Report of the Portfolio Committee on Public Works on HIV/AIDS Workshop in Construction Industry, dated 26 March 2003:

The Portfolio Committee on Public Works, having held an HIV/AIDS Workshop at the Elangeni Hotel in Durban on 25 and 26 November 2002, reports as follows:

CONTENTS
Executive summary
Introduction 3
Workshop Objectives 3
Expected Outputs 4
Summary Overview of Proceedings 4
Contextual Factors Increasing the vulnerability of the construction Industry to HIV/AIDS 4
The effects of HIV / AIDS on the sector 5
Current responses 5
2.3.1
The Department of Public Works 5
2.3.2
The Construction Industry Development Board (CIDB) 6
2.3.3
The Mining Houses 6
2.3.4 National House of
Traditional Leaders 8
2.3.5
Traditional Healers 8
The Institute of Security Studies 9
Social Development 9
The National Youth Commission 10
The Medical Research Council 11
3.0 Lessons learnt and outstanding challenges 12
4.0 Conclusion and Way Forward 14
5.0 Recommendations 14

Annexures

Pledge
ACKNOWLEDGEMENTS
Presenters

Mr Mabutho Shangase: The National Youth Commission
Ms Johannah De Beer and Mr. Leon Swart: Department of Social Development
Mr. Gyimah Osafo: The Construction Industry Development Board (CIDB)
Spencer Hodgson: The Construction Industry Development Board (CIDB)
Ms. Tracey Cheetham: Department of Public Works
Dr. Fazel Randera: Health Advisor to the Chamber of Mines
Mr. Martin Schonteich: The Institute of Security Studies
Dr Mark Colvin: The Medical Research Council
Mr. Des Skhele: JOB Construction and Mining Pty Ltd
Mr. J. Mhlongo: Chairperson of the Traditional Healers Association
Kgosi Shuping who presented on behalf of the National House of Traditional Leaders
Chairs for the sessions: Honourable MP, Inkosi M.W. Hlengwa
Honourable MP, S. Opperman,
Honourable MP, B. Radebe,
Honourable MP, M. Twala
Honourable MP, M. Chikane
Honourable MP, P. Majodini
:
Annextures / Presentation
Annex 1: Medical Research Council
Annex 2: Jo-Block Construction & Mining
Annex 3: Construction Industry Development Board
Annex 4: Department of Public Works
Annex 5: Department of Social Development

EXECUTIVE SUMMARY
A workshop on "the impact of HIV/AIDS in the Construction Industry" was held in Durban on the 25th and 26th of November 2002. The construction industry is the 3rd largest employer in South Africa. It is also the industry in which families are separated for long periods of time. Recent studies show that the industry is under siege from HIV and AIDS and therefore this is a matter that can no longer be ignored.
Workshop participants included the Minister of Public Works, Ms Stella Sigcau, the Chairperson of the Portfolio Committee on Public Works, Inkosi Hlengwa, Members of the Portfolio Committee and other stakeholders. These participants’ presence signified the government’s commitment to respond to the challenge of HIV and AIDS.

Presentations put forth highlighted the need for HIV/AIDS awareness programmes that would best serve these various groups. The construction industry attracts individuals with diverse socio economic profiles ranging from highly skilled civil engineers to contracted labourers at their prime reproductive ages of 18 to 35 years.

Response strategies from the various presenters included:
Recruitment of local labour where employees stay with their families and therefore maintain traditional and family values
Training of traditional leaders to lead community initiatives on the prevention of HIV/AIDS
Forming partnerships with various entities to fight HIV/AIDS, as well as the eradication of outmoded beliefs and myths with regards to HIV/AIDS
Integrating traditional healers into the conventional health care system
Disclosure of the HIV status
Recommendations put forth for this workshop include the development of a government policy which will make it compulsory for all government infrastructure projects to include an HIV/AIDS strategy. This would include coordination of other Portfolio Committees whose departments deal with building infrastructure by the PC for Public Works.
A declaration to this effect was consequently adopted by the workshop participants ( see attachment 1)

EXECUTIVE SUMMARY
The Workshop on HIV/AIDS in the Construction i ndustry was held on the 25th and 26th of November 2002 in Durban. The workshop was held in recognition of the devastating impact of HIV/AIDS on this sector and the communities from which the sector draws its human resources. The construction industry is the largest one of the largest employers in South Africa. It is also the industry that separates families for a long time. Recent studies show that the industry is under siege from HIV and AIDS and the impact on the sector can no longer be ignored.

