National Policy on HIV/AIDS PDF

NATIONAL POLICY ON HIV AND AIDS FOR LEARNERS AND EDUCATORS IN PUBLIC SCHOOLS AND D STUDENTS AND EDUCATORS IN FURTHER EDUCATION AND TRAINING INSTITUTIONS (10 AUGUST 1999 VOLUME 410 NUMBER 20372) 1. BACKGROUND HIV and AIDS is one of major challenges to all South Africans. It is estimated that a...

NATIONAL POLICY ON HIV AND AIDS FOR LEARNERS AND EDUCATORS IN PUBLIC SCHOOLS AND D STUDENTS AND EDUCATORS IN FURTHER EDUCATION AND TRAINING INSTITUTIONS (10 AUGUST 1999 VOLUME 410 NUMBER 20372) 1. BACKGROUND HIV and AIDS is one of major challenges to all South Africans. It is estimated that almost 25% of the general population will be HIV positive by the year 2010. In South Africa HIV is spread mainly through: Sexual contact Breast feeding Mother to child In keeping with International standards and in accordance with education law and the constitutional guarantees of the right to a basic education, right not to be unfairly discriminated against, the right to life and bodily integrity, right to privacy, the right to safe environment and the best interests of the child. 2. PURPOSE / INTENTION OF THIS POLICY To prevent the spread of HIV infection. To demystify HIV & AIDS Allay fears Reduce stigma Instill non-discriminatory attitudes Develop knowledge, skills, values and attitudes inorder that they may adopt and maintain behavior that will protect them from HIV infection and to support infected and affected. The policy provides a framework for development of provincial and schools policies and strategic plans for implementation thereof It further recommends establishment of health advisory committees 3. TARGET GROUP Learners and Educators in public schools Students and Educators in further education and training institutions Broader school community Provincial and District officials 4. THE SALIENT FEATURES/KEY MESSAGES OF THE POLICY 4.1 Premises Because of an increase of infection rates, learners, students and educators with HIV & AIDS will increasingly form part of the population of schools and institutions. Non-discrimination and equality with regard to learners, students and educators 4.2 HIV & AIDS testing and admission of learners and students and / or the appointment of educators 4.3 Attendance at schools and institutions by learners or students – right to attend any school/institution. 4.4 Disclosure of HIV & AID status  Learners and educators are not compelled to disclose their status. In cases where voluntary disclosure of their status has been done, it should be treated confidentially. 4.5 A safe school / institution environment Provision must be made for all schools and institutions to implement Universal precautions to eliminate risk of transmission. 4.6 Prevention of HIV transmission during play and sport 4.7 Education on HIV & AIDS – not to be seen as add on, but part of the curriculum 4.8 Duties and responsibilities of learners, students, educators and parents 4.9 Refusal to study with or teach a learner or student with HIV and AIDS or to be taught by an educator with HIV and AIDS. 5 What are its implications in relation to other polices? 5.2 Revised National Curriculum Statement 5.2.1 HIV and AIDS issues cut across all learning areas and therefore in the development of learning programmes these issues must be captured. 5.3 Assessment Policy 5.3.1 It is important that learners who are likely to experience barriers to learning and development are identified early, assessed and provided with learning support. – multiple opportunities, adaptive methods of assessment.. 5.4 Education WP 6 – Inclusive ed. (barriers and orphans, learners at risk) 5.4.1 The development of an inclusive education and training system must take into account the incidence and impact of the spread of HIV and AIDS and other infectious diseases. 5.5 Norms and Standards for funding 5.5.1 For the provisioning of all the appropriate equipment to implement universal precautions to eliminate risk of transmission (first aid kits, rubber gloves) 5.6 Work Place Skills plan 5.6.1 Should include development programmes that would address issues on HIV and AIDS. 5.7 IQMS 5.7.1 Whole school evaluation, school development plans (vision, mission) and school improvement plans must also include HIV and AIDS planned strategy to cope with the pandemic. SASA o Learners of compulsory school – going age with HIV/AID may be granted exemption form attendance in terms of Section 4(1) o If and when learners become incapacitated schools and institutions should make work available to them for study at home and should provide support where possible.  5.9 Constitution of the Republic of South Africa 1996. 5.9.1 To prevent discrimination, all learners, students and educators should be educated about fundamental human rights. 