Workplace and our people | HIV and AIDS

Our approach to HIV and AIDS recognises that the disease, its contributing factors and impacts require an integrated, sustainable approach, incorporating workplace and community initiatives and addressing contributing factors in addition to direct testing and treatment services. We employ around 11,500 people in South Africa and estimate that approximately 20% of our South African workforce is HIV positive. Following the acquisition of Falconbridge, we also operate in Tanzania and Dominican Republic, where HIV prevalence rates are elevated.

The business benefits of direct intervention include lower costs due to reduced absenteeism, lower recruitment and training costs, fewer families receiving death benefits, improved workplace morale and safety performance, and greater productivity. The principal business benefit of our community intervention programmes is to ensure the success of our workplace programmes can be sustained, resulting in no or very low levels of new infections, and HIV positive employees accessing treatment, remaining well, fit and able to participate fully in the workplace. Other significant benefits to Xstrata include improved community support and governmental relationships and an enhanced corporate reputation, closer, more co-operative relationships with unions and employees, lower employee turnover rates and the ability to attract talented individuals within our South African operations in an increasingly competitive environment.

Our approach to HIV and AIDS aims to:

• address contributing factors to the spread of the disease, both those associated with the mining industry and wider community issues;
• encourage 100% of employees, contractors and their partners to take up voluntary testing for HIV;
• encourage 100% of HIV positive employees and family members to take up free treatment;
• empower people to take individual responsibility for their health and eliminate the stigma associated with HIV and AIDS;
• engage traditional healers, peer educators and community outreach champions to promote safe sex, voluntary testing and treatment;
• support initiatives to address the impacts of HIV and AIDS on communities; and
• work together with government, NGOs, specialists and other companies to broaden our impact area as far as possible and ensure long-term sustainability for our programmes.

Workplace initiatives

Voluntary counselling, testing and treatment

Our workplace programmes in South Africa began in 2004 with prevalence, knowledge, attitudes and practices surveys. A cost-benefit analysis was undertaken, which estimated that the cost of ‘doing nothing’ to address HIV and AIDS amongst our workforce would add approximately 3%–6% to the annual wage bill. This analysis supported the business case for rapid intervention and voluntary counselling, testing and treatment (VCT) programmes were rolled out shortly afterwards. VCT programmes are run by an external partner, ReAction!, to ensure employee confidentiality and anonymity and encourage take-up. VCT is also provided to employees’ partners and family members free of charge, and to the community, through our public-private partnership and the Breyten health clinic (see below).

An important aspect of the workplace programmes is the HIV/AIDS steering committee established at both Xstrata Alloys and Xstrata Coal. These committees bring together union representatives, employees, senior managers, health professionals and consultants, to consult on and manage the roll-out of workplace initiatives. These committees have had an added benefit of fostering improved labour relations at the majority of operations and an increased level of trust amongst workers and management. Xstrata Coal and Xstrata Alloys have also established operational AIDS committees, led by the General Manager, which meet on a monthly basis and review take up of VCT and other indicators to determine what additional action needs to be taken.

Xstrata Coal senior management participate in the VCT programme, to demonstrate visible leadership and support for the programme. HIV and AIDS intervention has been introduced as a key performance indicator for site managers. Indicators measure the percentage of the workforce participating in health interviews and offered testing, the effectiveness of HIV and AIDS committees in place at sites and the effectiveness and frequency of training for peer educators. Programmes are regularly reviewed and evaluated to enable ongoing improvements to reach our targets.

Wellness Champions, comprising volunteers from the workforce, have been trained at Xstrata’s operations to encourage and support employees to take up voluntary counselling, testing and treatment and to break down the stigma associated with HIV on a formal and informal basis. Bi-monthly training is being implemented for Wellness Champions on general wellbeing, health and HIV related subjects. The ratio of Wellness Champions to employees is approximately 1:80.

In 2006, Xstrata Coal’s workplace voluntary counselling, testing and treatment programme moved to a continuous phase, introducing compulsory ‘health interviews’ for every employee and contractor on a regular basis. The interview covers a range of health issues, and aims to ensure that each employee and contractor has the opportunity to undergo voluntary HIV testing. Although attendance at the health interview is compulsory, HIV testing remains voluntary and confidential.

The Xstrata Alloys programme is using lessons learned from the Xstrata Coal programme to refine and improve our approach. Currently, around 20% of Xstrata Alloys employees have participated in recent voluntary testing programmes with a participation rate of 80% targeted for the end of 2007.

For Xstrata Coal, the focus for 2007 is to continue the workplace VCT programme to achieve 100% of employees knowing their status, 0% new infections, improve the proportion of HIV positive employees enrolled in the support programme and to improve TB intervention.

Tackling TB

Tuberculosis (TB) represents a major cause of death amongst HIV positive people in sub-Saharan Africa, and communities are often impacted by a pandemic of HIV and TB infections. A detailed TB protocol is being developed for Xstrata’s South African operations and will be rolled out in 2007. In addition, INH prophylaxis (preventative treatment) will be provided to all employees who test HIV positive, and proactive health action campaigns will seek to further control the spread of TB amongst employees and in the community.