The workshop was honoured by the presence of the Minister of Public Works, Ms Stella Sigcau and the Chairperson of the Portfolio Committee on Public Works. The Minister’s presence underline the Government’s commitment to respond to the challenge of HIV and AIDS. The deliberations of the workshop were further enriched by the participation of members of the portfolio Committee on Public Works (representing decision makers), representatives of the Department of Public Works (government officials), the Construction Industry Development Board representatives, stakeholders in the Industry, traditional leaders, traditional healers and experts in the field of HIV / AIDS.

Although the workshop was on creating awareness on the negative the impact of HIV/AIDS in the construction industry, the various papers presented led to a discussion of many other areas of concern such as.? The Industry [Who is the industry?] committed itself to the implementation of a national strategy [not mentioned elsewhere in report] dealing with HIV/AIDS within the industry developed by the Department of Public wWorks. It undertook to formulate a plan of action that will improve the Sector’s response to the epidemic [who is responsible for developing a plan of action? Public Works has developed a strategy to respond to the pandemic in the construction industry]]. The workshop participants further committed themselves to strengthening partnerships between communities and the construction industry; and to raising awareness of the epidemic in their immediate environments. [What declaration was adopted? To be attached to report]Workshop participants consequently adopted a declaration to this effect.

[The Executive Summary needs to be explicit but short in terms of capturing the proceedings of the workshop without reading the entire report. Has this been achieved?]
The Portfolio Committee on Public Works, in collaboration with the Department of Public Works (DPW), the Independent Development Trust (IDT) and the Construction Industry Development Board (CIDB) in its effort to bring to the forefront the fight against the HIV/AIDS pandemic organized the workshop. that brings together decision makers, government officials, traditional leaders, traditional healers, experts in the field of HIV/AIDS and the South African Construction Industry Stakeholders

1.0 INTRODUCTION
In its effort to bring to the forefront the fight against the HIV/AIDS pandemic, the Portfolio Committee on Public Works, in collaboration with the Department of Public Works (DPW), the Independent Development Trust (IDT) and the Construction Industry Development Board (CIDB) organized) organized a workshop that brought together decision makers, government officials, traditional leaders, traditional healers, experts in the field of HIV/AIDS and the South African Construction Industry Stakeholders.

The purpose of the workshop was to assess the impact of HIV/AIDS in the construction industry. The construction industry is the 3rd one of the largest employers in South Africa. It is also an industryan industry that separates families for a long time. While there are obvious economicobvious economic spin offs derived from the industry, there are negative impacts on the communities from which the industry sources its human resources which typically, are the rural, which typically, are the rural, and poverty stricken areas. A negative impact is also experienced by the receiving communitiesThe receiving communities also experience a negative impact where construction projects are undertaken.

While there are many economic benefits to those employed in the industry there are also negative sides like the separation of families. And yet when these employees get sick, they go back to their villages. IIt is the Amakhosi, in their traditional rural areas, who are often confronted by the faces of people living with HIV/AIDS or , orphans, as well as the elderly becomingand surrogate mothers with little or no financial support except the old age pensions. It is in this context that this workshop came into being.

1.1 Workshop Objectives
The objectives of the workshop are to determine the following:
How do weto support the rural areas in the fight against the HIV/AIDS pandemic
The challenges facing the construction industry with regards to HIV/AIDS
How to ensure government programmes have a strategic response strategy to the pandemic, both internal and external
How stakeholders can begin to have dialogue about ways to cope with the diseaseShare experiences from the various districts – give experiences of what is happening in our communities

1.2 Expected Outcomes
Getting Obtaining a broad overview from different stakeholders on what strides have been achieved in addressing the pandemic
Identifying key partnerships in the fight against HIV/AIDS
Developing approaches for mainstreaming HIV/AIDS into ggovernance Government policies, strategies and programmes.programs

