Case studies: South Africa

Success in recruiting peer educators at Great Noligwa Mine

The importance of the peer educator in workplace HIV/Aids management programmes is widely recognised. Peer educators are volunteers, drawn from the ranks of employees, who are given the necessary training to equip them with a knowledge of the elements of the disease and its management. Their role is then to interact, both formally and informally, with their fellow-employees, in order to impart knowledge and understanding of the nature of the disease and the resources available.

AngloGold Ashanti Health (AGA Health) HIV/Aids Workplace Manager Buti Kulwane comments: “Peer educators play a vital role in imparting knowledge across the spectrum of HIV/Aids management, whether through encouraging employees to learn their HIV status through the voluntary counselling and testing (VCT) programme, encouraging them to enrol in the wellness programme, or imparting knowledge about the availability of anti-retroviral therapy (ART) when clinically indicated.”

The target at all AngloGold Ashanti’s South African operations is to recruit one peer educator per 50 employees and by the end of 2007 this had almost been achieved, with 1 peer educator per 54 employees

In 2005, Great Noligwa Mine in the Vaal River area was the least successful of these operations in meeting this target, recruiting only 19 peer educators, equating to a ratio of 1:300. In 2006, the mine achieved a slight improvement, recruiting 26 peer educators. At the end of November 2007, this had jumped to 109, compared to a target of 110.

Great Noligwa’s HIV/Aids Co-ordinator Annalise Schoeman attributes this marked improvement to a number of critical success factors, with commitment from senior mine management one of the most important.

“We have allocated time so that, in rotation, the peer educator group members can dedicate one day a month to their role during HIV/Aids campaigns. This needed the co-operation of the mine overseers in taking them off their normal duties, and helped reinforce with the group the importance that mine management attaches to the HIV/Aids programme,” says Schoeman. “Generally, while peer educators receive full-time training (a six-day course, accredited to the health and welfare sector education and training authority (SETA) presented on AngloGold Ashanti’s behalf by a Johannesburg-based consultancy), they are expected to carry out their duties on a purely voluntary basis while doing their normal jobs. We’ve found this to be difficult for them.”

The importance attached by mine management to the implementation of the HIV/Aids programme is borne out by the fact that meeting VCT targets now forms part of the performance targets of heads of departments at the mine.

After a fatal accident at the mine in March 2007, the mine launched a safety intervention known as Lungisa (meaning ‘fix up’). “Every section was taken off production for a full shift,” says Schoeman. “VCT was incorporated into the programme for the day, and there was an excellent uptake.”

“Obtaining the co-operation of organised labour was also critical, and I am glad to say that the union leadership at Great Noligwa is fully supportive of our VCT campaign and wellness programme,” says Human Resources Manager Marius Steenkamp.

Other interventions included a number of innovative drives to recruit peer educators, including door-to-door campaigns in offices and the Great Noligwa Mine Residence. As peer educators were recruited, they were in turn encouraged to recruit others.

The Great Noligwa peer educator group has been divided into teams, each numbering eight members. Teams were encouraged to choose a team name and to select a team captain. “A competitive element has built up, with each team determined to achieve the most referrals to VCT,” says Schoeman. The Great Noligwa mine as a whole achieved the highest number of VCT referrals in AngloGold Ashanti for 2007. Another benefit of the team system, according to

Schoeman, has been the more focused, structured communication this has facilitated between the group and mine management. “It’s easier to communicate with a small group of team leaders than with 109 individuals.”

The success of these interventions is borne out by results: 101% of employees at Great Noligwa had come forward for VCT in 2007 assuming single testing, compared with 40% at the end of 2006. “We’re confident of achieving our target of 6 000 tests by the year-end, or slightly over our current complement of 5 964,” says Schoeman. There has been a 10% increase in the number of people attending the wellness centre, and a 54% increase in Great Noligwa employees on anti-retroviral therapy (ART). Absenteeism due to illness has also declined. In a cohort study conducted by AngloGold Ashanti Health at Great Noligwa on a group of 20 employees taking ART, the average number of days’ sick leave declined from 11 in August 2006 to two in September 2007. “Of course, a number of factors are involved and not all these successes are directly attributable to the peer educators’ efforts,” says Schoeman. “They are, nevertheless, an important link between employees and the resources of the HIV/Aids management programme.”

Looking ahead, the first priority for 2008 is the extension of the HIV prevention programme to the mine’s approximately 630 contract employees.