6. What are the possible gaps between policy and its implications? ¾ Insufficient training for educators with regard to HIV and AIDS ¾ Insufficient resources available at institutions ¾ Insufficient funding to purchase the necessary resources needed to address the issues of HIV and AIDS at institutions ¾ Inadequate co-ordination of inter and intra-departmental initiatives concerning HIV and AIDS ¾ Policy should be updated at regular intervals to accommodate the progress made in the prevention and treatment of HIV and AIDS. 7. What are the possible questions concerning the policy? Q. In the development of this policy, were all the relevant stakeholders part of the process? R. Yes. According to the NEPPA agreement, all the relevant stakeholders were consulted in the formulation of the policy. [Department of Justice, Health, Education and Social Services] Q. Is this policy limited to learners, students and educators of Public schools only? R. The policy is available to Independent schools. The recommendations and suggestions could be used by these schools. Q. Are there Provincial and District strategies in place for the monitoring and support of the HIV and AIDS policy? R. Yes. The National Integrated Plan supported by the Departments of Health, Social Services and Education addresses the issue of HIV and AIDS in a co-ordinated manner. Conditional Grant funding has been ‘ring fenced’ to provide resources and teacher training to support the implementation of the policy. In every province HIV and AIDS co-ordinators have been appointed to monitor and support the implementation of the policy. The services of a service provider has also been obtained to assist Schools and School Governing Bodies in developing their HIV and AIDS policy. Q. NGOs and other departments also run HIV and AIDS programmes for schools. What is the nature of the relationship of the Department of Education towards these programmes? R. The National Integrated Plan supported by the Departments of Health, Social Services and Education addresses the issue of HIV and AIDS in a co-ordinated manner. Q. Schools have admitted HIV and AIDS orphans, do these schools have additional support programmes for these learners? R. Schools can play a huge role in identifying these learners so that they are able to access social grants. Q. Is there a recourse for parents of learners, who refuse their child to be taught by a teacher, who is infected? R. Parents can not be punished. Q. What does the policy say regarding disclosure of HIV status by learners and teachers? R. Learners and teachers are not compelled to disclose their status, however a holistic programme for life skills and HIV/AIDS education should encourage voluntary disclosure. Unauthorised disclosure of HIV/AIDS related information could give rise to legal liability. Q Government Gazette Vol.410, No.20372, 10th August 1999. GENERAL NOTICES NOTICE 1926 OF 1999 DEPARTMENT OF EDUCATION NATIONAL EDUCATION POLICY ACT, 1996 (NO. 27 OF 1996) NATIONAL POLICY ON HIV/AIDS, FOR LEARNERS AND EDUCATORS IN PUBLIC SCHOOLS, AND STUDENTS AND EDUCATORS IN FURTHER EDUCATION AND TRAINING INSTITUTIONS I, Kader Asmal, Minister of Education, after consultation with the Council of Education Ministers, hereby publish the national policy on HIV/AIDS for learners in public schools, and students and educators in further education and training institutions, in terms of section 3(4) of the National Education Policy Act, 1996 (No. 27 of 1996), as set out in the Schedule. PROFESSOR KADER ASMAL MINISTER OF EDUCATION AUGUST 1999 SCHEDULE NATIONAL POLICY ON HIV/AIDS FOR LEARNERS AND EDUCATORS IN PUBLIC SCHOOLS AND STUDENTS AND EDUCATORS IN FURTHER EDUCATION AND TRAINING INSTITUTIONS PREAMBLE Acquired Immune Deficiency Syndrome (AIDS) is a communicable disease that is caused by the Human Immunodeficiency Virus (HIV). In South Africa, HIV is spread mainly through sexual contact between men and women. In addition, around one third of babies born to HIV-infected women will be infected at birth or through breast-feeding. The risk of transmission of the virus from mother to baby is reduced by antiretroviral drugs. Infection through contact with HIV-infected blood, intravenous drug use and homosexual sex does occur in South Africa, but constitutes a very small proportion of all infections. Blood transfusions are thoroughly screened and the chances of infection from transfusion are extremely low. 1  People do not develop AIDS as soon as they are infected with HIV. Most experience a long period of around 5 - 8 years during which they feel well and remain productive members of families and workforces. In this asymptomatic period, they can pass their infection on to other people without realising that they are HIV infected. During the asymptomatic period, the virus gradually weakens the infected person's immune system, making it increasingly difficult to fight off other infections. Symptoms start to occur and people develop conditions such as skin rashes, chronic diarrhoea, weight loss, fevers, swollen lymph glands and certain cancers. Many of these problems can be prevented or treated effectively. Although these infections can be treated, the underlying HIV infection cannot be cured. Once HIV-infected people have a severe infection or cancer (a condition known as symptomatic AIDS) they usually die within 1 to 2 years. The estimated average time from HIV infection to death in South Africa is 6 to 10 years. Many HIV infected people