Combating HIV-AIDS through workplace action

Combating HIV-AIDS through workplace action

'HIV is a workplace issue. Trade unions should lead the fight against the disease from the shop floor; they should start VCT clinics and care centres', says Annette, a Ugandan nurse from Kampala.

The success of the Workers' AIDS Project in Uganda launched in partnership with the National Organisation of Trade Unions (NOTU) in 2009 depended crucially on the close collaboration between men and women involved in its implementation. In a conversation with Bandula Kothalawala, TUC International Officer, they expressed candid views on a range of issues relating to HIV-AIDS in Uganda.

Annette Birungi is a qualified nurse attached to the Oral Surgery Unit in the Mulago Hospital-national referral and teaching hospital with some 1,500 beds. Annette has been working there for four years now. She had worked at the Mbarara Referral Hospital before. The thirty-year-old nurse comes from the Kabale District in south-western Uganda.

'As a nurse in the Mulago Hospital, my impression about HIV/AIDS prevention is not good because I feel that there is a lot of stigma. Many nurses and midwives have died without taking ARVs because they were not well informed about the disease and did not receive proper treatment', complains Annette. 'Nurses have left orphans who have nobody to care for them. Health insurance is not enough. When nurses fall sick, they cannot always afford the drugs doctors prescribe for them', says Annette. As for doctors, Annette says, 'I believe that medical practitioners, too, need training in the treatment and care of HIV/AIDS patients; sometimes, they seem to fear the very patients they are supposed to treat!'

Member of the Ugandan Nurses' and Midwives' Union, Annie, as she is known among her colleagues, has been involved in the Project since its inception. She is one of the Focal Persons of her Union and has played a leading role in winning support for the Project among her colleagues. She has taken part in awareness-raising activities and trained six people in prevention strategies. In addition, she is very keen on the promotion and protection of employment rights and entitlements of those affected by HIV or infected with it. She has also been instrumental in convening monthly meetings on HIV/AIDS, the training of shop stewards and in the dissemination of information and education material. Moreover, she has helped in the distribution of condoms.

'I believe that the Project has made it possible for us to get together, discuss our problems and share knowledge and experience in solving them. It was great; HIV is a workplace issue; trade unions should lead the fight against the disease; they should start VCT clinics and care centres', says Annette in conclusion.

Florence Lubenga is a qualified nurse. She, too, works in the Oral Surgery Department of the Mulago Hospital in Kampala. Florence hails from the Luweero District in Central Uganda.

The 45-year-old single mother with two children, one of whom she lost last year, is adopting another child. Florence has been introduced to the Project by Annie, her colleague in the same Department. Her involvement in the Project has been mainly concerned with awareness-raising of risks of infection and preventive methods among her colleagues and their families.

Florence has been encouraging colleagues to know their status so that they could go for appropriate treatment and receive counselling and care if they tested positive. She is also keen to ensure that those affected by the disease or infected with it are fully aware of their employment rights and entitlements. She considers it extremely important that stigma, discrimination and marginalisation associated with HIV/AIDS be eliminated from workplace and from the community. She points out that, contrary to the public perception that nurses are knowledgeable about the pandemic and the risks of infection, many of her colleagues are indeed not well informed about HIV/AIDS and that they are 'just as scared of it as the average worker.' Florence continued on the challenges facing workers who test positive.

'It is sometimes necessary to test people more than once, as they refuse to believe the results. They need a lot of counselling and support before finally accepting a positive result. There is often a great deal of anxiety, fear and even a sense of despondency when people test positive. Many become depressed, especially married women who have been faithful to their husbands', explains Florence.

'The fear of separation is overwhelming. They sometimes beg to be given negative results', adds Florence. 'In some cases, it is too late when they come to hospital. The disease is already in an advanced state and options are limited. The fear of losing their job is often one of the most difficult issues to overcome', says Florence.

She makes a number of suggestions to help workers living with HIV/AIDS. She is of the view that:

There should be special clinics for working people where confidentiality is strictly observed.

People need support when they are no longer able to work. There should be income generating activities organised in small clubs.

There should be bursaries for children when their parents are no longer able to send them to school due to the illness.

They also need shelter when they can no longer afford to pay rents and that,

People living with HIV/AIDS should also be able to travel freely from country to country. At present, they are denied visas in many countries.

