Other countries have progressed toward a more modern legal framework, under Occupational Health and Safety Acts. These are essentially drawn from ILO [International Labor Organization] conventions, tend to cover most workers, don't differentiate whether you work in industry or agriculture, and incorporate far more tripartite approaches.

Law on paper and law in practice, however, are two totally different things in Africa. You can have very nice pieces of legislation, and almost zero enforcement at the local level. Even countries that have moved to new legal frameworks may have incredibly weak enforcement systems.
MM:What accounts for the difference in approach?
Loewenson: There are a number of factors. Whether a country decided to move from an old to a new legal framework depends to some extent on the complexity of their preexisting laws. For example, ironically, a country like Zimbabwe, which has a more highly developed set of regulations, might find it more difficult to move from the old Factories and Work Act system to the new Health and Safety Act system. It also depends a bit on the administrative framework, how issues of health and safety are divided between ministries of health and ministries of labor, and other ministries. It depends on the economic level. It depends on the level of state infrastructure. It depends on the strength of the trade unions. It depends on the level of professional development.

But there are other differences that are partly political and partly economic. For example, even countries with the same legal frameworks may set very different penalties for breech of those frameworks. In the region, a penalty in South Africa may be more than 50 times higher than the penalty in Zambia or Tanzania. In part that relates to the pressure from workers. It also relates in a way to the strength of the currency. Some of these penalties may have been set some time ago, and the money will have devalued but the law will not have kept the pace with the value of the currencies. You can get ludicrous situations where the penalty for an act of negligence that leads to the death of a worker amounts to less than $50.

There are other factors, as well: how open the country is to tripartite negotiations, how much power the workers have had in terms of influencing the system directly or indirectly.

Even across those dimensions, over the period of structural adjustment, where macroeconomic reforms have made job security much weaker, and have put competition between industrial production much higher on the agenda, health and safety protections have really slipped. It is a lot more difficult for workers to enforce their rights, because they are worried about their job security.

The period of structural adjustment has had a very negative impact on issues of health and safety, in the same way it has had a negative impact on other areas of social protection.
MM: Do workers have formal rights to enforce workplace safety protections, and how often do they?
Loewenson: Yes and no. On paper, they will have health and safety representatives or they will be able to participate in things like health and safety committees, or they might even in some laws have the right to information, or to refuse dangerous work where they think there is a risk to health. But in practice, what you find is that these rights are not that well specified. For example, if you want to refuse dangerous work, what are the mechanisms, what are the procedures so that your job security is guaranteed? What you find in some cases is countervailing legislation in labor law which says that if you refuse to obey a lawful order, you will be dismissed.

It is difficult for workers to assert their rights unless they are organized. If the unions offer a very strong collective protective framework, if they have trained their representatives, who are selected not by the employer but are a product of active working class struggle, and if they get some degree of back up by the state, then there is a much higher level of enforcement of those rights. But where unionization is weaker, and workers don't have a strong union base to take actions, then even where these rights exist on paper, they are not that well implemented in practice, because of fear of job loss.

Having said that, one sees quite a lot of collective job action taking place over working conditions. It is not a small issue, either because people have been injured or killed at work, or because people find the working conditions untenable and they just react. It does seem to get to a point where people just say, "Enough." It gets to a level below human dignity, where people just take an action, irrespective of what their legal protections are.

But in the main, I think that laws such as the right to refuse dangerous work are very poorly structured and they don't give workers enough protection, and the social systems are quite weak to protect workers when they take these actions.
MM: Do you see those kind of assertions of worker rights where there are lower levels of worker organization - in the informal sector, the agriculture sector?
Loewenson: The agricultural sector is getting more and more organized. The informal sector is very weakly organized, though unions are growing there.

The informal sector is caught up in the circumstance of peculiar employment contracts, with family employment and a lot more casual types of employment. It is difficult to take a collective job action when you are two workers and you are on a casual contract or your uncle employs you. The small enterprises therefore have a much more general problem of how they enforce labor rights, over and above health and safety rights.
MM: In Zimbabwe, say, what is the governmental commitment in resource terms to worker health and safety?
Loewenson: Zimbabwe is a unique situation, because Zimbabwe raises its resources for worker health and safety from the workers' compensation fund, which is essentially employer contributed.

Most countries in the region fund compensation separately from the inspection and prevention services.

In every country that I have had exposure to - mainly in Southern Africa - there is an overwhelming complaint about the inadequacy of inspection services. The level of disease screening, for example, is extremely low. The revenues from workplaces to support these services are very, very low. Fees and penalties don't get rechanneled into inspection and prevention services or training. Unlike Zimbabwe, there is often a poor link between the money that is paid in compensation and the money which is linked to accident prevention.