progress to AIDS and death in much shorter periods. Some live for 10 years or more with minimal health problems, but virtually all will eventually die of AIDS. HIV-infected babies generally survive for shorter periods than HIV- infected adults. Many die within two years of birth, and most will die before they turn five. However, a significant number may survive even into their teenage years before developing AIDS. ____________________________________________________________________ No cure for HIV infection is available at present. Any cure which is discovered may well be unaffordable for most South Africans. ____________________________________________________________________ HIV/AIDS is one of the major challenges to all South Africans. The findings of the 1998 HIV survey among pregnant women attending public antenatal clinics of the Department of Health, show that the HIV/AIDS epidemic in South Africa is among the most severe in the world and it continues to increase at an alarming pace. The rate of increase is estimated at 33.8%. Using these figures, it is estimated that one in eight of the country's sexually active population those over the age of 14 years - is now infected. In the antenatal survey, the prevalence of HIV/AIDS among pregnant women under the age of 20 years has risen by a frightening 65.4% from 1997 to 1998. According to the 1998 United Nations Report on HIV/AIDS Human Development in South Africa, it is estimated that almost 25% of the general population will be HIV positive by the year 2010. The achievements of recent decades, particularly in relation to life expectancy and educational attainment, will inevitably be slowed down by the impact of current high rates of HIV prevalence and the rise in AIDS-related illnesses and deaths. 2 This will place increased pressures on learners, students and educators. Because the Ministry of Education acknowledges the seriousness of the HIV/AIDS epidemic, and international and local evidence suggests that there is a great deal that can be done to influence the course of the epidemic, the Ministry is committed to minimise the social, economic and developmental consequences of HIV/AIDS to the education system, all learners, students and educators, and to provide leadership to implement an HIV/AIDS policy. This policy seeks to contribute towards promoting effective prevention and care within the context of the public education system. In keeping with international standards and in accordance with education law and the constitutional guarantees of the right to a basic education, the right not to be unfairly discriminated against, the right to life and bodily integrity, the right to privacy, the right to freedom of access to information, the right to freedom of conscience, religion, thought, belief and opinion, the right to freedom of association, the right to a safe environment, and the best interests of the child, the following shall constitute national policy. 1. DEFINITIONS In this policy any expression to which a meaning has been assigned in the South African Schools Act, 1996 (Act No. 84 of 1996), the Further Education and Training Act, 1998 (Act No. 98 of 1998) and the Employment of Educators Act, 1998 (Act No. 76 of 1998), shall have that meaning and, unless the context otherwise indicates "AIDS" means the acquired immune deficiency syndrome, that is the final phase of HIV infection; "HIV" means the human immunodeficiency virus; "institution" means an institution for further education and training, including an institution contemplated in section 38 of the Further Education and Training Act, 1998 (Act No. 98 of 1998); "sexual abuse" means abuse of a person targeting their sexual organs, e.g. rape, touching their private parts, or inserting objects into their private parts; "unfair discrimination" means direct or indirect unfair discrimination against anyone on one or more grounds in terms of the Constitution of the Republic of South Africa, 1996 (Act No.108 of 1996); "universal precautions" refers to the concept used worldwide in the context of HIV/AIDS to indicate standard infection control procedures or precautionary measures aimed at the prevention of HIV transmission from one person to another and includes procedures concerning basic hygiene and the wearing of protective clothing such as latex or rubber gloves or plastic bags when there is a risk of exposure to blood, blood-borne pathogens or 3 blood-stained body fluids; "violence" means violent conduct or treatment that harms the person of the victim, for example assault and rape; "window period" means the period of up to three months before HIV antibodies appear in the blood following HIV infection. During this period HIV tests cannot determine whether a person is infected with HIV or not. 2. PREMISES 2.1 Although there are no known cases of the transmission of HIV in schools or institutions, there are learners with HIV/AIDS in schools. More and more children who acquire HIV prenatally will, with adequate medical care, reach school-going age and attend school. Consequently a large proportion of the learner and student population and