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Last Updated: Wednesday, 26 November, 2003, 08:39 GMT
The brutal reality of a dying workforce

By Briony Hale
BBC News Online business reporter in Gaborone

In Botswana - where more than one in three adults is HIV positive or already has Aids - no company is immune from the ravages of Aids. A generation of workers is dying.

Some companies are tackling the disease head on and providing healthcare and education. Some are still doing next to nothing, trying to pretend the problem doesn't exist.

BBC News Online looks at two firms taking two very different approaches.

In both cases, the nature of the work has required workers to move away from their traditional lifestyles, fuelling the spread of the disease.

In both cases, money is the underlying motive for the firm's action or lack of action.

  • "I'd be scared to talk about it [Aids], even with our very senior workers
    Mike Hehir (right)
    "They're fading away before your eyes, they're trying to work but they can't - it's heartbreaking to watch."

    Mike Hehir, the owner of one of Botswana's long-established construction companies, is describing the brutal reality of a workforce - in this case construction workers - who are dying from Aids.

    "They have to keep coming to work, they need the money, what can we do to help, except keep employing them and try not to look," he asks.

    "We lost one of our painters just last week, they dare not say its name, they say nothing, or maybe that it was TB," adds Tony O'Connell, a partner at the firm.


    The two Irishmen set up their business in Botswana in 1970, choosing Selebe Phikwe as a base. The town has since become infamous as one of the epicentres of Aids.

    Construction workers on building site in Gaborone
    Many construction workers are already very weak
    The life-prolonging anti-retroviral drugs are not yet being distributed there and there is precious little prevention work going on.

    The company - like most construction firms - has an extremely fluid workforce - ranging anywhere from 400 to 1,600 depending on the projects at any one time.

    All but a handful of the workers are on short-term contracts, meaning that no severance pay or pension is required by law unless they have been in employment for five years in a row.

    "If a guy dies after four and a half years there is no obligation to pay him anything," explains Mr O'Connell. "But out of compassion we try and help with the cost of the coffin or the funeral."

    Magnet for prostitutes

    The fact that the workers are required to move around a lot without their families is making matters worse.

    "We've just moved the guys from Selebe Phikwe down to Gaborone, now we're moving further up north. They have wives in their home villages but you can see the prostitutes in the towns," Mr O'Connell says.

    Both men stress that the disease is costing their business a huge amount of money.

    "The downtime is phenomenal. If I take on a labourer, a bricklayer or a carpenter, I factor in an additional cost of 40% to his wage to cover absence," explains Mr Hehir.

    Despite the desperate state of affairs, the company is not doing anything directly to tackle the issue.


    The huge social stigma that surrounds the disease is one of the reasons why.

    "I'd be scared to talk about it [Aids], even with our very senior workers," says Mr Hehir.

    The only way in which the disease is confronted in the workplace is when other organisations come in from time to time to give education seminars.

    Warrick Lattin, who chairs Botswana's association of building firms, defends the practices of construction companies, admitting that the very nature of the business makes it difficult to offer better benefits or help distribute drugs.

    He also says construction firms - which are facing fierce competition from Chinese firms in particular - can genuinely not afford any extra costs, and explains that many are already running on negative cash flow and very tight profit margins.

    While it may be true that some firms cannot afford to do more and that healthcare is ultimately the responsibility of the government, it does nothing to tackle the tragedy of dying workers.

    Economists warned us it would be more expensive to do nothing
    Louis Nchindo
    MD, Debswana
    In 1998, Botswana's giant diamond firm Debswana became the first company in Africa to offer its workers free anti-retroviral drugs.

    It was amongst workers at the diamond mines that the horrifying scale of the Aids pandemic in Botswana first started to become apparent.

    In some sectors of the workforce, up to 40% of staff were found to be HIV positive.

    Louis Nchindo, the firm's managing director, is blunt about the reason why his firm took action.

    "It's cost-effective. Economists warned us it would be more expensive to do nothing - if we didn't do anything it would cost us a lot more at the end," he explains.

    At Orapa - the largest diamond mine in the world - 3,932 mine workers and their families live in a purpose-built township adjacent to the mine.

    By building a hospital at the mine and giving workers free drugs, the company estimates it has prolonged 125 lives so far.

    And a high profile education campaign has led to the overall level of prevalence amongst its own workers falling from 27% in 1999 to 21% by 2003.

    'Medical apartheid'

    Contract workers - which can make up to half of the workforce at any one time - were not given drugs by the company, in what the mine doctor describes as "medical apartheid".

    These workers now have access to drugs from the mine hospital following the government's decision in 2001 to pay for drugs for everyone, but their travelling lifestyle makes effective treatment very difficult.

    There are about 3,000 contract workers at Orapa, primarily doing work such as maintenance or new construction. The alarmingly high level of HIV infection of 40% prevalence has not fallen.

    These workers - who often have no family base and typically move from project to project - have fuelled the spread of the disease.

    The very nature of the insular township - in the middle of semi-desert wasteland - is also unhelpful.

    "There's nothing to do here. Everybody knows everybody else. What else is there to keep you busy? That's why there's a lot of illness here," one worker at the mine told BBC News Online.

    Mr Nchindo, however, is convinced his company can effectively manage the impact of HIV.

    "We plan for the future - we test our people - we know the levels and trends and can manage the problem," he says.

    Ethical concerns

    The company identifies what they called critical workers - staff who need a significant amount of training and are vital to keep the business functioning. This may be anything from truck drivers to diamond sorters.

    "When somebody in one of the critical areas starts treatment I warn management - without disclosing who it is - that one more needs to be trained," explains Dudley Wang, Orapa's chief medical officer.

    The drugs only typically prolong life for between five and 10 years.

    The workers, however, are deeply concerned about the watchful eyes of the management.

    The stigma is enormous and not a single worker at the mine has come forward to publicly declare their status.

    Of the 500 or so people being given antiretrovirals, more than half are enrolled at national distribution centres - meaning they are travelling between 200km and 500km to get the drugs they need rather than going to the mine hospital.

    There have also been ethical concerns raised about the notion of keeping people alive in order to work.

    While the idea of companies giving out drugs because it is a cost-effective solution seems brutal, at least workers are being given the chance of a longer and more productive life.

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