in scaling up the response to HIV and AIDS at the workplace, for example through their encouragement of members’ participation in programmes, better testing outcomes have been realised within the SWHAP network.

VCT and wellness tests during the Ericom, SWHAP, ILO Social Football Tournament in Zimbabwe.

VCT and wellness tests during the Ericom, SWHAP, ILO Social Football Tournament in Zimbabwe.

SWHAP supported workplaces are working towards healthy working environments where the human rights and dignity of all people including those living with HIV or other medical conditions are protected and respected. Workplace HIV and Wellness policies recognise HIV and AIDS as a workplace issue and ensure, the provision of education, information sharing, confidentiality, access to medical treatment and support services for all employees. These polices are in line with the International Labour Organization’s HIV and AIDS Recommendation (No.200).

Workplace programmes are helping to address some of the social and structural issues that prevent employees and their families from accessing testing and treatment services. Structured programmes provide access to testing and treatment for employees and families at the workplace through regular on-site testing and wellness days. Employee Support Programmes with counselling, nutrition support and follow-up of positive employees are helping to promote adherence to treatment. Tuberculosis, Condom, Voluntary Medical Male Circumcision and Peer Education Programmes promoting behaviour change are also playing their role in ensuring no one in the workplace is left behind.

Through community outreach programmes, companies are working with vulnerable key populations, for example adolescent girls and young women in Kenya, whilst in the DRC peer education programmes are addressing information gaps on sexual orientation that perpetuate stigma and discrimination, making it difficult for Lesbian, Gay, Bisexual, Transgender and Intersexed individuals to access healthcare services. Furthermore, SWHAP participation and support of programmes such as “Getting to Zero at Work” and “VCT@Work” is also helping to ensure many more people in the workplace and surrounding communities have access to testing and treatment.

This World AIDS Day lets scale-up our commitment and efforts to ending AIDS as a global health threat by 2030. Workplace HIV and wellness programmes can “Close the gap”.

The cost of gender based violence

November 25 is the International Day for Elimination of Violence Against Women. It marks the beginning of the 16 day campaign against gender based violence (GBV).  “Gender based violence includes physical, mental or sexual harm or suffering, threats of such acts, coercion and other deprivations of liberty” (www.un.org/women). GBV is a serious health concern. Survivors can experience physical, emotional and psychological trauma and can be at added risk of infection from sexually transmitted infections including HIV. Moreover where HIV is concerned, persons who fear or experience violence can lack the bargaining power to negotiate for safer sex. The majority of persons affected by GBV are women and girls, but men are not exempt.

Apart from the suffering of individuals, the impact of GBV can also be seen at a macroeconomic level, as there are costs related to health (treating survivors), justice (bringing perpetrators to justice) and lost earnings, revenues and taxes. A recent study by the professional services firm KPMG, estimated that the cost of violence against women can be as much as 2% of gross domestic product. A study by the same company on South Africa found that violence against women cost the country between ZAR 28.4 billion and 42.4 billion for the 2012/2013 period. (www.KPMG.com/za)

The effects of GBV can have a negative impact on productivity in the workplace, even if the violence takes place elsewhere. This is because the effects of such violence are sustained and remain with victims even as they enter the workplace (www.un.org/women). Work performance of employees that are survivors of GBV can suffer, motivation and commitment amongst other staff members may also be affected, and this can in turn affect absenteeism and turnover. Companies have a vested interest in ensuring that their workplaces are safe and free from violence and to also help those employees that have been affected by GBV. Raising awareness and implementing policies on sexual harassment are some of the measures that can be used. Babcock Ntuthuko from South Africa is one example among many from the SWHAP network of a company proactively working to raise the profile on GBV and sexual harassment in the workplace.

“Home safe every day” an example from Babcock Ntuthuko South Africa

Wellness is an important component of how business is run at Babcock. The company is committed to ensuring that all employees go home safe every day. The nature of work, servicing boilers, means that all aspects of health, mental, physical and emotional, impact safety. In 2013 the Wellness Committee at Babcock Ntuthuko Generation initiated a programme to raise awareness on GBV and sexual harassment at the male dominated workplace.  The objectives of the programme were to promote understanding of sexual harassment in the workplace, clarify company policy on the subject, highlight zero tolerance of sexual harassment, and to encourage any victims to come forward.  The programme also addressed cultural norms and stereo types on masculinity that perpetuate GBV.

Forums and industrial theatre were used to enhance messages in a visual manner and explain the sexual harassment policy in a way that was memorable for employees. Voluntary counselling and testing was also offered after each performance. The programme reached all the employees at Babcock, a planning and implementation challenge considering that Babcock employees are located at five external power station sites.

Results of the initiative:

  • Employees were educated on sexual harassment policy and procedure
  • Employees were educated on how to identify the different forms of sexual harassment and the reporting procedures
  • Trust was built between management and employees and reassured GBV survivors of management commitment to fair treatment
  • As a consequence of offering VCT after each performance, an additional 43 HIV positive employees were identified through the programme and initiated on to treatment and or support.
  • Confidentiality was re-enforced
  • No new cases of sexual harassment have been reported since the initiative was completed

Babcock Ntuthuko were the recipient of the SWHAP Achievement Award 2013 for Best Progress in workplace programming. This initiative highlighted the importance of working with men to address issues of GBV.

