The sky is purple, just after dawn, and the air is still chilly in the veldt spring. A couple of hundred miners are milling around above the shaft elevators at Goedehoop Colliery. The miners wear thick green coveralls, white hardhats, big rubber boots. Some are young and lean; many are old and grizzled. They get their morning briefing: who's working where, lights are burned out here and cables aren't running there, what the day's targets are — all that, and a couple other things: One hundred per cent of employees who came back from leave last week volunteered to test for HIV, the supervisor tells them in Fanagalo, the miner's dialect that is a hybrid of South Africa's 11 languages. More than 8,000 condoms have been given out this week. He also tells them how to recognize and prevent tuberculosis, which is the main killer of people with AIDS.
This is not a special health bulletin, a message from the AIDS committee. Just like equipment updates and shaft closing warnings, information about HIV goes out in Goedehoop's every single interaction with its 2,000 employees. “It's been incorporated entirely — it's a factor in this business, like the price of coal or the strength of the rand,” said John Standish-White, the mine manager.
And as he stands in the roar of the mine yard, it's not difficult to understand why: One in five of the miners climbing into the steel-cage elevators has HIV (in other sections of Anglo American PLC's operations, the figure is one in three). This astronomical infection rate is a legacy of the migrant labour system on which the mining industry, still the backbone of South Africa's economy, was built, and it is more than a minor problem. “No one is going to say, ‘18 per cent of your work force has got HIV, oh bad luck, have a tissue' — this plant's got to run, there are trains waiting,” Mr. Standish-White said, gesturing toward the boxcars lined up at the bottom of the chutes for the day's haul of coal.
At the Goedehoop Colliery, two key things happen to keep those trains pulling out of the yard each day. First, there is a newly messianic drive (with incentives including T-shirts, gift packs and an annual cash bonus) to get employees to test for HIV at least once a year — only 5 per cent of the work force tested in 2003, before the drive began; last year it was 96 per cent And so far this year, 84 per cent of workers have tested again.
Then, anyone who tests positive is enrolled in a care program that includes, if the person is sufficiently ill, anti-retroviral (ARV) treatment. There are 135 Goedehoop employees on the drugs now.
“All those guys on [ARVs] are back at work; they're not going to die,” said Mr. Standish-White. Die, or cost the company anything in terms of lost hours, missed targets or disability benefits.
It's all part of Anglo's comprehensive HIV-AIDS management plan, which is, in the opinion of both industry and many public health experts, far and away the best in the world. Now, after years where the mining company was the undisputed leader in its response to the disease, many other businesses are catching up — but they're doing so just as Anglo is grappling with the fact that managing AIDS at work is much, much harder than even their worst-case projections imagined.
By the late 1990s, Anglo knew it had a problem: It was starting to feel the impact of illness and death due to AIDS in its work force. Mining, with its reliance on the physical labour of young men — the worst-affected demographic — was the industry hit hardest. Anglo, with about 121,000 employees, was staring a crisis in the face. HIV infection in Botswana, where the company had huge diamond mines through its interest in De Beers International, was 37 per cent of adults; in Lesotho and Swaziland, the source of a vast pool of labour, it was 39 per cent. In South Africa, 600 people were dying of AIDS each day.
