According to the 2007-2011 national strategic plan to combat HIV and Aids, new infections will be reduced by 50% and access to treatment, care and support expanded to 80% of those diagnosed with HIV.
The year 2011 should have been a big year for mitigating the impact of HIV-Aids and sexually transmitted infections in South Africa. However recent statistics related to the cohort of individuals of whom farmworkers form a part belie this.
Farmworkers in Limpopo and Mpumalanga’s commercial agricultural sector suffer the most, with HIV-prevalence levels around twice that of the general population. This was revealed last year by an international organisation for Migration (IOM) survey conducted with 2 810 individuals employed on 23 farms in three regions of Limpopo.
IOM claimed that “the prevalence of HIV among the farmworkers in this study is the highest published level among an employed population in the region”. out of 2 798 participants whose HIV results were available, 1 106 (39.5%) were HIV-positive, more than half (52.2%) of farmworkers infected were between the ages of 30 and 39 years and 46% of women tested HIV-positive, followed by a third of men.
Already in 1992, the rural Foundation (RF) sprang into action on a voluntary basis to combat HIV in the farming community of Hoedspruit, located at the base of the drakensberg mountains on the border of the Kruger national Park. in 2006, RF became the Hoedspruit Training Trust (HTT) and their initiative, Hlokomela: Farm workers care for Each other, was one of IOM’s first partners to develop an effective local health and wellness network for the farming sector. it reaches more than 10 000 people annually with various HIV-Aids-related programmes, treats 500 farmworkers with ArVs and maintains an 80% adherence rate.
When Hlokomela started on 18 farms, noone openly lived with HIV. Today, cultures of HIV disclosure and destigmatisation are the norm on the 69 farms it services. integral to this are Hlokomela’s nompilos who empower farmworkers to safeguard their own health through continual peer education. nompilos are nominated by farmers and employees and undergo rigorous training to provide healthcare information on farms. They are farmworkers themselves who become role models in their communities. Hlokomela started with only 18 nompilos, but today they employ 63. Thirty eight of them are paid a stipend by the department of Health.
The local authorities are not just taking notice of Hlokomela’s work, they are, in fact, relying on it. The local Maruleng municipality has a limited capacity to address the problem of HIV infection on farms and depends on the project to connect these vulnerable far-flung communities to health services. Hlokomela’s three clinics – all accredited by the Health department – attract patients from as far as Phalaborwa, about 100km away. Farmworkers trained in home-based care on 28 farms also take primary healthcare to the homes of fellow farmworkers who are too ill to travel to clinics.
Hlokomela creates communities of local activism through gender intervention workshops run for men and women, and public education on HIV and other related issues conducted at the local prison and shebeens. They respond creatively to the challenges illuminated by IOM’s study which noted that overall, 12.8% of males and 14.4% of females were forced to have sex against their will in the last year, while around one in 10 employees engaged in “transactional sex”.
Additionally, Hlokomela helps improve farmworkers’ employment conditions – another key recommendation of IOM’s study which reported that 30% of employees complained about harassment or discrimination in the workplace. Hlokomela recently published the workplace policy on life-threatening iillness.
It has already implemented this on all participating farms. it guides farm management in being more responsive to aspects of treatment and support for life-threatening and other chronic illness. This document took a year to develop with input from both farmers and employees and can be read in English, Tsonga and Sotho. it is used both domestically and in the southern African region.
Hlokomela is not all work and no play. They regularly organise healthy, fun recreational activities which also feed into their awareness campaigns. Hlokomela’s netball and soccer matches, annual Mr and Mrs HIV pageants, golf days, music and drama shows are attended by farmworkers and Hoedspruit’s broader farming community. Such interventions that improve the self esteem of farmworkers are vitally important. The IOM study also found depression and/or anxiety to be the second most common (13.8%) chronic illness after HIV.
In Hoedspruit, Hlokomela is everywhere. on billboards, nompilos, local municipal officials, farmers and farmworkers encourage people to get tested. Their slogans – Two is Too Many and it’s My Turn to Talk about My Life and Aids – are painted on walls and printed on T-shirts. Their strategic partnership with local community radio and newspapers publicise their many accomplishments, latest news and stories about farmworkers’ lives. Even game farms and lodges in the area serve food made with herbs grown at Hlokomela’s productive community garden. A food bank now distributes food donated by farmers and a new charity shop has been running this year to raise capital for a new hospice.
A 2006 study found that Hlokomela’s HIV Aids programmes together with other IOM partners reduced absenteeism and productivity losses, and saved six of seven companies an average of R329 per employee annually. This is one way South Africa can unite its farming communities against the scourge of HIV to improve the quality of life for farmworkers!
Read about the creative ways South Africans solve public problems every week from the Impumelelo Social Innovations Centre, the country’s repository for solutions that improve quality of life for the poor. If you have instituted an innovative project that alleviates poverty, apply now for the 2012 Impumelelo awards or visit impumelelo.org.za. Rhoda Kadalie is executive director of Impumelelo.
Originally published in The New Age on 19 September 2011