2.0 OVERVIEW2.0 OFOVERVIEW OF PROCEEDINGS
Presentations and discussions at theat the workshop focussed on a number of of areas includingareas including:
An outline and understanding of the factors which increase the vulnerability of people working in the construction industry to HIV/AIDS
Challenges facing the construction industry around HIV/AIDS
Current responses to the challenges by:
government through the initiatives of the Department of Public Works and the Social Development
the partnership programme between the Departments of Health, Social Development and Education
the mining houses,
the youth sector,
the National House of Traditional Leaders,
traditional healers and
the Medical Research Council
An outline and understanding of the contextual factors which increase vulnerability of the construction industry to HIV/AIDS [rework sentence]
Challenges facing the construction industry viz HIV/AIDS
Current responses to the challenges posed by the epidemic : by government through the initiatives of the Department of Public Wworks, the partnership programme between the departments of health welfare and education, the mining houses, the youth sector, traditional leaders, traditional healers and the research organisation

Key strategic questions raised were:
Key strategic questions To what extent is the industry committed to the course? Answers to this question are found in the presentation by the Department of Public Works and the Construction Industry Development Board
What are the critical success factors? Answers to this question are presented in the Mining and Construction industry presentation.
How would the strategy accommodate the changing face of the epidemic? The answer to this question is found in the presentation by the Medical Research Council and in the recommendation section of this paper
What internal modifications are critical in the success of the strategy? The answer to this question lies in the partnerships outlined in the presentation by the National House of Traditional Leaders, the DPW, the traditional healers and in the recommendation section
Other strategic questions are addressed per sector
[non of these questions have been included in the report. It would be advisable to capture the key questions asked by the audience after each presentation and the responses to these in order to provide further clarity]

2.1 Ccontextual factors ontextual factors increasing the vulnerability of the construction industry to HIV/AIDS
The various pPresentations providedresentations attempted to provide an understanding of how the demographic and socio-economic profiles of labour human resources within the construction Industryindustry has become one of the key drivers of the epidemic within this sector. . Typically, the industry attracts individuals with diverse socio-economic profiles ranging from the highly skilled civil engineer for instance, to the unskilled casual or contracted labourer Like many in the building or infrastructure sector, the other economic sectors thethe industry employs people who are at the prime reproductive age [ between the ages of 18 and 35 years.which is?], who therefore are generally at a higher risk for HIV infection. Furthermore, Tthe nature of jobs in this industry also tends to be short term, thus rendering the workforce into this industry a a highly mobile group.

2.2 The effects of HIV/AIDS on the sector
Research commissioned by the Department of Public Works, and other construction industry stakeholders indicates that the construction industry has the third highest incidence rate of HIV/AIDS per economic sector in South Africa.1 (Address by the Public Works Minister). The impact of HIV/AIDS withinAIDS within the industry manifests itself in the form of high rates of absenteeism; , depletion of skills which adding toadding to a high cost of trainingof training of new staff. and perpetuation of the poverty cycle particularly at household level.2
In addition, the high incidence of HIV/AIDS within the industry hinders its ability to manage and produce work in a timely manner.
[No mention is made of the economic effects of HIV/AIDS, e.g. ability for construction work to be finished; demand in construction services/infrastructure and ability to manage infrastructure delivery]
Current responses
Presentations on current responses included are sector specific and include responses as well as responses of otherof other playeother players rs regarded as key inkey in the construction industry likeindustry like the National Youth Commission, and the traditional leaders. Most of the construction industry labour is drawn from the rural areas that are governed by the traditional leaders.(e.g ???) Secto r specific responses are expanded below

2.3.1 The Department of Public Works
In response to HIV/AIDS in the construction industry , tThe Department of Public Works (DPW) has developed a strategy aimed at creating awareness. about the HIV/AIDS pandemic in the construction industry. The core of the DPW’s HIV/AIDS awareness strategy hinges on construction companies and employers making a conscious effort to effectively address this pandemic within the sector. The implementation of this strategy will become mandatory for all contractors tendering for DPW contracts after completion of the pilot projects.
that will ensure that the industry develops and implements a comprehensive programmes for HIV/AIDS within the industry. The strategic objectives of the proprogramme strategy includes:
; creating awareness about the HIV/AIDS pandemic in the Construction Industry in general, ensuring that service providers within the industry provide HIV/AIDS education within their projects,
Implementing HIV/AIDS awareness programmes on Department projects
Amending the Department’s procurement and contract documents
Bbriefing project managers within the DPW on strategies for mitigating the impact of HIV/AIDS within the industry. Briefing DPW project managers to be aware in a personal and professional way of the disease, its impacts and the Department’s approach in combating it.
Testing the strategy on four Departmental pilot projects
Finalization of the strategy and development of best practice guidelines
Pilot projects are currently underway to test the strategy and lessons learnt will inform the finalization of the strategy. (See Annexure 4) for implementation of the strategy are underway and are described in annexture … lessons learnt from the pilots will inform the implementation of the strategy across the industry.

