Lifeblood of Lesotho

Tuesday, 01 September 2009 11:17

Waging war against HIV in the country’s textile industry In the tiny landlocked Mountain Kingdom of Lesotho, the textile industry is the largest formal employer. Of some 39 000 textile industry employees, 85% are women – the group most vulnerable to HIV/Aids. Each woman is estimated, conservatively, to support five people. And almost one in two, or 43%, are estimated to be HIV-positive. One organisation, Apparel Lesotho Alliance to Fight AIDS (Alafa), is making inroads into the pandemic as it changes perceptions and provides both practical and in-kind assistance. CEO Bart Vander Plaetse, a Belgium-born clinical doctor who has headed up the organisation since January 2008, is confident that the corner has been turned, particularly with regard to the stigma associated with testing, and prevention of mother-to-child transmission (PMTCT). Alafa’s PMTCT programme is surpassing international targets, with a success rate – at nine months – of 95% of babies born to HIV-positive mothers remaining HIV-negative among its group of 151 babies. “It was difficult in the beginning,” says Vander Plaetse, “with cultural perceptions and stigma among the stumbling blocks. “But we’re in a situation now where, instead of having to ‘sell’ the idea to factories and workers, we have them lining up to become a part of the Alliance,” he says. As a result, the programme has rolled out to 90% of employees within the textile and fabric industry. This is comprised of 27 (60%) of Lesotho’s textile factories, including the largest employers such as Lesotho Precious Garments (Pty) Ltd and its sister company P&T Textiles (Pty) Ltd, together employing about 6 000; Shinning Century Ltd, with around 770 workers; and the denim Nien Hsing Textile Company Ltd groups’ three factories, which employ some 7 000 people. From modest beginnings as a ‘one-woman show’, kick-started with funds from international clothing buyer GAP Inc, Alafa has now entered into Memoranda of Understanding with private Health Ministry-accredited physicians – about 50% of Lesotho’s private providers are accredited – and the Lesotho Ministry of Health, for access to free antiretrovirals (ARVs). Alafa sponsors feeding formula, with assistance from global donors. Factories can select from among 13 medical providers, and individuals can consult doctors outside the factory clinics if the stigma of going for testing remains a problem. “Of the 12 000 people tested, 4 000 were positive. As a result, 900 people whose CD4 counts were below 350 are on ARVs and 3 300 are on opportunistic disease treatment,” says Vander Plaetse. Factories are required to provide primary healthcare clinics and employees must conform to follow-up regimens that vary from three consultations a year to six per year for those on ARVs. Software has been sourced and fine-tuned to Alafa’s needs, linking all facets of the programme to a central database. “This monitors the evolution of the disease within the cohort, and is invaluable for ensuring the sustainability of the project,” he says. Even with multiple service providers involved, it will signal ‘red flag’ issues such as no-shows at medical examinations and formula distribution. “This has been crucial to maintaining the public-private partnership relationship with all players,” he adds. In Lesotho, the majority of textile factories are Taiwanese-owned and managed, with a Singapore presence and one large global conglomerate, all of whom provide clothing for the United States market. In addition, there is a group of South African-owned enterprises. “It was difficult during the start-up phase to demonstrate the economic benefits of a workplace prevention and treatment programme. Now owners see the successes, especially the increase in productivity, and it’s gathering momentum steadily,” says Vander Plaetse. Even more heartening for the committed workers of Alafa has been the shift in mindset among the workers themselves. “There are still small pockets of resistance, mostly around people finding out that they are going for testing. Sometimes it is fuelled by misinformation about the dangers of ARVs. But it is increasingly common for people to be seen and heard encouraging their workmates to be tested, proudly proclaiming their having done so.” For HIV-positive mothers, consistent monitoring ensures their babies are getting the next best thing, after breast milk is ruled out, to ensure their survival. While PMTCT treatment involving no breast feeding remains controversial, the health of the babies born in the programme has boosted its acceptance. International concern about discouraging breast feeding in resource-poor communities, based on precarious water quality and accessibility, the high cost of formula, and a lack of education about correct formula quantities are all addressed by the programme. “Also, because the mothers return to work six weeks after childbirth, they are usually reluctant to start breast feeding,” says Vander Plaetse. Free formula means it adds no economic hardship, and water quality is not an issue. “The survival stories gladden my heart. So many times I hear: ‘I had given up. I thought I was dead – now look at me, bringing in money and looking after my family’.” Since completing his training and community service in Belgium, Vander Plaetse has made Africa his home. He has worked in Zimbabwe, Nigeria, Niger, Male and Rwanda among others. The lure? “I was young and idealistic and I thought I could change the world; now I know I can’t do that, but I can make a difference.” He is proud to be bringing up his three young children in a world far removed from ‘the land of plenty’ of his birth. “I think they are more sensitive to poverty than their peers at home. When we went home one Christmas, my older daughter was upset to learn of the St. Nicholas tradition, in which he brings many toys for children during Christmas. “She said: ‘I don’t like St. Nicholas – he brings lots of stuff for people who already have rooms full of toys and books. They don’t need them’.” But perhaps St. Nicholas works in mysterious ways. After all, Lesotho has Vander Plaetse and his dedicated team working at making a healthy, productive life possible for many of those who had given up hope.

Last Updated on Friday, 23 April 2010 08:26