Most countries have had very serious cutbacks on public funding under structural adjustment and economic reforms, which have generally reduced the state budgets overall. Unfortunately, under these reforms, the state has been weakened at the same time the production environment has become liberalized, so voluntary compliance has also become weaker. There has not been a compensatory pickup of self-inspection in the private sector. There is just generally a decline in resource allocation to health and safety, together with more uncontrolled production processes.
MM: When you speak of the structural adjustment period, you are referring to the last two decades?
Loewenson: It varies by country. In Zimbabwe it would be over the 1990s. In Zambia it would be over the 1980s and 1990s.
MM: What are the leading occupational safety and health issues in agriculture?
Loewenson: If you ask workers, they say pesticides and chemical hazards, ergonomic problems, carrying heavy loads and long hours of working in uncomfortable positions.

Agricultural dusts are also a problem - the problem comes out in things like asthmatic reactions and organic dust-related lung disease - but that is not recognized, because disease is hardly recognized. Of all the injuries that are reported at the workplace, only 2 percent are disease. In countries that have active surveillance systems for occupational disease, the rate is around 40 to 50 percent. So we tend to underestimate the things that are causing occupational disease, like organic dust.

In cases like the sugar plantations, if you look for it, you find so many people suffering from these kinds of problems and having to leave work. These are some of the more chronic, invisible work hazards that don't get picked up.

There is also a great deal of psycho-social stress in the agricultural sector, because the workers are living and working on the farms. They are constantly exposed to the environment of the occupation. They have to cope with it. They have long hours of work. They often have very crude industrial relations systems. They are paid way below poverty levels in many cases. So there is a lot of psycho-social stress, which is also not recognized as an occupational safety and health problem. But you see it manifested in things like alcohol-related problems - it traces back to the living and working conditions that they live in on the farm.
MM: Are those set of problems something that could reasonably be alleviated?
Loewenson: Perhaps 90 percent of the problems that cause workplace injury and illness in our countries are problems that can be prevented. If detected early, they can be managed. Those problems are not experienced in other parts of the world to the extent that we have them.

The profile of illness and injury in Africa is completely different than the profile of illness and injury in Europe, for example. That is due to two factors. One is that the European production processes have internalized systems for reducing hazards at the source. The second is that European production processes have shifted away from some of the risky processes.

The fact that these changes towards safer production have been made elsewhere signals that it is technically feasible in every single case to do something about the occupational risks faced by African workers. The issue is: What is society willing to spend on human beings? I think that is where the big debate comes in.

For example, in the mining sector, the very long hours of work put in are unacceptable elsewhere in the world and have acknowledged health risks. If you say. "Let's reduce the hours of work," it becomes an economic question. What are the employers prepared to pay for dealing with work-related hazard and injury? You can get into a very complex set of issues of how much is this costing them versus how much will they gain from making those improvements. But it also a basic human rights issue: once you know that a hazard exists and it is causing a fair amount of ill health, you have an obligation to reduce that hazard. That balance between human rights and willingness to pay for the economic costs of those rights is not simply resolved at the technical level - it is a product of political and legal struggle.

But we have some unique things in mining. For example, in South Africa where there are extremely deep mines, there is a high risk of heat and other problems that emerge from working in deep mines. There is also a very high rate of accidents, of mine collapses and cave-ins.

There are also stress-related problems due to hours of work. When you are working in very high risk conditions, and you are working a 48-hour week, you get high levels of psycho-social stress taking place.
MM: Are the problems similar in smaller mines?
Loewenson: They are clearly different, because working two kilometers underground and working above surface present a different set of conditions. But you still have problems of dust-related disease and of mechanical hazards, but of a different kind. You don't have problems of collapse; it is more a problem of direct contact with the material and the tools that are being used.

There is a major preoccupation in these old laws with mechanical risks like falls, and risks from scaffolding, elevators, escalators, hoists and such.

What perhaps is less well recognized in the industrial sector are the chemical hazards and the dusts associated with production, and even the heat-related problems. In heavy industry work, such as smelting, there is a high degree of heat-related hazards. This under-recognition of certain hazards means that you can have a sector like the chemical sector, which we know to be a high risk sector, rated as safe as the banking sector, which we know to be a less risky sector, because the chemical industry risks are generally resulting in chronic diseases, and they tend not to be detected.

