HIV/AIDS in Manufacturing and Construction Companies in Ekurhuleni
HIV/AIDS in Manufacturing and Construction Companies in Ekurhuleni
HIV/AIDS in Manufacturing and Construction Companies in Ekurhuleni David Dickinson (Wits Business School) And Marije Versteeg (Madibeng Centre for Research)
2 Executive Summary This report examines the impact of HIV/AIDS on manufacturing and construction companies based in Ekurhuleni and the response of companies to the threats posed by the disease. Three manufacturing companies located within Ekurhuleni and two national construction companies with activity in Ekurhuleni were researched. A total of 31 face-to-face interviews were conducted at company offices or operations, including construction sites in addition to a small number of telephonic interviews with a range of stakeholders.
Relevant company and industry documents were also used when access was granted.1 A small number of relevant meetings at company and industry level were attended by researchers. The Impact of HIV/AIDS Features of the manufacturing and construction industries result in different HIV/AIDS risks and different challenges in mounting effective workplace responses to the disease. Nevertheless, a number of common issues can be identified in regard to the two industries and HIV/AIDS. One shared feature is the lack of accurate information as to the extent of the problem faced by companies. Following on from this uncertainty is confusion as to how operations will be affected by HIV/AIDS.
The potential impact of HIV/AIDS on skills is probably of greatest priority to management. This needs to be placed in the context of wider skills shortages. In both industries it is higher-skilled, blue collar occupations where skill shortages are most acute and where it is feared that HIV/AIDS will have most impact. Within manufacturing this presents problems for companies seeking more efficient manufacturing practices. Within the construction industry it presents problems for its core hourly-paid workforce that forms the backbone of site-based operations.
Absenteeism associated with HIV/AIDS also presents a potential problem especially for manufacturing companies attempting to operate ‘high performance’ workplaces.
The impact on employee benefits presents a complex picture that cannot be understood without taking into account the differentiated systems of social protection operating. More skilled and better-paid employees are at relatively low risk of HIV/AIDS infection but have more comprehensive medical and insurance benefits. While there is likely to be a high incidence of HIV/AIDS among lowest -skilled workers they have very weak systems of social protection; a situation that presents relatively little risk to companies since the cost of HIV/AIDS is borne entirely by individuals, families and the state’s social protection network.
It is the social protection structures of semi-skilled workers that present the greatest systemic risk either because of inadequate healthcare for workers or because of the vulnerability of the industry-based benefit schemes. The emerging tensions (and potential crises) around employee benefits, particularly for semi-skilled workers presents potential industrial relations conflicts. Additionally, a second political economy tension is exposed by these issues; the responsibility of employers and the state to provide health care for employees. Company Responses to HIV/AIDS In the face of emerging threats from HIV/AIDS it is clear that companies in both the manufacturing and construction sector and now mounting workplace responses to the disease.
The response in manufacturing companies is clearly ahead of construction.
In so far as workplace responses have been mounted in construction companies the most immediate problem is the logistical difficulties of running programmes with geographically diverse and changing configuration of activity along with an extremely rapid turnover of employees. In addition to these challenges the nature of 1 Access was generally, but not always, granted. Sometimes documents were promised but then not forthcoming. One company felt unable to provide the researchers with their Employment Equity Plan, despite this being a public document. The document was subsequently obtained directly from the Department of Labour.
3 these workplaces contributes to the risk of HIV infection. The migrant nature of the core workforce (between sites and between sites and families), single sex accommodation, the system of monthly payment on leave weekends, and the relative wealth of employed individuals near poor communities all constitute potential risk factors. The more advanced nature of workplace HIV/AIDS programmes in manufacturing allows a greater analysis of their strengths and weaknesses. The key components of a workplace HIV/AIDS programme are largely (if not fully) understood by most managers responsible for company responses to HIV/AIDS: awareness and education, peer education structures, voluntary counselling and testing, wellness and treatment programmes, and corporate social responsibility initiatives.
The report highlights a number of limitations and tensions associated with these programme elements.
Education and awareness around HIV/AIDS is often approached in a heavy handed didactic fashion. The view underlying this approach – that information will lead to behaviour change – fails to take into account not only the resilience of behavioural norms (and constraints) but also the late nature of current interventions. Interventions need to understand both the cultural context of the intended recipients and the pre-existing beliefs that have been formulated prior to the arrival of those seeking to impart information. Peer educators provide a powerful educational mechanism. However, it would appear that peer educators are sometimes regarded as a ‘cheap option’ by management.
The reaction (or lack of reaction) among some sections of the workforce is, in part, a response to this approach. It also exposes the important fact that HIV/AIDS workplace programmes have to be mounted within often tense industrial relations environments. By and large, even the more advanced workplace HIV/AIDS programmes of the manufacturing companies researched had made limited attempts to introduce VCT programmes. The absence of any treatment offered by companies presents a barrier to the likely success of VCT programmes. This presents a ‘chicken and egg’ situation in that it is difficult to obtain senior management commitment on the provision of anti-retroviral drugs, while the lack of such provision limits the success of VCT interventions that could be used to justify such expenditure.
The provision of health services in general constitutes a complex set of problems for companies. There is recognition that attention has to be given to this area, but there appears to be no consensus on how this should be approached. Industrial nurses are, despite their professional status, often marginal to managerial structures and HIV/AIDS programmes. The state’s provision of health care is limited and relatively difficult for workers to access. Traditional healers, despite being an important resource for many African workers, are totally excluded from company healthcare strategies.
