The HIV/AIDS epidemic in Africa is made worse by a severe shortage of nurses and other healthcare workers, who also are experiencing high rates of infection or are leaving Africa for jobs abroad, says AFT vice president Candice Owley.

In a briefing for the AFT democracy committee and later for the union’s executive council in February, Owley, also chair of AFT Healthcare’s program and policy council, reported on her trip last summer to Botswana, South Africa, Swaziland and Zimbabwe, where she and AFT Healthcare division director Mary MacDonald visited hospitals and met with representatives of nurses unions.

HIV/AIDS is "changing the face of the continent," Owley told council members. Because so many have died from the disease, the average age of the population is now 18, and life expectancy in some countries has dropped into the 30s.

Owley noted that the healthcare systems in these countries have been overwhelmed, "some to the point of complete breakdown," by the epidemic. Hospitals are overcrowded beyond capacity, with few supplies and little or no safety equipment—sometimes not even latex gloves. Even though HIV drugs are becoming more available in certain countries, "the bigger problem is the infrastructure to distribute those drugs," she said.

In Botswana, a relatively prosperous country compared to its neighbors, many nurses trained under the British system there are quickly recruited by employers in the United Kingdom, Australia, New Zealand and the United States. The same is true in Swaziland, she noted, where up to 80 percent of nursing positions sit vacant. For every 90 nurses who graduate each year, more than 200 leave the country.

A key part of the trip was meeting with a nurses union in Botswana that was seeking advice on becoming a trade union. The way the labor laws are written, however, only a union that represents a majority of all healthcare workers can receive formal recognition, and there already are two large, well-organized healthcare unions, said Owley and MacDonald. Nevertheless, all agreed that the group should continue as a professional association with an alliance with the unions to deal with working conditions and economics.

In South Africa, the two visited a public hospital in Soweto, where half the patients had HIV/AIDS. As is the case throughout Africa, there also is a severe shortage of nurses and lab professionals in South Africa. The Soweto hospital has 1,000 vacant positions. Owley and MacDonald met with union leaders who are aggressively fighting for adequate wages and benefits, as well as supplies and equipment. Zimbabwe, once a vibrant country with a robust tourist trade, is essentially in economic collapse under a corrupt government, they reported. Healthcare employees are "leaving in droves," they noted, and there is not enough gasoline to run the ambulances. There are no antiviral drugs to treat HIV/AIDS, even for the nurses who have been exposed to the disease, and no safety supplies. In spite of the situation, they noted, nurses and teacher unionists had joined forces for a successful wage strike.

The unionists told Owley and MacDonald that they would continue to fight for better working conditions, even though they knew they were under government surveillance via tapped phones. "We were amazed at the determined and in many ways optimistic attitude of these brave union leaders," they said.

The AFT is helping a number of African teachers unions fight the HIV/AIDS epidemic. For more information, visit our AFT-Africa AIDS Campaign at http://www.aft.org/partners/africa-aids/index.htm.