2.3.2 Construction Industry Development Board (CIDB)
The Construction Industry Development Board (CIDB) is a statutory body established by Parliament, Act 38 of 2000, to stimulate growth, reform and improvement of the construction industry and to enhance the construction industry’s role in the socio- economic development of the country. As such, one of their key responsibilities is to drive the implementation of strategies for improvement within the industry. In this regard, the CIDB has developed a specification which aims at influencing the way clients engage contractors by making the HIV/AIDS awareness on site, part of the total deliverables to the client and to make it the client’s responsibility to pay for the cost of introducing HIV/AIDS awareness on construction sites.

Given the complexity and fragmentation of the industry, with many different role players from both the formal and informal sectors, the role of the client as the ultimate employer of all construction works and services is therefore seen as the strongest link to achieving the desired intervention necessary to make any meaningful impact in the fight against HIV/AIDS. The specification has therefore been designed to make the role of the client central to an HIV/ AIDS strategy. This is achieved by making HIV/AIDS awareness on site an item that the contractor can price and be expected to deliver as part of the entire project.

The objectives of the specification are to raise awareness to reduce risk of infection, promote early diagnosis and to assist infected and affected individuals. The purpose of the specification is to have HIV resilient workforce, resilient communities and minimize the impact of the disease.
From presentations made by the Department of Public Works and the CIDB the following strategic questions were raised:

a) Considering that the effects of HIV/AIDS creates a vicious circle of the depletion of skills, leading to unemployment and perpetuation of poverty that impacts at the household level how would
the strategy accommodate the changing face of the epidemic?
Who are the strategic partners?
Within government
Within the industry
Within governance structures
Within communities
What are their roles?

The Construction Industry Construction Board ( CIDB) is a statutory Body appointed in 2001 to promote the contribution of the industry to the country’s social and economic objectives while improving performance, efficiency & competitiveness within the industry. As such, one of their key responsibilities is to drive the implementation of strategies for development within the industry. In this regard the CIDB is the implementing arm of the Department of Public Work’s strategy for HIV/AIDS prevention. The CIDB is currently driving the implementation of the strategy in the four pilot sites which would be rolled out throughout the industry in due course. (See Annexture3 …) [The CIDB is not driving the implementation of the strategy on 4 pilot sites – the Department of Public Works is currently implementing four pilot projects. In the CIDB presentation, they allude to 4 initiatives currently happening within the industry, but they are only driving their CIDB office project at the SABS building]The CIDB acknowledged that the industry is fragmented, it’s all over and there are different players. However the CIDB is in the process of developing an effective and broad based strategy for the Construction Industry. One of the main challenges is the coordination and integration of issues.

Sharing of resources and joining hands in training communities was also discussed.
[What were the strategic questions raised and discussed after this presentation?]

2.3.3 The mining housesThe South African Chamber of Mines and JOB Construction and Mining Pty Ltd
An overview of the impact of the HIV/AIDS within the mining houses was highlighted by presentations from this sector and included the following:
70 percent of the workers in the mining industry are migratory labour
There is a high infection rate in the surrounding communities where these migrant workers are housed3
Increased cost of recruitment and training
Additional sick and compassionate leave
Negative impact on staff morale
Cost of occupational health standards
Dealing with prejudice
Loss of turnover and profits

The concern for the mining houses as well as the labour broker, was an observation that when an employee dies of AIDS related disease, quite often, the death is not reported to the employer ( who at the same time is often not able to contact the family members). Consequently the deceased employeedeceased employee is regardedis regarded as having taken leave without permission and subsequently loses outloses out on all death related benefitsrelated benefits.4

One of the responses of theof the mining houses has been to establish workplaceestablish workplace programmes designed to address factorsaddress factors which increase the vulnerability of the mine workers to HIV/AIDS.

