Case study

Design for life

Lesotho's factory workers get access to HIV treatment, thanks to DFID funding

Mathabang and her son. Picture: Dianne Tipping-Woods/DFID
Mathabang and her son. Picture: Dianne Tipping-Woods/DFID

South Africa may be out of the 2010 World Cup but Bafana Bafana shirts still fill the country’s streets with a sea of green and yellow.

For Mathabang Taaso, who lives in Lesotho, just 100 kilometres from South Africa’s Free State Stadium, this is a positive reminder of how far her life has come in the last few years.

Like many women in Lesotho, Mathabang works in the clothing industry making T-shirts, jeans and the ever present football shirts.

In a country where more than 40% of the population are living on less than $2 a day, Mathabang’s job is her lifeline.

But a few years ago, after finding out she was HIV positive, Mathabang’s health, work and the future of her family looked uncertain.

Fighting for life

“Five years ago my husband got ill. I got a job at the clothing factory which means I can support myself and my three sons - I want them to have a good education,” says Mathabang.

“But I started getting ill at the factory. I began vomiting and losing weight.

“I was tested at work and they found that I was HIV positive and that I had tuberculosis.

“Without treatment I was going to die. I was very ill and I was worrying a lot about my children. As the family’s breadwinner, I had to fight for my life.”

Mathabang’s worries about her children’s future are shared by many women in Lesotho. The workforce in clothing factories is largely female and a few years ago more than 40% of its employees were HIV positive. Men often leave Lesotho to find work in neighbouring South Africa and women become the main earners in many households.

Thankfully Mathabang is one of the 83% of workers who can access HIV care and treatment services at work through the Apparel Lesotho Alliance to fight AIDS (ALAFA).

Supported by £2.55 million of UKaid funding from the Department for International Development, the ALAFA workplace programme offers 40,000 workers and their families voluntary HIV testing and counselling, regular health monitoring and treatment, comprehensive family planning and prevention of mother to child transmission services.

Treatment where it’s needed

Long walks, queues and days off work used to make it hard for women with HIV to get to clinics. However ALAFA’s primary health clinics operate in or near the factories which makes it easy for people like Mathabang to get the care and support they need.

“It helps to get treatment at work,” says Mathabang.

“I don’t have to queue at clinics and I know the doctor here. I feel comfortable because I know that I will have help if I am ill again.”

And if Mathabang changes jobs or moves away, the ALAFA programme refers her to her nearest clinic so that she can continue with treatment.

Staying healthy

In the small, poverty stricken country of Lesotho, nearly a quarter of adults are living with HIV or AIDS.

The ALAFA alliance between factory owners, the government, UKaid and other funders brings prevention and treatment services to factories, making them accessible and affordable to employees.

With help from the programme, more than 6,000 women and their families have accessed antiretroviral therapy, 75% of employees have been tested for HIV and 320 HIV negative babies have been born to factory workers.

ALAFA also distributes condoms to almost 38,000 workers every month and has trained hundreds of peer educators to run support groups and counselling services.

When Mathabang first found out that she was HIV positive she weighed just 40 kilograms and her CD4 count, which measures how the body’s immune system is responding to the disease, was very low. 

Today, she is responding well to treatment. She has gained weight and her CD4 count continues to improve.

For Mathabang, staying healthy means that she can support her family, send her children to school and watch them grow.

“When I was ill it also affected my children. My oldest son had to care for me and he was afraid of me dying. It affected his studies and he did not go to school for some time. But now I am healthy, he is back at school.

“I am happy that I can do my work again and I am healthy, and my children are healthy with me.”

Facts and stats

In Lesotho, 270,000 people are living with AIDS.

Lesotho ranks third (after Swaziland and Botswana) among countries most severely affected by HIV and AIDS.

The clothing industry is Lesotho’s largest employer and provides jobs for around 40,000 workers, 80% of whom are women.

DFID has provided £2.55 million of funding to ALAFA, which launched in May 2006.

ALAFA has reached 94% of workers in the clothing industry with preventative HIV services and 83% of the workforce with HIV and AIDS care and treatment.

ALAFA has also trained more than 400 peer educators and distributes condoms to almost 38,000 workers in 33 factories every month.

In October 2008, the DFID-funded ALAFA programme received the Southern African Regional Drivers of Change Award in the business category.

Published 1 July 2010