Margherita Licata and Kofi Amekudzi, Technical Specialists ILOAIDS

The more we learn about the challenges of responding to the Ebola Virus Disease  in West Africa, the easier it becomes to discern parallels to the HIV epidemic —  another health crisis , which we’ve been battling for over 30 years now. The HIV response has some valuable lessons for the way we confront the disease in general, particularly in the workplace. Here’s an example.

About four years ago, we were working in southern Malawi with the ILO Programme for HIV/AIDS on a project targeting workers at the Lujeri Tea Estate. Though the rate of new infections has slowed, Malawi still has some of the highest HIV infection rates in the world, affecting one in every four people who lives there.

If we at the ILO have learnt anything in 15 years of combatting HIV, it’s that the workplace can provide a powerful bulwark against an advancing epidemic.

Our job was to work with the management and workers to decrease their own risks of exposure while making sure that those living with HIV had access to treatment and protection from discrimination.

It was a daunting task. The workers, who lived away from their families in compounds, typically had multiple sexual partners, consisting largely of women who would offer them sex for money. They generally lacked enough information to protect themselves and met with stigma and discrimination when they got infected.

Find out more about ILO’s respone to the Ebola Outbreak. Copyright: AFP/Issouf Sanogo

All of this will sound familiar to anyone engaged in the fight against Ebola. Fear and misinformation fuel the spread of the disease while making survival and recovery harder for those infected.

It’s true that the Ebola outbreak in West Africa is first and foremost a public health crisis. But if we at the ILO have learnt anything in 15 years of combatting HIV, it’s that the workplace can provide a powerful bulwark against an advancing epidemic.

Protection of rights

Another important lesson is to follow a human-rights-based approach. We developed the HIV workplace response based on a policy environment that promised non-discrimination and protection of rights.

The same approach which helped to inform and protect workers at the Lujeri Tea Estate can empower workers in West Africa to help stop the spread of Ebola.

At the Lujeri Tea Estate, we worked with management and employees to set up an education programme that reached over 5,000 people with information about how to reduce the risk of transmission and how to access health services if they got infected.

A committee comprised of both workers and management was created to encourage all employees to know their status. Workers, who felt more comfortable receiving this information from their peers rather than from an official source, became more likely to get tested and more likely to seek treatment when they tested positive.

Workers at the Lujeri Tea Estate in southern Malawi, where an ILO-supported project helped to reduce the rate of HIV infections.

In the meantime, the company made clear that it wouldn’t tolerate discrimination against workers living with HIV.

As examples like this one illustrate, the workplace provides a strong entry point for reaching workers and whole communities with information that can save lives. The same approach which helped to inform and protect workers at the Lujeri Tea Estate can empower workers in West Africa to help stop the spread of Ebola.

Dispelling the stigma

It can help to establish common principles for how to avoid infection while dispelling the stigma which continues to haunt survivors. As health workers are on the frontline of the Ebola response, their working conditions are of utmost importance. They should have  decent work conditions, get paid on time and have adequate training and equipment.

Fundamentally, we must continue to tackle underlying factors like poverty and inequality, which are driving the spread of the disease.

Traditional authorities, faith-based organisations, civil-society groups, employers’ associations, workers’ organisations and leadership at every level of government all have a role to play.

Experts agree that with climate change and growing urbanization, public-health emergencies like the Ebola outbreak may only become more common. If that’s true, then we must be ready to use the lessons and experiences we’ve learned from fighting HIV to deal with them, in the workplace and beyond.

Dennis Zulu, Chief Program Officer, ILO Office for Nigeria, Gambia, Ghana, Liberia and Sierra Leone.

When news of the first cases of the Ebola outbreak started filtering out of Guinea and Sierra Leone in late 2013, it received little media attention—even here in West Africa. The affected villages were so remote that most people assumed it would be easy to contain.

As someone who travels frequently to Freetown (Sierra Leone), I took a special interest in the news. The village of Kenema, now thought to be the epicentre of the outbreak, was formerly the site of an ILO development project.

Fast forward to August 2014, the epidemic has now spread to Liberia, a country where I lived and worked for close to two years, and Nigeria, where I am currently based.

The rising number of Ebola deaths has spread panic and fear through West Africa. Tragically, many of those who lost their lives were medical personnel on the front lines of the emergency response. Their loss has dealt a serious blow to the health systems in both Liberia and Sierra Leone, which were already ill-equipped to manage a crisis of this magnitude.

The ILO has developed over the years a wealth of Occupational Safety and Health instruments and tools which can be of use for the protection of workers against Ebola infection at work. Read the joint WHO/ILO briefing note.