Programmes arei designed to maintain traditional values and family structure increased self-worth of their employees, providing e access to medical care, are particularly found to be appropriate.
Some specific strategies suggested in the approach described above include:

Recruitment of workforce from the local population rather than using migrant labour. The merit of going local is that employeesthat employees stay with their familiestheir families and within their communities wherecommunities where traditional and local values are maintained. In addition the families offamilies of employees have accesshave access to medical benefits that they may be entitled to through the employed member . member. This type of arrangement also makes it easier for the employee’s spouse or family members to access the employee’s benefits in the event of death. Housing for the employee is also of benefit to both the familythe family and the company and there is a stabilizing effect on children as theas the family unit is intact.

Provision of occupational and ABET training and HIV awareness program geared to empower employeesempower employees by improving their selftheir self worth.
Provision of on site services for occupational and primary health care including free HIV testing services. In addition the family of the infected employee is provided with counseling and support systems.5

[What were
The the strategic questions raised and discussed after these two is presentation were:
What are the merits of going local vis a vis getting the migrant labourers
How can traditional family values be maintained.
Discussants argued that going local means that employees stay with their families and within their communities and therefore traditional and local values are maintained. In addition to this, if employees stay with their families it also means they benefit from the workplace programmes developed by the employers.
?]

The mining house and construction industry noted that the reported loss of turnover and profits resulting from increased costs of recruitment and training and having to provide additional sick and compassionate leave and bearing the costs of occupational health standards are high. These factors impact negatively on staff morale. And yet care has to be taken to preserve the confidentiality of staff members who are HIV positive or else, dealing with prejudice becomes a massive problem.

As a result, mining houses are reluctant to expose their records so available statistics are unreliable. Forty percent plus of mining employees appear to be HIV positive, but the general belief is that the figure is higher than that on record. When an employee dies, no family member reports the death to the employer. The absence is then recorded as absent without leave, with the result that they loose all their benefits.

2.3.4 The National House of Ttraditional leadersLeaders
The traditional leaders feel they are in an advantageous position to make a significant contribution in the fight against the scourge of AIDS. In his opening remarks Inkosi Hlengwa highlighted the fact that a significant group of migrant labourers come from traditional areas and when they get sick they go back to the traditional areas. The onus therefore falls on the community to take care of their sick and dying.

The National House of Traditional leaders’s response to the virus was the formation of the has formed a twenty member HIV/AIDS forum in association with the National Department of Health. The task Task teams emanating from this forum, are to be trained in order to lead community initiatives on prevention of HIV/AIDS. Traditional leaders are mindful of challenges around issues of HIV/AIDS facing this sector including:

breaking of taboos such as free discussion of sexual matters between parents and children,
forming a Nnational Framework that is aimed at guarding traditional initiation schools and the difficulty of getting rural people to practice safer sex.6
The Traditional leaders urged for a multi sectoral approach to the disease
The [What were the strategic questions raised and discussed after this presentation? were:
what can be done to combat the scourge?
.
Discussants informed the participants that the National House of Traditional leaders has formed a twenty member HIV/AIDS forum in association with the National Department of Health. Task teams emanating from this forum, will be trained in order to be able to inform the community about the causes and prevention of HIV/AIDS.

Other initiatives are taking place countrywide with traditional leadership forming partnerships with business as is the case with Inkosi King Goodwill Zwelithini,Isilo Samabandla, His Majesty, the King of the Zulu National Unit in partnership with Glow Master Colours who have started a project called "AIDS awareness, Lighting Board Project" 7 –

It was refreshing to learn that the stand point of the NHTL is that all customs related to rituals and initiation into various stages of development has to be reviewed. Their argument is that outmoded beliefs and myths with regards to HIV/AIDS have to be eradicated.

They advocate to the old morality such as:
No sex before marriage
No extra marital affairs
Respect for tradition e.g. initiation ceremonies
Respect for cultural life and values

Key Challenges
Breaking of taboos such as free discussion of sexual matters between parents and children
Forming a national Framework that is aimed at guarding traditional initiation school
Difficulty of getting rural people to use condoms

In conclusion the Amakhosi are in total support of the formation of a Moral Regeneration Movement in which they can be involved
]
2.3.5 The Ttraditional healers
The discussions emanating from the traditional healers presentation demystified the role of traditional healers around the HIV/AIDS virus. The presenter noted that real t Traditional healers emphasized the fact thator IziNyanga do not claim to cure AIDS. Instead they dispense medicines made from herbs and ingredients to keep their patients strong and healthy and help them regain their strength after illness. He also acknowledged however that there were unscrupulous elements who advertised themselves as having the ability to cure AIDS.

