Service Contract No 2007 / 147-446 Strategic ... - Swaziland

- Analysis to determine risk/trends at organisational level as they relate to the sugarindustry (e.g. statistical projections, Health Impact Assessments, research projects),including an analysis of stakeholder response to the possibility of risk. The effects ofpossible changes need be assessed, such as reduction in smallholder projects,mechanisation, and introducing different irrigation systems to reduce employmentrequirements and/or to alleviate the workload of those who are ill.- In any analysis of the HIV/AIDS situation, it is critical to consider issues of gender,particularly as studies have shown that women and girl children are most vulnerableto infection. Concerns include high levels of violence against women and girl children,including sexual assault and rape, linked to HIV/AIDS 49 .- Mainstreaming HIV/AIDS in all activities, not only in sugar companies but also in theout-grower schemes. This will involve co-ordination of tasks and collaboration of effortin HIV/AIDS between all bodies operating within the industry – private, governmentaland non-governmental, drawing on what is currently being undertaken, filling anygaps and ensuring no repetition.- Greater investment in health services impacting on the sugar industry, with extendedoutreach in communities, and particularly to small-scale farmers. All service providerswithin the industry need follow standardised national protocols, in order to ensureadequate training of health providers and adequate treatment at all levels of thehealth care delivery system.- Placing emphasis on VCT programmes, for the industry and those affected byHIV/AIDS within it, to be able to manage the disease; through knowing their status,workers can receive treatment timeously and effectively. According to the SwazilandDemographic and Health Survey (SDHS), the percentage of the adult population whowere tested for HIV and knew their results in 2006 was 22% for women and 9% formen 50 . Although the health service is currently stretched beyond capacity, in order toraise the number of people who know their HIV status, the MoH has been involved inincreasing HIV testing and counselling services at health facilities, utilising mobileoutreach services in the workplace, and including rural communities in VCT 51 .Supplementary to this, through the Global Fund the MoH makes ART available tomost in need.- FAs to include aspects of HIV/AIDS-related organisational policies adopted by theprivate sector; for example, where those medically unfit are given light-duty tasks ortrained to undertake other (newly created) activities.- Implementation of AMS 16001, or a similar system based on South African NationalStandards (SANS) 16001/2007, across the industry. The impact on the workplacefrom high infection rates necessitates the management of HIV/AIDS as a risk to49 Analysis of the Gender, Sex and Power Relations: The Relationship with HIV and AIDS, in: Sekunjalo: ImplementingCEDAW for National Development. Volume 1, Issue 2. January 2009. Cofunded by the UNDP and the EU, Sekunjalo is anewsletter that details the activities of the gender programme within the Gender Coordination Unit (GCU), Ministry ofHome Affairs.50 Central Statistical Office (2007).51 An article on 11 May 2010 (PlusNews) stated that, although mobile clinics for HIV patients have been benefitingcommunities in rural Swaziland, “tight budgets have scuppered plans to expand, or even sustain a fleet of just twovehicles” according to a representative of Swaziland Positive Living (SWAPOL), an NGO that provides mobile clinicsdonated by UNICEF. In theory, mobile clinics are unnecessary because the MoH’s goal of having a medical clinic within 7km of every dwelling has been achieved for about 95 % of the population. However, this can mean travelling for severalhours, particularly difficult for ill patients – and many people cannot afford the bus fare, leading to people defaulting fromtaking their ARV medication. According to the UNDP, 80 % of rural Swazis live in chronic poverty, and on average it takesthem two hours to reach a clinic.RDMU (Strategic Environmental Assessment of the National Adaptation Strategy) - Page 86