Christine Du Preeze

Ashoka Fellow
South Africa,
Fellow Since 2014
Christine Du Preeze - Indivudual

Citation

This profile was prepared when Christine Du Preeze was elected to the Ashoka Fellowship in 2014.
The New Idea
Agriculture is considered one of the main industries providing employment to the majority of the labor force in rural areas of South Africa. Many people in rural areas are employed on farms either as permanent or seasonal workers providing unskilled labor to the farmers. Almost 85% of people employed on the farms migrate on a daily basis from rural communities as far as more than 100 km away from the farms. This makes it difficult for those that are HIV positive to access decent health and support services on a regular basis from health centers in their communities since they spend the whole day on the farms, leaving home around 4:30 am and coming back around 7 pm. Christine has developed a practical solution for reaching out to the farm workers on site with effective, reliable and regular healthcare solutions on HIV/AIDS and other related diseases. Through her organization, Hlokomela Training Trust (HTT), Christine makes sure that HIV positive farm workers are able to access medication and support services on-site and during working hours consistently and conveniently to ensure their wellness and positive living.

Hlokomela’s entry point is the establishment of HIV/AIDS clinics that are conveniently accessible to farm workers. The clinics are staffed with professional healthcare workers and provide all basic HIV/AIDS services including Voluntary Counselling and Testing (VCT), administering Anti-Retroviral Treatment (ART), counseling, nutrition and all round wellness services. HTT also has an outreach program through mobile clinics to ensure that workers even from distant farms and game reserves are accessing the services conveniently. One of Christine’s strongest innovations is in the way she has incorporated into her idea a peer caregiving strategy that influences behavior change on the farms and ensures integral wellness of farm workers that are HIV positive. Each farm has a caregiver called Nompilo (meaning “one who brings life”) who is a farm worker selected by the farm workers themselves and acts as a pivotal figure responsible for the health and wellness of their colleagues. These Nompilos are trained in relevant courses to equip them with the knowledge and leadership skills to effectively assume their roles. The Nompilos initiate behavior change in their fellow workers to reduce the spread of HIV and eliminate stigmatization both from other workers on the farm, community members and the farm managers. They are responsible to ensure that workers regularly go for VCT and practice safe sex and also reduce the rate of defaulting on ART.

Nompilos are at the core of Christine’s model in linking the farm workers, the farm owners/manager and HTT and together provide a holistic inside-out caregiving structure for migrant farm workers. They also represent their colleagues to the farm managers on labor issues relating to HIV/AIDS care (like negotiating for sick leave to go for check-up). Therefore, Christine is also working to improve the working conditions of farm workers by brokering relationships between farm workers and the farm owners. Christine realizes that the strained and poor working conditions for farm workers on most farms contribute to the deterioration of the farm workers’ health especially those that are HIV positive and this has a direct negative impact on overall productivity on the farms. This is based on the concept that a satisfied worker in good health is the most valuable asset to increase productivity.

Christine is currently reaching out to about 12,000 farm workers on more than 69 farms and game reserves, through a network of about 70 Nompilos. HTT has negotiated for a revised work place policy with assistance from the International Organisation for Migration which has now been adopted on 65 farms around Hoedspruit. Further, low HIV prevalence have been reported on the farms where Christine works: currently at 29% as compared to the average prevalence rate of 40% for farm workers in South Africa. She is now ready for national spread and is negotiating a partnership with the government’s department of health which wants to adopt her model and scale out to other farms beyond the Limpopo province. She is also seeing early adoption of her model in neighboring Lesotho.
The Problem
The Strategy
The Person

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