Wayne Dunn presents to World Bank Development Marketplace on the South African Mining Industry’s  response to HIV/AIDS
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Wayne Dunn presents to World Bank Development Marketplace on the South African Mining Industry’s response to HIV/AIDS



Wayne Dunn’s presentation to a World Bank Development Marketplace Seminar. The presentation provides an in-depth look at the South African mining industry’s response to the HIV/AIDS crisis. ...

Wayne Dunn’s presentation to a World Bank Development Marketplace Seminar. The presentation provides an in-depth look at the South African mining industry’s response to the HIV/AIDS crisis. www.waynedunn.com



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Wayne Dunn presents to World Bank Development Marketplace on the South African Mining Industry’s  response to HIV/AIDS Wayne Dunn presents to World Bank Development Marketplace on the South African Mining Industry’s response to HIV/AIDS Presentation Transcript

  • Beyond the Paycheck Mining Industry Response to HIV/AIDS at the Family and Community Level Presentation to World Bank Development Marketplace June 16, 2003 Phillip Von Wielligh Jim Cooney Wayne Dunn Placer DomeBeyond the Paycheck 16-June-03 1
  • Agenda • Background • Meeting the challenge • DM Project – Development – Implementation – Impacts – Challenges and Learnings • Care Positive – Scaling up and addressing economic impactsBeyond the Paycheck 16-June-03 2
  • Background • HIV/AIDS is the worst epidemic in human history. At every level it is causing devastation, destruction and suffering throughout Southern Africa • The mining industry and its stakeholders are experiencing severe social and economic impacts • Mine employees have a higher HIV prevalence rate (~25%) than the general populationBeyond the Paycheck 16-June-03 3
  • Background (cont) • Impact is felt more severely in the rural areas – Mineworkers come from throughout Southern Africa (South Africa, Lesotho, Mozambique, Swaziland, Botswana) to work in South African gold mines – Each mineworker is supporting an extended family of 10-20 people – When they become too ill to work they are faced with going home, literally to die – Families and communities not only lose remittances but they must care for the terminally ill worker with little or no training and very little public health infrastructureBeyond the Paycheck 16-June-03 4
  • Background (cont) • Over 250,000 mineworkers in South African mining industry • Medical repatriation rate of 1.25% per year • Increasing numbers mineworkers are medically repatriated every month – If one considers all other employers (government, rail, ports, etc.) this number increases exponentially) • Numbers will increase as AIDS epidemic progressesBeyond the Paycheck 16-June-03 5
  • Background (cont.) • Not only is this a human tragedy, it also affects mining industry economics adversely • Mineworkers, faced with a choice between staying on the mine as long as possible, where they receive medical care and are able to continue sending money home, or losing their paycheck and returning home where health services are minimal and over extended • Most were staying onsite, often to the point of death • In addition to leaving families unprepared, this had huge impacts on industry productivity and profitabilityBeyond the Paycheck 16-June-03 6
  • Meeting the Challenge • The mining industry recognized that it had to be a key stakeholder in addressing this catastrophe • Placer Dome, through the South Deep Care Project had already committed to developing HIV/AIDS programming to follow-up on its groundbreaking retrenchment mitigation project (more on this later)Beyond the Paycheck 16-June-03 7
  • Minesite and Local Community Programs • Minesite Programs • Local Community ProgramsBeyond the Paycheck 16-June-03 8
  • Beyond the minesite • Mineworkers’ families were scattered over an 800 by 4000km area, much of it in isolated and inaccessible areas. • Entire mining industry was facing a common set of problems • Collaboration created economies of scale and potential for additional scalability • TEBA had an existing infrastructure and presence throughout the regionBeyond the Paycheck 16-June-03 9
  • Developing a Home Based Care Program • Placer Dome, as operator of the Placer Dome Western Areas Joint Venture South Deep Mine, took the lead in working with TEBA to develop an industry wide approach • Decision was made to address the social impacts in the first stage and then to develop additional programs to mitigate the economic impactBeyond the Paycheck 16-June-03 10