IMG_4637

Related articles:

Gender Based Violence 

Felix Mwanza advocate for access to treatment

FelixIn Zambia, Felix Mwanza is a well-known HIV and AIDS activist, advocating for equitable, affordable and sustainable access to treatment, care and support for people living with HIV and AIDS in the country. During the 10th Anniversary Conference held by the Swedish Workplace HIV and AIDS Programme, he gave a moving and inspiring testimony of how he became an advocate. His story is one that highlights personal leadership, passion and the importance of a good support structure when dealing with HIV diagnosis.

My task is to give HIV and AIDS a human face. I liken my situation when I found out about my status to what is happening with Ebola, there was no treatment, no one to take care of the sick and a lot of stigma. My CD4 count was a single digit at the time of my diagnosis. I was afraid to tell my wife, until she told me she just wanted to know what was wrong with me. I asked if she was prepared for HIV testing, to which she responded, yes. 

A positive diagnosis can be a nightmare if the spouse or partner is not supportive. In fact I managed to pull through because I had a very supportive wife and my family was also on hand to help me out. It is very important for couples to participate in couples counselling as it allays fears and subsequent backlash and misunderstanding that may ensue after a positive diagnosis.  Suffice to say, women are more understanding if their husbands are found to be HIV positive first, but in most cases it is complete opposite if the woman tests HIV positive first. I was lucky that my wife did not abandon me.

The physician who diagnosed me at the time told me that treatment was expensive and not sustainable. At ZWM 286 per month(about USD 48) the cost was beyond the reach of many. My uncle bought the expensive medication before I got back on my feet and started purchasing the drugs on my own.  I made the decision to leave my job as a software engineer in order to join the advocacy movement. I wanted to provide leadership so that each and every person living with HIV could feel special. After reading a story in news magazine on People Living with HIV (PLWH), I volunteered to be part of a PLWH group.

Felix Mwanza is now the Director of the Treatment Advocacy and Literacy Campaign (TALC) based in Lusaka, with over 100 affiliates throughout the country. TALC works with nongovernmental, faith and community-based organisations focusing the nation’s attention on the plight of PLWH. Zambia has a generalised epidemic mainly driven by unprotected heterosexual activity. TALC advocates for behaviour change sensitising communities on the importance of having one partner and using condoms.

Felix is an example of personal leadership in health and strongly believes in the importance of everyone playing their part. When the existence of the Presidents Emergency Plan for AIDS Relief (PEPFAR) was threatened in 2008, Felix wrote a letter to President Obama petitioning for the continuation of the commitment to support HIV and AIDS prevention, treatment and care programmes in developing countries, as stopping it would have meant a death sentence for many people, himself included.

He encourages others to be responsible citizens. I am a global activist, I contribute to the national development of this country, through paying my taxes.

Felix also highlights the important role workplaces can play in addressing HIV and AIDS.

Invest in workplace programmes. If I had died at the time I was diagnosed, my skills and expertise would have gone to waste. Investment in workplace programmes allows the retention in expertise ultimately improving productivity. There is a ripple effect, people you save through such programmes will also save other lives. My CD4 count is now above 1000. I have been on first line treatment for the last nine years. I shall continue to advocate for treatment and prevention strategies.

SWHAP has been working in partnership with four Zambian companies, Atlas Copco, SKF, Sandvik and Orica Mining Services, in the Copperbelt since 2005 and more recently with ABB, Bayport, Ericsson and Scania Hazida in Lusaka. In total over 6400 employees have been reached through the programme in Zambia, including companies participating in the Atlas Copco Supply Chain Programme.  The SWHAP Supply Chain Programme assists companies in mentoring their customers and supply chain in setting up and implementing HIV and AIDS programmes.

Drug resistant TB on the rise

A new report by Medecins Sans Frontieres (MSF) has found that “Multidrug- resistant tuberculosis (MDR-TB) is increasingly being found in patients with no history of TB treatment, indicating that the resistant strains of the disease are being transmitted from person to person” (www.msfaccess.org/outofstep). MDR-TB are new strains of the disease which are resistant to first line treatment. These strains usually develop as a consequence of mismanagement of TB treatment.

The World Health Organisation estimates that in 2013, 480,000 people worldwide developed MDR-TB with 9% of these cases being extensively drug-resistant tuberculosis (XDR-TB). With MSF reporting cure rates of 56% for MDR-TB and only 27% for XDR-TB, these are worrying statistics. A new report by the organisation sheds light on implementation gaps in the current TB response.  The report identifies five gaps: in the diagnosis of drug-resistant TB, lack of prompt and correct treatment after diagnosis, limited access to new drugs, under funding of TB programmes and routine hospitalisation of TB patients as opposed to outpatient care which yields similar results and is more cost effective.

Addressing these gaps will help save many lives, particularly where HIV is increasing the susceptibility to infection. To read the MSF report, please follow the link “Out of Step”. You can also read about how SWHAP partners are addressing TB in the workplace here.

Lunch time discussion raising awareness on TB at Scania Botswana

Lunch time discussion raising awareness on TB at Scania Botswana