To make matters worse, many health centres in Liberia are closed because their staff are afraid of getting infected. Their fears are understandable. In many cases, they lack the protective gear and training necessary to treat Ebola patients safely.

Across the region, we’ve seen growing awareness about Ebola and how to prevent it, but there’s still plenty of misinformation going around. Riots and attacks on health centres have been the result. People need to be better informed about what’s happening from sources that they trust.

In the meantime, life goes on. People continue going to work even amid a general atmosphere of disquiet. The traditional handshake and hug has given way to an uneasy wave of the hand. It’s common to see people rubbing their hands with sanitizing solution.

As the hundreds of infected medical workers illustrate, the Ebola outbreak is not just a public health emergency—it’s an issue of occupational safety and health. Doctors and nurses aren’t alone. Cleaning personnel, waste management workers, laboratory technicians and anyone else who handles bodies could also be at risk.

“Equipped with the right knowledge from a trusted source, more people can begin taking the necessary precautions to avoid getting infected.”

ILO has a long track-record of working with employers and workers organizations to protect the health and safety of workers. Programmes to inform workers about HIV/AIDS prevention and defend the rights of workers living with HIV are just one example.

For the ILO, supporting the wider response to the Ebola Outbreak will mean activating workplaces across the region as information hubs for the distribution of pamphlets and brochures. Workers themselves can help to spread that information through their own community networks.

Equipped with the right knowledge from a trusted source, more people can begin taking the necessary precautions to avoid getting infected, which will help to contain the spread of the disease.

ILO will also help to disseminate guidelines for the safe handling of patients and materials to healthcare workers, laboratory technicians and anyone else who may come into contact with them.

Our job is to work with unions, employers and governments to equip workers with the knowledge they need to protect themselves. Hopefully, that will help to save lives today as well as tomorrow, the next time Ebola rears its head.

Dennis Zulu

By Dennis Zulu, Chief Program Officer, ILO Office for Nigeria, Gambia, Ghana, Liberia and Sierra Leone.

The room was filled with about 50 excited Liberian youth, all sporting white T-shirts with the inscription “Graduate” printed on the back.

The young women and men had completed three-month apprenticeships with enterprises in the Liberian capital, Monrovia. For many of them, this was the first time in their lives that they had received any form of training, let alone a certificate.

And many had hopes their new skills would open the door to a bright future.

Unfortunately, if past experience was anything to go by, it would not be long before they would face the reality of unemployment head on.

After the ceremony, at which I had presented the certificates, one of the new graduates asked whether I could help him get funds to start a business. He had never heard of microfinance institutions but said he had tried – without success – to borrow money from friends and relatives.

He was convinced his newly acquired skills would enable him to start and run a successful business, and could then help his unemployed father provide for their large family.

I asked what options he had if he could not start the business. He said he feared he might have to go the way of many of his friends who had turned to a life of crime.

Liberia has been at peace for over a decade. But the high youth unemployment rate threatens stability in a country where about 70 per cent of the population is under the age of 30.

Liberian youth have had high expectations since the end of the civil war and demand jobs and improved livelihoods. But these demands have largely remained unmet, despite impressive economic growth rates.

The war deprived young Liberians of the opportunity to get an education: almost 40 per cent of Liberians over 15 years old have never attended school. Young people roam the streets, having none of the skills or experience needed for the few jobs that are available.

Liberia has a labour force of 1.13 million, but only 195,000 people are in paid employment.

Despite unemployment being so high, sometimes it is hard for employers to find candidates with the right set of skills. As many young people lack the numeracy and literacy skills required by technical and vocational training institutions, solving this situation in the short run is not easy.

On top of that, training schools use outdated curricula and have a lack of staff and physical infrastructure. They are therefore ill-equipped to produce graduates who are prepared for the labour market.

The informal economy is often the only available option for Liberian youth – from operating motorcycle taxis, to selling second-hand clothes.

Unfortunately, most of them work under precarious conditions and have little or no support in entrepreneurship training, business development services or access to finance. Consequently, they are unable to grow their businesses or work themselves out of poverty.

In my work I meet a lot of young Liberians who, despite these challenges, are still eager for opportunities to improve their education and ultimately secure good jobs or run successful business.

A lot is already being done by the government of Liberia and many other stakeholders with respect to policy reform and access to basic education, skills development, finance, jobs and income-generating opportunities.

The ILO has implemented successful programmes to generate employment, including the Poverty Reduction through Employment Creation, and three Employment Intensive Investment Programmes, focused on road infrastructure.

Given the magnitude of the problem, it is crucial that the issue be tackled urgently and that programmes have a wide enough scope to meet the hopes and expectations of my graduate friend and the many other Liberian youth looking for jobs.

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