Richard M. Kavuma
2 April 2002
opinion
Until recently, Dr Charles Sezi was just a regular guy. If you knew him at all, he was an elderly light-skinned elderly doctor with grey hair and a reserved countenance often to be seen driving his well-maintained Peugeot 504 pick- up truck. You may even have hired the services of this consultant physician.
Then he wrote himself into a controversy.
In January 2002, in the Mulago Hospital Bulletin's section entitled "Controversies," Dr Sezi wrote:
"In order to discourage the youth from getting infected with HIV, government should sponsor only HIV negative students to tertiary institutions and subject them to yearly routine HIV tests in order to avoid wastage of resources on HIV positive students."
Dr. Sezi also suggests that only HIV negative recruits should be absorbed into the civil service. This, he argues, should be an appropriate disincentive for acquiring HIV.
Not surprisingly, the suggestions have sparked a public debate about what institutions, companies and employers should do with HIV positive students and job seekers. Most, but not all people The Monitor interviewed poured water on Dr. Sezi's prescription against the rampaging epidemic.
Annet Namatovu, first year Law student at Makerere University
I don't think somebody's health should be the qualification for admission to University or other tertiary institutions, as long as they are able to study.
The parents and relatives of any students with HIV also pay taxes and so the issue of wasting state resources does not arise.
Jacob Masika, Paramedic at Mulago
It would be very unfair to the infected person. What if they got HIV only a year before? Someone would go through university and be able to help their parents before they die. Having HIV does not mean you are dying tomorrow.
Okot, lecturer in Literature at MUK
That would be outright discrimination against the HIV-positive people. Such people need to continue living and to continue participating and to continue being productive. That is the only way to give them hope. I want him [Dr Sezi] to put himself in the shoes of those people: What if it was his daughter? How would he feel about it?
John Ekudu, Dean of Students, MUK
I don't think HIV tests should be tagged to admission to University. These people should be given an opportunity. People with HIV can live long, depending on how they are cared for.
Actually, if they are denied such opportunities, if they are discriminated against they can degenerate very fast since they feel dejected and rejected.
William Kakuru, Deputy Principal, Makerere University Business School
I think the suggestion is repugnant and miserable. AIDS is like any other terminal illness. In fact AIDS today is no longer such a hopeless case.
But it is also impracticable. How do you ensure that the people you have admitted do not get infected? Do you check them every other month?
Charles Onyango-Obbo, Managing Editor, The Monitor
As a taxpayer I would like to see my taxes used to help relieve people with HIV/AIDS.
It is wrong to discriminate against people with HIV for instance when it comes to going to the university. First, like I said, the people who pay taxes which take such people to college expect that their taxes will help to educate them. Secondly, being HIV positive is not the end of the world - the best you can do is to give these fellow citizens means to be able to make a life of their own in a world where the possibilities of their being employed might be limited by their condition.
***
While Dr Sezi may have kicked off a debate over an issue that's relatively alien to Ugandans, managers the world over have for some time now been grappling with issue of avoiding taking on new recruits whose life expectancy is, well, uncertain.
For several years now the issue of HIV/AIDS and its impact on the work place has been a major concern of the international Labour Organisation (ILO) whose primary goal is the provision of decent work, work in conditions of freedom, equity, security and human dignity.
"The direct and indirect costs of HIV/AIDS to business and the economy in these countries as a whole are staggering," said Asseta Baquelle, Director of ILO's Labour Protection Department in a 1999 paper on "HIV/AIDS and the world of work."
Baquelle goes on to state, "HIV/AIDS also affects the quality of labour. Finding qualified top management and skilled workers to replace those who have died or can no longer work can be extremely difficult. It takes a long time to train a newly recruited work force. The pandemic is also leading to increased labour costs."
Because of such pressures on employers, notes Baquelle, People Living With HIV/AIDS (PLWHA) are often discriminated against in respect of employment and occupation. Many employers have responded by testing potential recruits to ensure they do not carry such life-threatening illnesses as AIDS, cancer or tuberculosis.