'It's necessary that employers understand and recognize that people with HIV can change their condition anytime anywhere and that they should not be harassed when they cannot turn up for work', concludes Florence.

Project Coordinator

Baligasima Yazidi has been the Project Co-ordinator for the past two years. He was responsible for organising all activities in the implementation of the Project. In addition, he was instrumental in making arrangements for the evaluation visit in March 2011.

Yazidi is 32 years old and married. His wife, Hidhat, is expecting their first baby. They live in Kampala. Hidhat is a graduate from the Nkumba University. Yazidi who holds a degree in public administration from the Islamic University in Uganda, Mbale, is at present studying for a master's degree at the Uganda Management Institute. The Project Co-ordinator comes from Jinja - city on the shores of Lake Victoria, 87km east of the Ugandan capital.

Yazidi successfully organised all project activities - training of shop stewards and focal persons as well as the production of information and education material - in collaboration with the unions affiliated to the National Organisation of Trade Unions (NOTU). He has developed close links with a number of agencies concerned with HIV/AIDS in Uganda such as the Uganda AIDS Commission (UAC), AIDS Information Centre (AIC), The AIDS Support Organisation (TASO). He sums up the HIV/AIDS situation in Uganda as follows.

'Uganda was among the first countries to come out strongly on HIV/AIDS. This has helped us to reduce its prevalence in the country. Uganda is indeed one of the successful stories in Africa. We also recognize that it is seriously affecting workers. So we have come out with an HIV/AIDS Workplace Policy. It is aimed at reaching out to workers in all workplaces. We hope that the incidence will be reduced to the minimum in time to come', says Yazidi.

According to the Project Coordinator, the WAP has helped the NOTU to reach out to most of its affiliates. They have been sensitized about HIV/AIDS. Many union members have gone for testing. Those who were diagnosed with HIV have started treatment. However, many still need to be approached. Yazidi wishes to request the TUC to continue its support. 'This project not only promotes awareness of risks of infection, but it also improves trade union membership. In other words, in addition to reducing the prevalence of the disease, it helps us to increase membership in our unions', notes Yazidi.

'What is required now is to have more Peer Educators and more workplace programmes', points out Yazidi.

Support from NOTU affiliates

Odongpiny Charles Luwum is the HIV/AIDS Focal Person in the Uganda Building Workers' Union. Charles, aged 38, too, has been closely associated with the Project from the beginning. Father of twins and two other children, Charles lives in Kampala and has been involved in the training of peer educators. He was also responsible for awareness-raising activities on the shop floor. He explains the role of peer educators in the awareness-raising campaign:

'Peer educators talk to colleagues individually and encourage them to go for testing and provide counselling as well. They also play a role in the elimination of stigma and discrimination at workplace'.

Charles who began his career as a porter has been in the Union for 13 years now. He is following a diploma course in leadership in the Uganda Christian University (UCU) in Mukono, 23km from Kampala. He is a third-year student in the UCU. He looks forward to acquiring more skills and experience.

He claims that Uganda is one of the countries that have done well in combating the pandemic. 'But there is a need to help unions to carry on their work on HIV/AIDS at workplace for the benefit of workers', emphasizes Charles.

'I am really grateful to the TUC for its support for the NOTU. Our union has long been fighting HIV/AIDS at workplace. The support from the TUC has enabled us to train more peer educators', says Charles in gratitude.

Working hand in hand with employers in combating HIV-AIDS

Godfrey Businge - qualified nurse - is in charge of the Health Centre at Roofings Ltd Uganda. The Company is specialised in the manufacture of steel construction material and employs some 2000 workers. According to the Company website, 'Roofings Ltd strives to be a one stop shop for all steel building requirements'. In a conversation with Bandula Kothalawala from the TUC, Godfrey described the function of the Health Centre:

'We see about 30 workers a day here. They come with a variety of health problems. On the average, there are one or two cases of HIV per week. We test them here and then refer them to appropriate institutions for treatment. We use Determine for testing workers for HIV. It is quite easy and can be used in non-clinical settings'. 'The Company bears the cost of treatment when workers are referred to hospitals', clarifies Godfrey. 'The Company attaches great importance to its workforce. Health and safety is a top priority for us. We do care about their wellbeing and do our best to accommodate their needs', adds Chris Mayenda, Environment, Health and Safety Officer.