educators are at risk of contracting HIV/AIDS. 2.2 HIV cannot be transmitted through day-to-day social contact. The virus is transmitted only through blood, semen, vaginal and cervical fluids and breast milk. Although the virus has been identified in other body fluids such as saliva and urine, no scientific evidence exists to show that these fluids can cause transmission of HIV. 2.3 Because of the increase in infection rates, learners, students and educators with HIV/AIDS will increasingly form part of the population of schools and institutions. Since many young people are sexually active, increasing numbers of learners attending primary and secondary schools, and students attending institutions might be infected. Moreover, there is a risk of HIV transmission as a result of sexual abuse of children in our country. Intravenous drug abuse is also a source of HIV transmission among learners and students. Although the possibility is remote, recipients of infected blood products during blood transfusions (for instance haemophiliacs), may also be present at schools and institutions. Because of the increasing prevalence of HIV/AIDS in schools, it is imperative that each school must have a planned strategy to cope with the epidemic. 2.4 Because ,of the nature of HIV antibody testing and the "window period" or "apparently well period" between infection and the onset of clearly identifiable symptoms, it is impossible to know with absolute certainty who has HIV/AIDS and who does not. Although the Department of Health conducts tests among women attending ante-natal clinics in public health facilities in South Africa as a mechanism of monitoring the progression of the HIV epidemic in South Africa, testing for HIV/AIDS for employment or attendance at schools is prohibited. 2.5 Compulsory disclosure of a learner's, student's or educator's HIV/AIDS status to school or institution authorities is not advocated as this would serve no meaningful purpose. In case of disclosure, educators should be prepared to handle such disclosures and be given support to 4 handle confidentiality issues. 2.6 Learners and students with HIV/AIDS should lead as full a life as possible and should not be denied the opportunity to receive an education to the maximum of their ability. Likewise, educators with HIV/AIDS should lead as full a professional life as possible, with the same rights and opportunities as other educators and with no unfair discrimination being practiced against them. Infection control measures and adaptations must be universally applied and carried out regardless of the known or unknown HIV status of individuals concerned. 2.6.1 The risk of transmission of HIV in the day-to-day school or institution environment in the context of physical injuries, can be effectively eliminated by following standard infection-control procedures or precautionary measures (also known as universal precautions) and good hygiene practices under all circumstances. This would imply that in situations of potential exposure, such as in dealing with accidental or other physical injuries, or medical intervention on school or institution premises in case of illness, all persons should be considered as potentially infected and their blood and body fluids treated as such. 2.6.2 Strict adherence to universal precautions under all circumstances in the school or institution is advised. 2.6.3 Current scientific evidence suggests that the risk of HIV transmission during teaching, sport and play activities is insignificant. There is no risk of transmission from saliva, sweat, tears, urine, respiratory droplets, handshaking, swimming-pool water, communal bath water, toilets, food or drinking water. The statement about the insignificant risk of transmission during teaching, sport and play activities, however, holds true only if universal precautions are adhered to. Adequate wound management has to take place in the classroom and laboratory or on the sports field or playground when a learner or student sustains an open bleeding wound. Contact sports such as boxing and rugby could probably be regarded as sports representing a higher risk of HIV transmission than other sports, although the inherent risk of transmission during any such sport is very low. 2.6.4 Public funds should be made available to ensure the application of universal precautions and the supply of adequate information and education on HIV transmission. The State's duty to take all reasonable steps to ensure safe school and institution environments, is regarded as a sound investment in the future of South Africa. 