The key challenge facing this sector was being integrated into the conventional health care system, which, in their view, would only be possible once the government acknowledges the overall role of traditional healers in health care provision. In their view, the logical starting point for working with the government would be for the government to offer training programmes to traditional healers at local levels on HIV/AIDS.8
[What were
the strategic questions raised and discussed after this presentation?]2.3.6 The Institute of Security

Studies (ISS)
The highlights of this presentation showed that there is:
more direct impact of the epidemic may undermine democracy and institutions
epidemic has a ‘ripple effect" as it affects the various government departments like the army, the police services

Terminal illness is demoralizing
Households have to fund the sick with limited resources and end up getting loans
Strain to other members of the households
Estimated that there would be more than 1 million orphans by 2005
The psychological impact too intense
Loss of familiar surroundings and trauma 9
[What were the strategic questions raised and discussed after this presentation?]

2.3.7 Soci al Development
The presenter gave an overview of the HIV/Seroprevalence Survey whichSurvey, which showed an increase from 1991 to 2000. She noted that:
HIV/AIDS is the fastest growing epidemic
has an impact on life expectancy
those born with the virus die within 2.5 years
life expectancy is likely to drop to 40 years by 2010
HIV positive children are likely to drop out of school because of psychological distress
The response from this sector focused on:
Workplace programmes to manage the impact as the service demands on social services increase
The need for partnerships to address child headed households to ensure the basic needs for children are met
Destigmatization and disclosure of the HIV virus as a disease like any other
Developing programmes and partnerships as Department of Social Development has done with Department of Public Works
Ensuring that caregivers come from the community
The presenter noted however that the main challenge is integration and coordination10
[What were the strategic questions raised and discussed after this presentation?]

2.3.8 The National Youth Commission
The presenter noted that the construction industry is one sector of the economy that is very much reliant on transient labour, which basically means that its labour force is very much mobile, interacting with different settled communities at different intervals while still very much attached to their families.
Some of the National Youth Commission’s response strategies include:
Provision and more roll out of youth friendly health services
More promotion of confidential Voluntary Counselling and Testing (VCT)
More peer education programmes in the school curriculum as well as for tertiary institutions not only in the context of formal schooling. Peer education facilitates open dialogue amongst peers even in a work environment.

Strengthening of the government partnership against HIV/AIDS, mobilising broad based support and resources with particular attention on prevention and education, as well as community support in home based care

The role of the private sector has to be emphasized, current efforts by some companies in the fight are appreciated but more still needs to be done. The sector has acknowledged the impact that HIV is having in terms of the human, financial and social costs to its operations and communities. HIV/AIDS affects people within their most productive years and in the long-term this leads to declining productivity and economic growth as a result of absenteeism, organisational disruption, and drainage of pension as well as medical insurance schemes. It has been established that for poor bereaved families, it may take up five months or more to recover financially from a single funeral.11

The prevalence of infection amongst the age group 25 – 40 indicates that there is considerable interaction between the different age groups and that young people are not alone amongst those infected. This interaction is the result of young people not being able to afford a descent lifestyle while the older generation can afford and provide- this creates a phenomenon that further perpetuates the spread of the disease. High levels of unemployment are indicative of the fact that poverty is still behind the spread of the virus. Other factors cited are lack of recreational facilities or gainful use of free time, prevalence of violence and alcohol and substance abuse.

Strategic questions raised during this presentation were:
What role does he foresee coming from the private sector
The discussant noted that the role of the private sector has to be emphasized, current efforts by some companies in the fight are appreciated but more still needs to be done. He then further looked at the main remedial measures which were the following:-
Peer education programs in the school curriculum as well as tertiary institutions, and providing for open dialogue for peers, even in a work environment
Strengthening of the governmental partnership against HIV/AIDS by mobilizing broad based support and resources with particular emphasis on prevention and education as well as community support in home based care.
The private sector has acknowledged the far reaching consequences of the HIV/AIDS pandemic and is involved in remedial measures but the important role of this sector cannot be over emphasized.
[What were the strategic questions raised and discussed after this presentation?]

