Like any project, the vision and commitment of the drivers make the difference. MBSA’s Dr Clifford Panter and Siyakhana project manager Dr Simeon Odugwu keep the Siyakhana project moving.
Panter was part of the team that conceptualized the MBSA HIV and AIDS work place policy and four years ago the company resolved that 25% of its corporate social investment spend would go into addressing HIV and AIDS.
“MBSA has a vested interest in the stability and economic growth of the communities and regions in which we are based. In looking at developing an HIV and AIDS project that assisted suppliers and particularly smaller companies who typically have neither the time, resources nor expertise to address HIV and AIDS, we believed there were a number of key elements the project should address,” Panter said.
“Firstly we know that any information, education and communication activities to promote testing have low penetration if they are not supported with an offer of treatment if this proves necessary. Similarly treatment is less likely to be strictly followed, if there is not seamless access to support. The project provides this through workplace voluntary counselling and treatment (VCT) and then a patient wellness programme.
“Secondly while we believe in principle that people should be able to access treatment within the public health sector, our research and conversations with local business indicated we might need to rethink this as an intermediate and emergency measure. What we were hearing was that their staff go to clinics and don’t get treatment, so we established the general practitioner network so that people can access quality treatment easily.
“Next we looked at what we could do to ensure that over a period, we could migrate people on treatment back into the public health services and we have boosted capacity at seven Buffalo City clinics in the form of 21 staff, deployed evenly throughout.”
Panter said that this component of the project has been quite a hard sell to funders and business who rightly believes that government in South Africa has the resources to run efficient clinics, but as the situation currently stands, there is a strong argument for augmenting the public sector to get people onto treatment.
Mindful of the National Strategic Plan on HIV and AIDS’ target of halving new infections by 2011, Panter says Siyakhana needs to look at being more radical in its activities around social mobilization to encourage status knowledge.
“Unless we handle prevention more strategically our clinics will continue to be swamped with people needing treatment. Yet workplace programmes are not always the best site to talk about changes in sexual behavior, which is why we need as many voices saying the same thing.”
“It is easy enough to have a technical approach, one partner at a time with a condom, but we know many South Africans practice multiple concurrent relationships and there needs to be mobilization of a single mantra across civil society with leaders from churches, trade unions, schools and universities encouraging one partner at a time with a condom – it worked in Uganda where a number of the social economic demographics are similar to South Africa’s.”
Panter said MBSA’s involvement in the Siyakhana project goes beyond simply funding and that there is day to day guidance activities, which is significantly more satisfying than simply providing money and receiving reports.
Panter’s guidance and experience in HIV and AIDS both from policy formation through to implementation is highly valued by Odugwu.
The Eastern Cape sometimes struggles to get to bring new skills and expertise into it and the Siyakhana project considers itself particularly fortunate that Dr Odugwu was willing to give up a permanent job as the Chief Medical Officer at the National Health Lab Services and a lecturer at Wits for a 20 month contract in East London.
“After living in Johannesburg for ages, it is easy to think that is where life is and that it wouldn’t be easy to go anywhere that was better,” said Odugwu who hails from Nigeria. Place is part of his narrative. Within a month of his birth, Odugwu’s family fled their rural home town, and took refuge in a nearby forest and when they returned their town had been totally destroyed by Nigerian Federal Forces during the Nigerian Biafran War of secession. “There is not a single building standing in my hometown that was there before 1970.”
And now he is in East London where he has adjusted to the laid back pace and can’t think of going back to Johannesburg. So what made the Siyakhana offer attractive?
“I wanted to make a direct impact on the every day lives of people and I have had an interest in working in the HIV and AIDS field. Working on the Siyakhana project could not have been a better way of achieving these objectives. It has really been fulfilling.
“Previously I was working on my own and I have found working with Clifford inspirational and I have valued having easy access to his years of experience in the field. I thought the programme comprehensive but quite a tall ask since we targeted 20 companies in the pilot phase and the programme had to be replicated in each.
“Certainly once we began implementing the model, we realized the need for it to be organic and evolve. Initially we wanted to work with companies who could demonstrate they had been thinking about HIV and AIDS and had existing workplace policies. We also wanted to conduct prevalence surveys as useful baseline data.
“What we found was that many companies hadn’t thought about HIV and AIDS and we were aware that with the necessary consultation required to develop a policy this might prevent us getting into workplaces for months. Also conducting the prevalence surveys could have taken months and while we were doing this, the virus would have spread and people would have died. So we decided to hit the ground running, and although from a scientific point of view, it may have been less rigourous than intended, we conducted VCT in 17 companies and over 3000 people were tested and over 200 are active in our treatment programme.
“We now have 28 new companies who have indicated a willingness to join Siyakhana and in this phase we can take on the smallest SMME which we are extremely pleased about because their needs are greatest,” Odugwu said.