Improving Company Responses to HIV/AIDS Perhaps the major challenge facing companies in responding to HIV/AIDS is not the question of resources (though this is critical) but the ability to co-ordinate a wide range of internal and external agents who can deliver elements of an effective workplace HIV/AIDS programme.
The limited involvement of unions, industrial nurses, and traditional healers, along with tensions around the mobilisation of peer educators, point to limitations in workplace programmes. Further, the almost total lack of co-ordination between company- based and public health provision points to limited co-ordination around responsibility for the national response to HIV/AIDS.
A number of recommendations for interventions and further research directed at addressing the problem identified are put forward in Section 4 of the report.
4 Contents Executive Summary Glossary of Terms 1. Introduction 2. Manufacturing 2.1The Companies Researched 2.2 The Research Conducted 2.3 HIV/AIDS Prevalence in the Companies 2.4 The Impact of HIV/AIDS 2.4.1 Skills 2.4.2 Absenteeism 2.4.3 Employee Benefits and Social Protection 2.5 Company Responses to HIV/AIDS 2.5.1 The Response to Date 2.5.2 Programme Components 188.8.131.52 Awareness & Education 184.108.40.206 Peer Education 220.127.116.11 Voluntary Counselling and Testing (VCT) and Treatment 18.104.22.168 Corporate Social Responsibility: Glossy and Safe or Local and Difficult? 2.5.3 Health Resources 22.214.171.124 Industrial nurses 126.96.36.199 Public Sector Health Provision 188.8.131.52 Traditional Healers 2.6 Process, Actors and Capacity 3.
Construction 3.1 The Companies Researched 3.2 Research Conducted 3.3 The Construction Industry 3.4 HIV/AIDS Prevalence in the Companies 3.5 The Impact of HIV/AIDS 3.5.1 Skills 3.5.2 Absenteeism 3.5.3 Employee Benefits and Social Protection 3.6 Company Responses to HIV/AIDS
5 3.6.1 The Response to Date 3.6.2 Programme Components 3.6.3 Health Resources 3.7 HIV/AIDS and the Cyclical and Geographically Diverse Nature of the Industry 3.8 Limited Duration Contract Workers, the Construction Industry and HIV/AIDS 4. Summary and Recommendations 4.1 Summary 4.2 Recommendations 4.3 Suggestions for further research References
6 Glossary of Acronyms AIDS Acquired Immuno Deficiency Syndrome CIRBF Construction Industry Retirement Benefit Fund CIDB Construction Industry Development Board CSR Corporate Social Responsibility (also CSI – Corporate Social Investment) EMM Ekurhuleni Metropolitan Municipality HIV Human Immunodeficiency Virus HR Human Resources KAP Knowledge, Attitudes and Practices (survey) LDC Limited Duration Contract (i.e.
fixed-term employee) NUM National Union of Mineworkers SAFCEC South African Federation of Civil Engineering Contractors STI Sexually Transmitted Infection (or STD – Sexually Transmitted Disease) TB Tuberculosis VCT Voluntary Counselling and Testing
7 Section 1: Introduction This report summarises the findings of a qualitative research conducted in Ekurhuleni-based manufacturing and construction companies. It provides a detailed, though narrowly focused, addition to the background paper (Dickinson 2004) written for Ekurhuleni Metropolitan Municipality (EMM) Local Economic Development Unit which summarised the possible impact of HIV/AIDS on the Ekurhuleni Economy. As outlined in the background paper it is expected that HIV/AIDS will negatively impact on companies – though exactly how this will happen and its magnitude remains uncertain.
Any impact on the Ekurhuleni companies has economic and developmental implications and is important. So too is the response of companies to HIV/AIDS which might be able to avoid, mitigate or control the impact of the disease.
As indicated in Table 1 manufacturing and construction represent a sizable part of the Ekurhuleni economy. Table 1: Contribution of Manufacturing and Construction to the Ekurhuleni Economy Manufacturing Construction Percentage of Gross Geographical Product (GGP) (2001) 29% 4% Percentage of Employment (2001) 25% 8% Source: Kgori, Lebelo, Johannes & Roberts (2002) Given their share of Gross Geographical Product and employment the manufacturing and construction sectors are of importance in themselves. The purpose of this study was, through a small number of case studies, to identify the possible impact of HIV/AIDS in these two sectors and their responses to the disease.
Studying companies from two different economic sectors allows us to compare the impact and response to HIV/AIDS under different circumstances. Section 2 of the report looks at manufacturing and Section 3 construction. Each section outlines the companies and the research conducted before presenting evidence from the case studies. The extent of HIV/AIDS prevalence is assessed and the possible impact of the disease, particularly in terms of skills, absenteeism and employee benefits, is discussed. The companies’ responses to HIV/AIDS are then outlined.
Section 2, dealing with manufacturing companies, draws attention to questions of awareness and education, peer education, voluntary counselling and testing, corporate social responsibility, and available health resources. This section concludes with a discussion on actual and potential processes, actors and capacity that made up the HIV/AIDS workplace programmes observed. Section 3, dealing with the construction industry, emphasises the multi-tiered level of social protection operating within the workforce and the implications of this in regard to HIV/AIDS. It also discussed the key issue of the project nature of construction work and two critical issues that result from this; migration and the widespread use of temporary workers.
Section 4 draws together key issues raised in the case studies and provides a number of recommendations and suggestions for future research.