Moving beyond denial

Living with the reality of AIDS in our country, say some of our truck drivers, is like playing pool. Sometimes you shoot the black ball first and then it's game over... but sometimes you miss the black ball, and then the game can go on. Alwyn Viljoen reports from the road

The meltdown that HIV and Aids can cause in our productive workforce has been predicted for some time now. In the trucking industry it has taken on a significant presence: if the trucks stop, the economy stops. South Africa's fleet operators are suddenly realising that the pool of professional drivers is fast diminishing and that the pandemic is affecting their productivity levels.

"We predicted a 'viral meltdown' in 2002, and in the four years hence, the shortage of experienced drivers is really putting the transport industry - and hence the economy - under pressure. "These are the words of Patrick O'Leary, editor of Fleetwatch magazine. His magazine has campaigned
hard for initiatives to stem the tide.

"It used to be that when a company needed a driver, they'd simply have to test a couple of drivers from the queue outside the gate... today, there are no queues left," he says.

It is a view shared by DaimlerChrysler South Africa, whose war on the immune deficiency illness has recorded demonstrable past successes. Its own workplace programme in East London has already won several awards, notably one from the Global Business Coalition on HIV and AIDS. What began in 1996 with the free medical care of employees suffering from AIDS, has developed into a programme over the past few years which serves as an example to many others on how business and community partnerships can fight the disease.

Over the past five years 96 percent of the company's workforce has already submitted to voluntary HIV tests. As a result, work absences due to illness have been reduced significantly, and the death rate has even been halved. The chances of survival for those affected rose to 93.5 percent - a level that is otherwise only met in Western Europe and North America.

Challenging times for truckers
"Trucking really drives the South African economy and so it is vital that all of those organisations involved in this sector redouble their efforts and drastically scale up comprehensive HIV and AIDS prevention, treatment care, support and risk management," says Kobus van Zyl, divisional head of Mercedes-Benz Commercial Vehicles (MBCV). With this philosophy in mind, MBCV has made a concerted effort to assist initiatives in support of this aim.

Education and awareness of the disease is a way to start, but at present AIDS education approaches are ditching the do-or-die messages of the past in favour of a positive message to people that the diagnosis can be managed with success. The MBCV division recently sponsored a handbook Living Positively with AIDS in conjunction with Fleetwatch.

"In 2002, dire predictions were made of a looming driver shortage to be caused by AIDS-related deaths. Back then, Unisa's Bureau of Market Research predicted an overall 2003 HIV-prevalence rate of 14.87 percent in this sector, and the Human Sciences Research Council 11.4 percent. Four years later, I guess that 56 percent of all truckers are HIV positive," says O'Leary.

However the booklet aims to tell people living with HIV and AIDS that they can live full and meaningful lives as productive members of society. Tertius Wessels of the industry-sponsored Trucking Against AIDS programme says that with the prevailing conditions it was hoped that trucking operators would take part in, or start their own programmes to limit the risk and impact of AIDS on drivers, tyre fitters and diesel mechanics in their businesses.

Yet according to Wessels, the majority of the players in the trucking industry are not really getting
involved.

Trucking against AIDS
Since Trucking Against AIDS was created in 1999 by the National Bargaining Council for the Road Freight Industry (NBC) to improve HIV/AIDS and STI awareness among long-distance truck drivers and sex workers, 12 roadside wellness centres have been established in all provinces along the national trucking routes in South Africa.

MBCV sponsors a mobile clinic in the form of a Sprinter 416 panel van and together with two other Sprinters from the Trucking Against AIDS project, visits truck businesses on site. Wessels, of Trucking Against AIDS, says that the wellness centres on the trucking routes and the Sprinters have enabled them to provide education and primary healthcare. The initiative has dispensed treatment for sexually transmitted diseases to 95 350 people and distributed some 7.9 million condoms.

Like Wessels, O'Leary worries about the industry's participation in the fight against HIV and AIDS. "Trucking Against AIDS are doing wonderful work, but it is a drop in the ocean without buy-in from the entire industry," he says.

"The shortage of experienced drivers is really putting the transport industry - and hence the economy - under pressure."

Shortage
His sentiments were echoed in high places by Jeff Radebe, Minister of Transport, who told the Shell Business Forum in July 2006 that South Africa's six percent economic growth target could be negated by a range of factors, especially the HIV and AIDS pandemic and the effect that it has on the transport industry.

O'Leary described it as "a crisis mode", and added that his magazine was doing everything in its power with industry players such as Mercedes-Benz to get the industry out of the denial mode it is in and to start treating their drivers - AIDS does not have to be an immediate death sentence.

Straight-talking O'Leary warns there was no longer room for political correctness in the fight to keep drivers active behind the wheel.

"Despite all the fantastic work being done by everyone in the AIDS prevention and care industry, the reality is still that very few people, especially drivers, use condoms. The guys like flesh on flesh, and are willing to pay a premium for it. "This is the first reality that we as an industry need to admit: it is not unique to South Africa, but the same the world over."

What is happening on the road?
Transport tested his assertion with several drivers, and met with a surprising mix of results.

At Nikkie's Truck Stop outside Ladysmith, Johan "Pop Rivet" du Toit tells us that the AIDS issue is academic for a lot of older drivers.

"We maintain a celibate lifestyle, not for lack of opportunity - most truckers have girlfriends in every town - but zipping up is the only way to stay healthy," says this veteran trucker.