Eliminating single sex hostels

The accommodation of mineworkers in single sex hostels was identified as a causal factor in a number of social problems, including the spread of HIV and AIDS. To address this, Xstrata has implemented a programme, now in its fourth year, to eliminate hostels and encourage employees to rent or buy their own homes, living together with their families in established towns. The programme has resulted in the elimination of all but one hostel, which houses migrant workers. Over 95% of employees have taken up the funding made available to them to own or rent family homes. Xstrata has supported the establishment of several small enterprises, run by mineworkers’ family members, to assist families to establish themselves in new locations and reduce dependency on our operations. These include a sewing business providing work clothing for a number of local businesses, a cleaning services business and a catering company.

Ongoing education
and information

Xstrata’s operations continue to run poster campaigns, site-level education seminars and briefings about HIV and AIDS, treatment and prevention. In addition, each site provides free condoms and regular training and technical support is provided for site management and peer educators.

Xstrata Nickel’s Falcondo operation in the Dominican Republic supports community health programmes through the Falcondo Foundation. In 2007, Falcondo is implementing HIV and AIDS training programmes, together with interfamilial violence and drug and alcohol abuse prevention programmes for all employees and contractors.

Community initiatives

We recognise that to be sustainable and truly effective, our workplace programmes need to extend to the communities in which our employees and their families live. In addition to direct testing and treatment programmes, our initiatives aim to address contributing factors such as poor nutrition, social and economic deprivation and limited access to healthcare, which increase vulnerability to HIV and TB infections. Wherever possible, we find ways of creating synergies between our projects and our workplace programmes. As a result, we are starting to witness a powerful transformation in how HIV/AIDS and TB is seen and spoken about by the broader community – both in the workplace and where people live. Our community interventions therefore address both the short-term urgent needs, such as access to basic health services and HIV treatment, as well as longer-term strategies to strengthen community resilience.

Access to treatment

In 2005, we opened a community clinic in Breyten, a remote area with little access to healthcare services. A public-private partnership was established to manage the uBuhle Bempilo (beauty of life) clinic, involving Xstrata, Re-Action! and Aurum Health (NGO), and received funding from President Bush’s Emergency Plan for AIDS Relief (PEPFAR) to extend this forerunner project into other areas. In its first year, the clinic has provided life-saving treatment and care to more than 400 community members and attendance is increasing from the local community and farther afield. The clinic remains the only point of access for anti-retroviral treatment in the rural town of Breyten/Kwa Zanele and surrounding area. Following its success the programme model will be duplicated in the Witbank region in 2007–08.

Outreach programme

We have extended the treatment and care provided by the uBuhle Bempilo (the Beauty of Life) clinic through a door-to-door community outreach programme with our implementing partner, Re-Action!. Community-based Wellness Champions, Community Outreach Workers, Treatment Counsellors, and programme coordinators have been trained and are supported to visit community members at home on a regular basis. We currently reach more than 100 homes through this programme.

Traditional Healers

Xstrata has engaged with traditional healers in the Breyten region, to extend our reach in the community. Traditional healers play a vital role in local communities and we are integrating this influential and trusted group into the healthcare services we offer to the community. Our work with traditional healers, lay health workers and other members of society aims to facilitate the acceptance of conventional medicine, testing and treatment and to ensure a co-ordinated, complementary approach, encouraging people to test and where necessary take up treatment at the sub-district level.

Traditional healers at the Xstrata Coal sponsored Breyten community HIV/AIDS clinic

Enterprise and social
development projects

We invest in inter-linked health, social and food security projects and are working towards sustainable livelihoods through supporting skills development and income generation activities. These projects include sustainable farming, adult basic education, vocational skills development, orphan care centres, support and educational materials for schools and provision of community health workers. Key programmes are outlined in the social responsibility chapter.

One issue directly associated with the impact of HIV and AIDS is the plight of children who lose their parents to AIDS. For several years, Xstrata has provided direct support for these children in partnership with the Department of Social Welfare and the Rotary Club, through three specialist centres in South Africa in local communities: Middelburg Care Village, Ratanang Care Centre 1 and Ratanang Care Centre 2. These centres accommodate more than 220 orphans and provide daycare facilities for 40 disabled children.

Leadership and Advocacy

Xstrata is a member of the Global Business Coalition (GBC), the lead organisation for the business response to HIV/AIDS, and in early 2006 was awarded the GBC Award for Excellence for Voluntary Counselling and Testing, in recognition of the success and innovation of our workplace programmes.

Xstrata Coal is a voting member of the Steering Committee of the HIV/AIDS Powerbelt Project. The project is a collaborative initiative established by Xstrata, Anglo Coal, Ingwe, Sasol and various governmental departments including the Department of Mines and Energy, Department of Health, Council for Scientific and Industrial Research to advocate action by businesses in the workplace and in the community in South Africa.