2.6.5 Within the context of sexual relations, the risk of contracting HIV is significant. There are high levels of sexually active persons within the learner population group in schools. This increases the risk of HIV transmission in schools and institutions for further education and training considerably. Besides sexuality education, morality and life skills education being provided by educators, parents should be encouraged to 5 provide their children with healthy morals, sexuality education and guidance regarding sexual abstinence until marriage and faithfulness to their partners. Sexually active persons should be advised to practice safe sex and to use condoms. Learners and students should be educated about their rights concerning their own bodies, to protect themselves against rape, violence, inappropriate sexual behaviour and contracting HIV. 2.7 The constitutional rights of all learners, students and educators must be protected on an equal basis. If a suitably qualified person ascertains that a learner, student or educator poses a medically recognised significant health risk to others, appropriate measures should be taken. A medically recognised significant health risk in the context of HIV/AIDS could include the presence of untreatable contagious (highly communicable) diseases, uncontrollable bleeding, unmanageable wounds, or sexual or physically aggressive behaviour, which may create the risk of HIV transmission. 2.8 Furthermore, learners and students with infectious illnesses such as measles, German measles, chicken pox, whooping cough and mumps should be kept away from the school or institution to protect all other members of the school or institution, especially those whose immune systems may be impaired by HIV/AIDS. 2.9 Schools and institutions should inform parents of vaccination/inoculation programmes and of their possible significance for the wellbeing of learners and students with HIV/AIDS. Local health clinics could be approached to assist with immunisation. 2.10 Learners and students must receive education about HIV/AIDS and abstinence in the context of life-skills education on an ongoing basis. Life-skills and HIV/AIDS education should not be presented as isolated learning content, but should be integrated in the whole curriculum. It should be presented in a scientific but understandable way. Appropriate course content should be available for the pre-service and in-service training of educators to cope with HIV/AIDS in schools. Enough educators to educate learners about the epidemic should also be provided. 2.10.1 The purpose of education about HIV/AIDS is to prevent the spread of HIV infection, to allay excessive fears of the epidemic, to reduce the stigma attached to it and to instill nondiscriminatory attitudes towards persons with HIV/AIDS. Education should ensure that learners and students acquire age and context-appropriate knowledge and skills in order that they may adopt and maintain behaviour that will protect them from HIV infection. 2.10.2 In the primary grades, the regular educator should provide education about HIV/AIDS, while in secondary grades the guidance counsellor would ideally be the appropriate educator. Because of the sensitive nature of the learning content, the educators selected to offer this education should be specifically trained and supported by the support staff 6 responsible for life skills and HIV/AIDS education in the school and province. The educators should feel at ease with the content and should be a rolemodel with whom learners and students can easily identify. Educators should also be informed by the principal and educator unions of courses for educators to improve their knowledge of, and skills to deal with, HIV/AIDS. 2.10.3 All educators should be trained to give guidance on HIV/AIDS. Educators should respect their position of trust and the constitutional rights of all learners and students in the context of HIV/AIDS. 2.11 In order to meet the demands of the wide variety of circumstances posed by the South African community and to acknowledge the importance of governing bodies, councils and parents in the education partnership, this national policy is intended as broad principles only. It is envisaged that the governing body of a school, acting within its functions under the South African Schools Act, 1996, and the Council of a Further Education and Training Institution, acting within its functions under the Further Education and Training Act, 1998, or any provincial law, should preferably give operational effect to the national policy by developing and adopting an HIV/AIDS implementation plan that would reflect the needs, ethos and values of a specific school or institution and its community within the framework of the national policy. 3. NON-DISCRIMINATION AND EQUALITY WITH REGARD TO LEARNERS, STUDENTS AND EDUCATORS WITH HIV/AIDS 3.1 No learner, student or educator with HIV/AIDS may be unfairly discriminated against directly or indirectly. Educators should be alert to unfair accusations against any person suspected to have HIV/AIDS. 3.2 Learners, students, educators and other staff with HIV/AIDS should be treated in a just, humane and life-affirming way. 3.3 Any special measures in respect of a learner, student or educator with HIV should be fair and justifiable in the light of medical facts, established legal rules and principles; ethical guidelines; the best interest of the learner, student and educator with HIV/AIDS; school or institution conditions; and the best interest of other learners, students and educators. 3.4 To prevent discrimination, all learners, students and educators should be educated about fundamental human rights as contained in the Constitution of the Republic of South Africa, 1996. 