  • Developing a Home Based Care Program• Develop a home based care program that would enable mineworkers to return home to a functioning care system• Pilot the program in several areas and then roll it out throughout the labour supply area• Develop a fee for service model that would facilitate broad buy-in from the mining industry – and eventually from other industries and public sector stakeholders• With support from World Bank Mining Group we submitted a proposal to the Development Marketplace (AIDS Campaign Team Mining)Beyond the Paycheck 16-June-03 11
  • Implementation Steps Mineworker Medically Discharged • Consult with stakeholders (NUM, TEBA Home Based Care Process Family Chamber of Mines, Service prepared for his arrival Providers, Governments, etc.) • Develop a draft process to go from Arrival counseling medical repatriation at the Appointment of Caregiver minesite to reception in home community and ongoing provision Training of Caregiver of support • Secure mining company support Ongoing support and monthly medical kitsBeyond the Paycheck 16-June-03 12
  • Implementation Steps (cont) • Develop a Steering Committee – Design training curriculum (Care Masana Clinic Supporters and Providers) XAI XAI, Mozambique – Oversee program operation – Develop rural implementation capacity (recruit and train fieldworkers and Care Supporters) – Pilot area first then more general rolloutBeyond the Paycheck 16-June-03 13
  • In the communities • Develop partnerships and relationships to enable families to access any existing local services and support (e.g., NGO, government, education, welfare, etc.) • Traditional healersBeyond the Paycheck 16-June-03 14
  • Overview of Home Based Care Patient Home-Based Carer Village Care Supporter TEBA Rural Development-HBC MinesBeyond the Paycheck 16-June-03 15
  • Project Impacts • Broad stakeholder participation in HBC • Monthly medical kits • Improved nutrition and care for affected families • Full industry participation – 8 mining companies – Over $300,000 in direct cash payments • DfID support enabled extension to all affected employees in LesothoBeyond the Paycheck 16-June-03 16
  • Project Impacts • Care for patients through HBC enables families to better care for others who are suffering from AIDS but not eligible under this program • External evaluation of the project is currently being done by the University of PretoriaBeyond the Paycheck 16-June-03 17
  • INDUSTRY HOME BASED CARE RESULTS (Year One) Milestone Target Actual Community Care 87 127 Supporters engaged 87 123 Community Care Training People under Home 696 801 Based Care THE PROJECT EXCEEDED TARGETS IN EVERY AREABeyond the Paycheck 16-June-03 18
  • Scaling Up and Expanding • Currently planning year two rollout (we didn’t want to plan until we had the results of the external review • Expectations are to double the number of homebased care families, caregivers and regions where the program will be delivered • A strategy for rolling out into additional industries will be developed in year 2Beyond the Paycheck 16-June-03 19
  • Challenges and Learnings • Difficulty getting proper repatriation notification from mining houses (need improved communication and coordination) • Families needed more counseling than originally anticipated • Patients needed medical attention on arrival – Dehydration, exhaustion, etc.Beyond the Paycheck 16-June-03 20
  • Challenges and Learnings • Traditional healers are vitally important stakeholders – Xai Xai training programBeyond the Paycheck 16-June-03 21
  • Challenges and Learnings (cont.) • Maximizing the role of local stakeholders results in improved efficiency and increased local capacity • Involvement of local leadership and traditional healers improves local acceptance and enhances community and family impact • Expanding into other markets (industries) and developing financial partners requires sophisticated communication and strategic marketing skills (organizational development)Beyond the Paycheck 16-June-03 22
  • Challenges and Learnings (cont.) • Utilization of local suppliers (e.g. trainers) and professionals increases local acceptance of the program and increases overall community capacity to address the epidemic •An industry-wide approach is much more effective and efficient than a company by company approachBeyond the Paycheck 16-June-03 23
