HIV/AIDS and Malaria

When Joseph Mohlakoana was asked if he would like to work with people living with HIV/AIDS, he had no hesitation. At the time he was working as a professional nurse in the casualty department of Anglogold Health Service's West Vaal Hospital at Vaal River. He was delighted at the challenge of setting up AngloGold Ashanti's first Wellness Clinic from scratch. He also felt strongly that HIV/AIDS was not being accorded the priority it deserved.

Starting out initially as a wellness programme in October 2000, under the auspices of Aurum Health Research in the Free State, the centre evolved into the Wellness Clinic a year later. Looking to Aurum for guidance on how to run a clinic, Mohlakoana started off with five counsellors, two professional nurses (including himself), one medical officer, one enrolled nurse and a data capturer. Today, Mohlakoana is in the position of unit manager, overseeing a staff of 24 which includes nine professional nurses and an equal number of counsellors.

As his staff complement grew, so have his 'clients', as Mohlakoana respectfully refers to HIV/AIDS people attending the clinic. In the early days, about 30 to 40 clients trickled through the clinic monthly; now there are up to 400 visits a month, comprising first-time appointments and follow-ups. All AngloGold Ashanti employees are eligible for treatment - also their spouses and dependents, provided they are on medical aid.

The clinic offers HIV/AIDS awareness and education, voluntary counselling and testing (VCT) and preventative treatment for TB. Anti-retroviral therapy (ART), which controls the viral load and supports the body's defence mechanism against opportunistic illnesses, was introduced in 2002.

What Mohlakoana enjoys most about his involvement in the clinic is his interaction with clients at a personal level. He knows two-thirds by name - important, he says, in breaking down barriers and destigmatising the disease. Although there have been inroads in removing the stigma, Mohlakoana is disappointed that it has not gone as far as he expected, and he still has to deal with cases of discrimination from clients' peers and management. He goes as far as to say that attitudes are "sometimes appalling" with clients labelled as malingerers and sometimes reprimanded when they are absent due to treatment - ironic, he adds, since those critics belong to a company that is not only at the forefront of HIV/AIDS programmes, but is also 'committed to creating workplaces free of harassment and unfair discrimination'. In an attempt to change attitudes, Mohlakoana holds awareness days to dispel some of the myths around the disease. "I use a very different approach," he says, which includes speaking in the vernacular and making use of analogies relevant to the culture of the audience. He also makes a point of greeting clients each morning when they arrive at the clinic by bus, using the opportunity to give an informal talk on general health issues, not just HIV/AIDS.

Mohlakoana's down-to-earth approach rubs off on his colleagues, in whom he tries to instil his attitude of caring and compassion. Some of his counsellors already have those qualities, living as they do with HIV/AIDS. "Those are the types of counsellors you would wish for," enthuses Mohlakoana, without a hint of irony, because they understand and have empathy for clients. They are also proof that HIV/AIDS is not a death sentence and that people living with the disease can regain much of their health; even clients who arrive in a wheelchair are often able to return to work after treatment.

The centre has become a prototype for wellness clinics at other AngloGold Ashanti operations and, if Mohlakoana's vision for the future is realised, they should succeed in reducing the company's disease/ill health burden significantly in the years to come.