"The Monitor's policy is to have a broad ranging medical test, and they are more stringent for people entering at senior level," said Managing Editor Charles Onyango-Obbo. "It only stands to reason that HIV is one of the dozen or so areas we look at, but we don't single it out.
"This is because we have a very expensive life insurance scheme for our staff and the insurance company expects full disclosure, because this affects the premiums you pay. Insurance companies make a very big issue of what they call 'pre-existing conditions'."
Onyango-Obbo further explained that where there are "pre-existing conditions" such as HIV the insurance companies will consider the liability to be very high.
"The good thing is that this issue does not arise once you become sick with HIV after you are in The Monitor's employment. It doesn't affect your job security or prospects."
However, the trend within the international human rights movement is to push for a workplace environment where HIV-positive employees and applicants are treated the same as any other staff. ILO, with other partners, has been involved in the development of policies that allow PLWHA a chance to obtain and keep work.
"We are working for a non-discriminatory work place environment as regards HIV/AIDS," said Lydia Mungherera, head of the corporate program of the one year-old Uganda Business Coalition on HIV/AIDS, a local non-governmental organisation. Mungherera said the response of companies that they have contacted (such as MTN, Unilever, Shell) has been very encouraging.
The Uganda Business Coalition on Aids (UBCOA), a task force of multinational and other large companies is also working towards creating "best practice policies" in private sector work places.
"Mandatory HIV/AIDS testing will not be part of recruitment screening procedure nor be included in any regular physical examinations though some company benefits may require such testing to be done," reads one of the policies.
Consequently several companies that have signed up to the "best practice policies" are putting in place elaborate HIV/AIDS policies. Officials of Shell, Uganda Breweries and Unilever Uganda told The Monitor that their policies are modelled on universal policies regarding HIV/AIDS.
"We do not test people for HIV upon joining Shell Uganda. We however do general medical tests, evaluate them on their ability to work," said Severine Gamsonre Thouvenot, Human Resource Manager (HRM) at Shell Uganda.
The company, she said, is seriously considering going into anti-retroviral therapy as part of the health package it extends to its staff.
In addition to not having mandatory HIV tests the companies are also running educational programmes about the epidemic and preventive measures.
Said Stephen Onyait, HRM at Unilever Uganda, "We want people to have as much information as possible and then use it as a basis for making personal decisions."
Martha Elimu, HRM at Uganda Breweries said their employees are not required to disclose to the company their HIV status but if they do, shifting them to appropriate jobs helps them continue working with minimal impairment to their health.
"And even when they fall sick and can't work anymore, we have policies that guide us, we do not just sack you," she said
This, though, is where the dilemma is. While the human rights movement tries to push for the rights of the PLWHA, the fears of the employers, the concerns of businesses are real, as the ILO itself has pointed out.
But it is not only in the corporate world that fears such as these exist.
Concerns about HIV vis-à-vis employment have also been expressed on the domestic front.
Some, though not the majority of affluent men and women in Kampala are sparing no effort to secure their families. While the majority will judge the health of a potential domestic servant just from their casual appearance, there are people who will not take them on unless they have passed the ultimate test - of HIV.
"It may not be easy to enforce HIV screening, but what we did when we suspected that our housemaid might have been HIV-positive, we just asked her to leave," said a respectable married father of two.
Although both Margaret Zziwa, a Member of Parliament, and Lydia Mungherera said they haven't insisted, and wouldn't insist on an HIV test for their domestic employees, again the fears here are real.
In the world of today's working woman, as opposed to house-wife, maids are entrusted with the care of little children and they can do many things out of ignorance, say, shave your child with their razor. A recent newspaper report said that a mother found her baby suckling the maid's breast.
Moreover, it's not unusual for employers to have sex with their servants.
But perhaps we should end this report where we started: With Dr. Sezi's controversial demand for a discriminatory law on AIDS.
Sezi argues that in order to successfully control, and mitigate the impact of AIDS, society must be ready to make sacrifices.
As the costs of the pandemic vis-à-vis the corporate world rise, as the risks to families are exposed and the devastation to society reaches new highs, especially in sub-Saharan Africa, one wonders whether human rights and work ethic are some of the sacrifices that governments and employers in Africa will be willing to make.
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