  • Challenges and Learnings (cont.) • Continual communications and reaching out to external stakeholders can identify additional partners and synergies • External evaluation can provide valuable insights and also help to attract new partners • Metrics and indicators are critical to success and should be planned from the onsetBeyond the Paycheck 16-June-03 24
  • Challenges and Learnings (cont.)• Service Termination – service to the families currently terminates with the death of the mineworker. This leaves a huge gap at a critical point for the families, who have come to depend on and trust the caregivers. Support should continue for a period beyond death to assist the family to cope• The prestige and profile of the Development Marketplace award helped tremendously to open doors with other partners and stakeholdersBeyond the Paycheck 16-June-03 25
  • What happens to children and families when the breadwinner can’t workBeyond the Paycheck 16-June-03 26
  • Building on the Care Project • Placer Dome has successful experience in assisting mineworker families to become economically active • In 1999 the company retrenched over 2,500 workers who returned to their families in rural areas throughout Southern Africa • The Care project was designed to mitigate the economic impact on familiesBeyond the Paycheck 16-June-03 27
  • Building on the Care Project• A unique 13-step process was Planning Phase 1. Labour Force Rationalization Plan 2. Retraining/Redeployment Assessment 3. Detailed Retrenchment Plan designed that provided counseling, training and support to retrenchees Awareness/Orientation Phase , 1. Counselling Economic Lifeskills & Opportunity Orientation 2. Opportunity Awareness Workshops and their families, right in the areas (Economic Opportunity/Career Fairs) 3. T raining Needs Assessment Personal where they lived Economic Plan Prepared & Assessed• Proxy model enabled direct Decision on Economic Option participation by women and other Enterprise S tream Employment S tream family members Business Planning & Preparation 1. Business Orientation a) Idea Generation Workshops b) Business T raining Activities Employment Planning & Preparation 1. Skills T raining (Vocational/Agricultural) 2. Employment Counseling / Placement• The project has enabled nearly 2. Develop Draft Business Plan (Job search/Resume, etc.) (to be reviewed with Counselor) (plan will contain financial, operational and skills upgrading plan) Personal 3. Preparation of Micro-Finance Application Employment Plan 60% of the affected families to 4. Submission to Micro-Finance Agency Business & Prepared develop alternative economic Financing Plan Prepared Ongoing Processes Follow-up sessions/ opportunities Evaluation of Micro Finance Application Business Operation activities to monitor effectiveness of• An extensive network of 1. Ongoing availability of T echnical Assistance and Business Counselling interventions 2. Ongoing faclitiation of skills training needs (i.e., business, agriculture, vocational, etc.) Communication and consultation with fieldworkers and project partners stakeholders Continuous improvement were developed and are still in Retrenchee is Re-Integrated and Economically Active process (review feedback; enhance programs, place procedures, processes)Beyond the Paycheck 16-June-03 28
  • Moving forward • The Care project piloted an innovative means of assisting rural families to become economically active and it has an effective infrastructure and management system in place • ACT Mining Home Based Care project piloted a cost effective, fee for service program to support medically repatriated workers and their familiesBeyond the Paycheck 16-June-03 29
  • Our Vision for the Future Care Process Care Positive • Integrate the Home Based Care + project with the Care process and launch as a fee for service based Home Based Care program to address the social and = economic impacts that AIDS is having on rural families and Care Positive communities • Start with the mining industry but design the infrastructure and management systems to enable participation by other industries, governments and donor community stakeholdersBeyond the Paycheck 16-June-03 30
  • SummaryBeyond the Paycheck 16-June-03 31
  • Conclusion • The pieces are available to put in place a cost-effective, scalable program to help mitigate the family and community level impact of AIDS in rural areas • Placer Dome is willing to lead and co- finance but the project is beyond the scope of a single mining company • We request your guidance and assistance to develop the appropriate financial and technical cooperation that can make this dream a realityBeyond the Paycheck 16-June-03 32