And then you have a whole new sector growing up around microelectronics and the new production processes that are taking place, including in export processing zones. Those sectors feature ergonomic problems and long hours of work, and the kinds of risks associated with microelectronics, which are partly chemical and partly ergonomic, and sometimes even involve reproductive hazards. Many of these jobs are in free trade zones, and often held by women and people on insecure employment contracts. Their injuries and illnesses tend also not to be detected, because people will leave the job and suffer the problem back in their home environments, and the liability does not come back to the workplace.
MM: What is the safety and health record of the multinationals in Southern Africa?
Loewenson: It is mixed. The multinationals themselves are coming from different waves of entry. There are relatively large multinationals that have their own international safety codes, have a reasonable level of value added in their production processes and have made some level of investment around health and safety, but in a very tightly controlled manner. Multinationals that are working in high-skill sectors tend to invest a bit more in safety than multinationals that are not. They tend to run and monitor their own systems. They tend not to have that much engagement with the state, and sometimes may not even be willing to entertain the unions - they basically control the system.

There are multinationals that don't look that different than the national producers, that basically set themselves at the level of what domestic employers are willing to do.

And then you have multinationals that are actually brought in under legal frameworks - like export processing zone frameworks - that have in some cases suspended health and safety law, or labor law. In those situations, they can have even worse conditions than domestic producers, because they see that as part of their competitive advantage.
MM: Do even the larger multinationals employ double standards, so that they have different standards in African countries than in their home countries?
Loewenson: I have more experience in Zimbabwe, but we've had some discussion with countries like Botswana and South Africa. You cannot say the same standards are being applied in Africa as are applied in their bases in Europe, for example. (I'm saying Europe, because a lot of our multinationals come from Europe, but we also have American companies.) Even those companies that might have codes and practices about doing this, don't. They have different standards.

What kinds of differences do we notice? First, they have different kinds of employment conditions. They may have completely different hours of work, for example, which in itself influences the risks, because you have different levels of exposure. They pay different levels, so workers might be coming in at a different level of nutrition and background good health. They have different commitments to basic benefits like canteens, so the workers' surrounding ability to deal with risks is lower. And then when you look at the actual production processes, you often find that the technological levels are different.

Take a sector that is dealing with paint: the European countries may have moved to water-based paints, removing solvent risks at the source, while we still produce solvent-based paints, so workers are still exposed to solvent risks. Those necessary technology transfers for improved working conditions haven't necessarily been brought into Africa.

The other thing is that there has been a lot more mechanization in Europe, for example, compared to Africa. In African countries, the direct human exposure to hazards is greater. With the broad shift in the production process in Europe, away from very dirty industries, some of these have relocated themselves into our parts of the world.
MM: To what extent is HIV/AIDS a workplace disease in Africa, and how are employers responding to it?
Loewenson: The way HIV/AIDS comes from and affects work is not just an African issue, it is a global issue.

People can be exposed in the workplace - it is a direct occupational risk for people who work with body fluids, or who are exposed to HIV, like health workers.

Others experience risks not directly from the work process, but more around the organization of work. If you travel for work, if you have to be away from your family for a long time, if you have the kind of migrancy that we have in sectors like mining and agriculture and tourism, you are taking people away from their families and increasing the risk of HIV transmission. In that case, it is related to the workplace, and you expect employers to put in place measures to try and mitigate these sorts of risks.

The employer's obligation to reduce these workplace risks for HIV does not mean that the employer also has a right to invade privacy, to get into people's personal lives to find out what their HIV or STI (sexually transmitted infection) status is. A bus driver, for example, does not transmit sexually transmitted infections in their job and you should not be screening them for STIs or HIV as part of their employment. But there is a risk for the worker when they have to travel long distances, particularly without adequate accommodation, and the employer does have an obligation to put in place prevention measures.

This is not something which has been easy to deal with, because employers want on the one hand to find out what people's HIV status is, so they can protect themselves from the costs of AIDS, and on the other hand not take on board the kinds of risk factors that are deriving from the production system and putting workers at risk. That is why unions have pressured both for legal codes of practice that protect workers' employment rights in relation to HIV/AIDS and workplace programs that prevent HIV risks from the way work is organized. Notably, the rights that unions have pushed for on HIV/AIDS are not special rights - they are the same rights that relate to wider medical conditions but that unions have found are being breached in relation to HIV/AIDS.

We do now have in the region a Southern African code on AIDS and employment, and I think we are one of the first regions in the world to do it. This was negotiated by the unions, accepted by government and employers at the regional level, based on certain national codes, and is now being spread across the region. It sets basic employment rights around HIV/AIDS that conform with UN standards. It has been put in law in a number of countries in the region - though how well it is enforced emerges as a new challenge.