As part of his health regimen, he eats healthy food, stops to sleep at the same time every night "so I can get the maximum benefit from deep sleep" and keeps his blood pressure low by "avoiding brokers as much as possible!"

He is part of the group of a quarter of a million people who have been reached by Trucking Against AIDS, and one who voluntarily had himself tested.

A different tune is sung at the truck stop outside Columbus Steel in Middelburg, Mpumalanga, where John Hlongwane dropped a handful of change in the Ziyaduma jukebox while joking with Johannes Vilakazi and Christopher Pagathi at the battered pool table.

The Columbus Steel weighbridges are among the busiest in the country, with a truck leaving every minute from either of the scales. The group of drivers whiling away a boring Sunday afternoon at the truck stop outside the entrance have heard all the AIDS messages, and concur: "we prefer flesh-on-flesh".

They profess not to use sex workers, preferring to call on "regular" girlfriends, saying "of course we give them a little pocket money." "It's like this, morena, that ‘slimming disease' may kill me in 10 or 20 years, but I can die in this truck tonight. That worries me more than AIDS."

Added one of the onlookers, (by now made wise by a quart of cider): "Ja, AIDS is like playing pool with these impimpi, they are so bad they sometimes shoot the black ball first and then it's game over, finish and klaar… but sometimes they miss the black ball, and then the game can go on. AIDS is like that."

Living longer
O'Leary agrees that drivers can live and work a long time despite having AIDS.

"That is the crux of Living with AIDS/HIV: a trucking perspective - first admit you have it, and then take the necessary steps to counter the effects of the syndrome on your immune system.

Giving drivers anti-retrovirals is essential for the economy, and staying healthy will prevent a lot of driver fatigue, which I believe is often caused by AIDS symptoms," said O'Leary.

The reality is that drivers who are unwell, are on the road - either from an unhealthy lifestyle that brings on diabetes or from the symptoms of AIDS.

Minister Radebe has announced programmes to beef up the training standards, curricula and certification procedures of recipients of professional driving permits in particular.

"We want to move to a situation where professional driving permits are granted with the provision that a course in advanced/defensive driver training has been completed with a practical test, and stricter medical criteria be adhered to. This is especially necessary in the light of increasing trends in diabetes, and of course HIV and AIDS, which can affect driving ability if not controlled.

"We will have to find ways to balance the need for ensuring an industry that does not discriminate against those affected, but one that also ensures
safety for all road users," said Radebe.

The bottom line is that government cannot do it alone, especially in the trucking industry. "We depend on you to move people and goods safely around the country, to self-regulate your industry and make recommendations to us for improvements," said Radebe.

O'Leary stressed that while drivers are brutally blasé about the reality of being killed by AIDS one day, their employers need to invest in keeping their drivers healthy.

Most experts are in agreement that a combination of in-house programmes and roadside clinics is the best way to reach drivers. Despite the mammoth task, Wessels is undaunted: "The fight has but begun. The growth and continued successful operation of the network of centres has been encouraging as is the financial support received from the NBC of the Road Freight Association and key industry players such as Imperial Logistics, DaimlerChrysler, Unitrans, UTI, TNT, Caltex, Crossroads Express and Engen. Since its inception, these stakeholders have invested a total of R4.3 million in the project.

"Small-time truck operators still need to move on establishing in-house programmes to complement this work.

It seems that to improve the situation on the ground and stem the tide, companies would be wise to invest in anti-retrovirals.

As the classic business maxim goes: You cannot
buy experience.

Goal-getting HIV education
DaimlerChrysler's wish to help children living in areas where they are at risk of becoming infected with HIV has seen them sending two new Sprinter vans onto home ground

South Africa has one of the highest HIV infection rates in the world, with over five million people infected. Children live in areas where they are exposed to a high risk of infection and many of them are orphans and live without parents. In most of these places however, simply arrive at a makeshift field with a soccer ball and you win instant friends and immediate access into the community. And if some of their professional soccer heroes are there to watch the action...

Enter onto the field an organisation called Grassroot Soccer. Part of the FIFA-aligned streetfootballworld Network, they link up with development programmes in South Africa and work within this existing structure, training role models - pro players, coaches and youth players themselves - to get the message out to boys and girls to remain HIV-free. Its curriculum is designed by professional soccer players, educators and doctors to empower young people to make better decisions when they reach sexual maturity.

Recently two Sprinters joined the Grassroot Soccer team. Tobias Reich, director at Mercedes-Benz Vans, explained the objectives of the commitment: "Team sports such as street football have the potential to bring about positive social change in the lives of the young players and give them a better start in life. By taking part in sport, young people learn about competition, team spirit and how to channel aggression."

The 14-seater buses are used to carry children and teenagers to football games and to a variety of outreach events. Community-based football development programmes in the Western Cape use the Sprinter vehicle in an after-school soccer and life-skills programme in various disadvantaged communities. This project builds on the Hoops 4 Hope basketball and life skills programme that has been operating in Cape Town schools for more than 10 years and reaches more than 4 000 children each year.

In Gauteng, DaimlerChrysler is also providing financial support and a Sprinter vehicle to help run a collaborative project with the international NGO, Play Soccer. This programme is run in six different sites throughout Gauteng and provides recreational soccer training and life skills for more than 700 learners.

"The bus is helping us a lot to run and supervise our weekly activities in the sites," says Luciano Cadoni of Play Soccer South Africa. "Girls are also showing a lot of interest in the initiative and the local Supersport channel came to film our practice, while Banyana Banyana and assistant national coach Pitso Mosimane also came to visit.