Case studies: South Africa

Sister Montimi Malatji, Manager: West Wits Wellness Clinic

Sister Montimi Malatji, Manager: West Wits Wellness Clinic

West Wits, South Africa

West Wits, South Africa

West Wits, South Africa

West Wits, South Africa

Increased ART uptake at TauTona

HIV & AIDS remains an issue of concern in African countries, with sub-Saharan Africa most affected. As part of its response to this pandemic, AngloGold Ashanti’s South African HIV & AIDS programme is comprehensive, as this is where the disease has had its greatest impact and where the company has the greatest number of employees.

In line with an increase in voluntary counselling and testing in South Africa, there has been a similar rise in participation in the AngloGold Ashanti wellness programme, as those who have tested positive for the HI Virus are persuaded to manage their health proactively. While the programme has achieved significant uptake at both the Vaal River and West Wits operations, TauTona mine seems to have enjoyed most success. The number of employees infected with HIV who had signed up for the anti-retroviral treatment (ART) programme by October 2008, exceeded the originally stated 25% target of membership on the programme. The figure currently stands at 29%.

“This figure is based on studies conducted in 2000 on the prevalence of HIV & AIDS in the mining industry. We expect that 30% of our [South African] workforce is infected with HIV so our target is based on the fact that they should all be registered with the wellness programme, subject to them being tested first,” explains Buti Kulwane, HIV & AIDS Manager. “Of the 30% infected, the target is that 25% would be on treatment as those individuals would be in more advanced stages of the disease and would therefore require treatment.”

Out of a total of 3,716 employees at TauTona, 1,074 are HIV positive and are already registered on the wellness programme. It was expected that 228 HIV-positive individuals would be on treatment, however, the operations are currently distributing antiretroviral treatment to 348 employees. Statistics also show that TauTona’s number of sick leave days taken in relation to HIV & AIDS has dropped, as have the number of employee deaths related to HIV & AIDS, since the implementation of the wellness programme. TauTona had a total of 15.1 deaths in every 1,000 in 2004 and it came down to 7.4 in the second quarter and 5.4 in the third quarter of 2008. “We assume that deaths have dropped because more employees are healthier because many of them are registered in the Wellness programme,” says Kulwane.

Another contributing factor to the success of the project is the presence of peer educators – AngloGold Ashanti employees who are mobilised to provide HIV & AIDS counselling and support to their colleagues.

“In 2005, we started accredited training for peer educators; to date we have trained 749 people. Our target is one peer educator per 50 employees. At TauTona, we have exceeded this target: instead of the targeted 74 peer educators in the workforce, we currently have 100,” explains Kulwane.

Elements of the wellness education programme include induction sessions to motivate new employees to get tested and treated; quarterly campaigns which focus on voluntary counselling and testing; and alignment of company initiatives with calendar AIDS initiatives such as World AIDS Day, Youth Day and Condom Week.

Underground ‘green area sessions’ are conducted during which a shift team spends time talking about safety prior to beginning work. These vital meetings include information on HIV & AIDS.

The formal testing and wellness programme at West Wits is conducted primarily at the Western Deeps Level Hospital in Carletonville, which serves the employees of AngloGold Ashanti. Five counsellors, three professional nurses and a doctor are based there and provide comprehensive and continuous post-testing wellness advice. Additional counsellors have also been placed at the Savuka, Mponeng and TauTona medical stations for easier access for employees.

“We have also found it very beneficial to work in partnership with employee bodies; we hold regular mass meetings with the National Union of Mineworkers where HIV & AIDS issues among staff are discussed. The union’s shop stewards and other leaders are also trained as ambassadors of HIV & AIDS education,” adds Kulwane.

These interventions serve ultimately to encourage behaviour change: creating a culture of regular HIV testing which will hopefully erode the stigma associated with the disease and, most importantly, provide the affected individual the opportunity to acquire essential treatment to manage the disease.

Kulwane explains that treatment continuity is a priority even when employees leave AngloGold Ashanti. Doctors provide the patient with a three-month supply of ART and refer him/her to a government facility where treatment can continue.

The programme does, however, encounter challenges on a daily basis. “For instance, we have traditional healers encouraging people to take herbal medicine instead of ART which can be problematic, as the effectiveness of traditional medicine is not proven,” he explains.

“We have people dropping out of treatment; some get tested while they are still well and they wait until their condition has deteriorated too far before they begin treatment, which negatively impacts recovery. These are a few of the reasons wellness and HIV & AIDS education is a work in progress,” concludes Kulwane.


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ANGLOGOLD ASHANTI Report to Society 2008