2.3.8 The Medical Research Council
The specialist epidemiologist from the Medical Research Council in his presentation said the UN characterized HIV/AIDS as "greatest single threat to Africa’s social and economic development". The HIV/AIDS epidemic is rapidly reversing the social and economic achievements of the past half a century and now poses a threat to development in Sub Saharan Africa, a growing threat in Asia and the Caribbean a probable threat in some Eastern European Countries.12 He argued that development projects may actually promote the transmission of HIV and so undermine key developmental objectives.

He gave the example of the Akhosombe River Dam in Ghana where construction necessitated the displacement of an approximately 80 thousand farmers who then obtained jobs on the construction site. Women found work in hotels and bars while others resorted to commercial sex. The upshot of it all was that surveillance surveys in 1985 showed that in the town of Agomaya the administrative center of the district that abuts the Akhosome Dam, the HIV infection rates were 5 to 10 times above the level of average HIV prevalence in Ghana.

The life expectancy of those children born with the virus is 2.5 years. Those who are born free of the virus, but who contracted during youth or early adulthood have a life expectancy of 25 years. Those born free of the virus and practicing a life style which places them at low risk of contracting the virus can expect to live until 60 years and over. The majority of those infected will be during the periods of peak sexual activity i.e. the late teens and early twenties. This group will fall ill and die in their late twenties and early thirties. HIV positive pregnant women might infect their newborn children during the process of delivery or through breast feeding. In this category, infant and child mortality rates are increased as a result of these infants quickly developing AIDS.

The foregoing figures have alarming implications for child welfare. Often children loose rights to family land or property; it falls to welfare to care for these orphans by way of child care and orphan grants, finding homes for them and dealing with the expenditure. Welfare is faced with the problem of relatives moving in, and exploiting these children, many children suffer from malnutrition and other illnesses and have no access to health care, others are sexually exploited. The implications for welfare are numerous; it does not end with paying pensions and social grants. Welfare has to secure resources to ensure the survival of programs. In addition, they have to strengthen the capacity of families to cope with problems. Over and above all this, they have to monitor the impact of HIV/AIDS on children and their families, the challenges that have to be faced are all tied up with the vicious circle of the consequences of children either being infected, or affected through HIV/AIDS parents dying at an early age, and leaving orphans to survive. The question is how? Poverty, death and illness have a direct effect on food production and food security and add to the nutritional deprivation of children already living in poverty. The education of girl children might be sacrificed causing illiteracy amongst girls. Ultimately girls have no education or skills to fend for themselves and become economically dependent on men.

For the specific management and mitigation of HIV/AIDS he advocates voluntary counseling and testing, prophylactic therapies, administration of anti retroviral, home based care programmess and medical aid policies for the workforce. For addressing the "vulnerability of the workforce, the following sector suggestions were made:

Promoteion of the use of local labour
Adjust labour recruitment to address gender issues
Improve labour housing to accommodate families and provide integration into the community as well as recreational facilities
IIn addressing the vulnerability of the impacted communities, he put forth the following:
Outreach to sex workers
Resettlement policies
Access to STD clinics to treat STIs in the community
Capacity building in the community
Social marketing of condoms

[What were
Tthe strategic questions raised and discussed after this presentation were:
What are the ?demographic implications of the epidemic to society
The discussant explained that children being orphaned as a result of the AIDS epidemic have placed an increased burden in society. Orphanages cannot cope, so there is an increase in the number of street children. HIV/AIDS children fall into two main categories, namely infected children and affected children.
]

3.0 LESSONS LEARNT AND OUTSTANDING CHALLENGES
Expand the section ???
The workshop identified the following as key challenged challenges facing the industry:
1)
Bringing the HIV and AIDS to the center of the governance agenda
1) At a strategic level i.e bringing the HIV and AIDS to the centre er of the Ggovernment’s policies, strategies and programmes
2) At an operational level i.e. responding to two basic questions which are
What is the impact of AIDS on development
What are the negative impacts on the spread of HIV in the community? What policies, strategies and actions should be put in place to enhance the positive impacts
The discussions brought to the fore the importance of:
Mainstreaming of HIV/AIDS by going beyond "business as usual" t hus ensuring that the impact of HIV/AIDS is addressed and reduced within the industry and the communities from which the industry’s human resources is drawn.

Changing the way people work i.ework i.e improvement of the situation of people already affected by HIV/AIDS using lessons learnt from the presentations eg (As highlighted in Jo Block’s presentation)
Partnerships (see expected outcomes)

4.0 CONCLUSION / WAY FORWARD
The workshop brought HIV/AIDS to the centerre of development and helped expand theexpand the response away from the Department of Health. and forced everybodyforced everybody to focus on the virus as ouras our business because it impacts on all of us. It also brought home the factto light that as government, development agenciests, traditional healers, traditional leaders as well as the , the industry as well as the community, there is a need to look at the impact of the policies, laws, and procedures .that are influencing the spread of HIV/AIDS. By the end of the proceedings it becamewas clear that individualsthe various representatives were beiginningbeginning to talk about moving the goal posts towards a resolution that would commit the participants to taking the workshop decisions forward. an emergency response through the integration of plans from the different players.
MTherefore maainstreaming the HIV/AIDS epidemic will mean developing plans that take care of address the epidemic. It has to be a core mandate. Development agencies should focus on the following: The following is what development agencies can do:

Creating guiding coalitions for an emergency response to deal with the HIV/AIDS
Creating an awareness of an emergency response which will accelerate the knowledge base [what will?] and ensure that the message it [what] reaches more people (intensification)

Expand health education and awareness programmes [what] to other key stakeholders [like?] across all government departments ance institutions in partnership with civil society. Use of stakeholder mapping will be helpful [to do what]to ensure that the message reaches a wider audience
Providing platforms for these partnerships to flourish

5.0 RECOMMENDATIONS
The workshop partciaipantsparticipants ended by arguing that if we are in agreement that many people are dying of the HIV/AIDS pandemic, related issues and therefore our governments institutions need to position themselves in an emergency mode just as the case when there is a disaster. It further argued that all government institutions have to leadas leaders in the fight against HIV/AIDS. the efforts.Partnerships were suggested as one of the important strategies to fight the epidemic.
It is therefore recommended that the Portfolio Committee should create a forum for a dialogue with other stakeholders to ensure that their efforts are not lost. Such a forum may include all the departments that deliver infrastructure such as the Departmen t of Water Affairs, Transport, Housing and others. With the expanded public works programme the Portfolio Committee has to influence the Cconstruction Iindustry Development Board through public works to make it compulsory for all government infrastructure projects to have an HIV/AIDS strategy. with a dialogue with the other Portfolio Committees. In this endeavour, it is important that the Department of Public Works takes the leadership role in coordinating the process.discussions. [need to revisit recommendations stated in report to ensure implementation]

Partnerships between communities, government & contractors / construction industry
Promote the use of local labour
Adjust labour recruitment practices to address gender issues
Improve labour housing to accommodate families and provide integration into the community as well as recreational facilities.

Migrancy, the disruption of social support mechanisms and family structures and overcrowded living conditions are but some of the defining features of the Construction industry that have to be borne in mind when developing appropriate interventions. Furthermore, the concentration of ‘young ’ men in a given locality at a given point in time encourages a thriving informal sector among women to supply food, alcohol, casual and commercial sex.

It is feasible and cost-effective for the construction industry to provide awareness programmes, condoms and facilitate access to health clinics to treat STIs and other infections for their employees and in some instances (e.g the mines), even extend this to the surrounding communities. Government is in a position to develop and implement strategies that would enforce the implementation of HIV/AIDS programmes by prospective service providers in the construction industry intending to tender for government contracts.
Increasing the opportunities for workers to remain in their communities with their families would address the issue of separation of construction workers from their families for too long. To a large extent, this would also go a long way towards addressing unemployment, and subsequently high poverty levels in South African communities.

In addressing the vulnerability of the impacted communities, the following suggestions emerged from presentations and discussions:
Outreach to sex workers
Access to STD treatment for the community
Awareness campaigns and capacity building in communities
Provision of condoms

ANNEXTURES
Presentations
HIV/AIDS WORKSHOP
25 – 26 NOVEMBER 2002

Workshop participant list