4. HIV/AIDS TESTING AND THE ADMISSION OF LEARNERS TO A SCHOOL AND STUDENTS TO AN INSTITUTION, OR THE APPOINTMENT OF EDUCATORS 4.1 No learner or student may be denied admission to or continued 7 attendance at a school or an institution on account of his or her HIV/AIDS status or perceived HIV/AIDS status. 4.2 No educator may be denied the right to be appointed in a post, to teach or to be promoted on account of his or her HIV/AIDS status or perceived HIV/AIDS status. HIV/AIDS status may not be a reason for dismissal of an educator, nor for refusing to conclude, or continue, or renew an educator's employment contract, nor to treat him or her in any unfair discriminatory manner. 4.3. There is no medical justification for routine testing of learners, students or educators for evidence of HIV infection. The testing of learners or students for HIV/AIDS as a prerequisite for admission to, or continued attendance at school or institution, to determine the incidence of HIV/AIDS at schools or institutions, is prohibited. The testing of educators for HIV/AIDS as a prerequisite for appointment or continued service is prohibited. 5. ATTENDANCE AT SCHOOLS AND INSTITUTIONS BY LEARNERS OR STUDENTS WITH HIV/AIDS 5.1 Learners and students with HIV have the right to attend any school or institution. The needs of learners and students with HIV/AIDS with regard to their right to basic education should as far as is reasonably practicable be accommodated in the school or institution. 5.2 Learners and students with HIV/AIDS are expected to attend classes in accordance with statutory requirements for as long as they are able to do so effectively. 5.3 Learners of compulsory school-going age with HIV/AIDS, who are unable to benefit from attendance at school or home education, may be granted exemption from attendance in terms of section 4(1) of the South African Schools Act, 1996, by the Head of Department, after consultation with the principal, the parent and the medical practitioner where possible. 5.4 If and when learners and students with HIV/AIDS become incapacitated through illness, the school or institution should make work available to them for study at home and should support continued learning where possible. Parents should, where practically possible, be allowed to educate their children at home in accordance with the policy for home education in terms of section 51 of the South African Schools Act, 1996, or provide older learners with distance education. 5.5 Learners and students who cannot be accommodated in this way or who develop HIV/AIDS-related behavioural problems or neurological damage, should be accommodated, as far as is practically possible, within the education system in special schools or specialised residential institutions for learners with special education needs. Educators in these institutions 8 must be empowered to take care of and support HIV-positive learners. However, placement in special schools should not be used as an excuse to remove HIV-positive learners from mainstream schools. 6. DISCLOSURE OF HIV/AIDS-RELATED INFORMATION AND CONFIDENTIALITY 6.1 No learner or student (or parent on behalf of a learner or student), or educator, is compelled to disclose his or her HIV/AIDS status to the school or institution or employer. (In cases where the medical condition diagnosed is the HIV/AIDS disease, the Regulations relating to communicable diseases and the notification of notifiable medical conditions Health Act, 1977 only require the person performing the diagnosis to inform the immediate family members and the persons giving care to the person and, in cases of HIV/AIDS-related death, the persons responsible for the preparation of the body of the deceased.) 6.2 Voluntary disclosure of a learner's, student's or educator's HIV/AIDS status to the appropriate authority should be welcomed and an enabling environment should be cultivated in which the confidentiality of such information is ensured and in which unfair discrimination is not tolerated. In terms of section 39 of the Child Care Act, 1983 (Act No. 74 of 1983), any learner or student above the age of 14 years with HIV/AIDS, or if the learner is younger than 14 years, his or her parent, is free to disclose such information voluntarily. 6.3 A holistic programme for life-skills and HIV/AIDS education should encourage disclosure. In the event of voluntary disclosure, it may be in the best interests of a learner or student with HIV/AIDS if a member of the staff of the school or institution directly involved with the care of the learner or student, is informed of his or her HIV/AIDS status. An educator may disclose his or her HIV/AIDS status to the principal of the school or institution. 6.4 Any person to whom any information about the medical condition of a learner, student or educator with HIV/AIDS has been divulged, must keep this information confidential. 6.5 Unauthorised disclosure of HIV/AIDS-related information could give rise to legal liability. 6.6 No employer can require an applicant for a job to undergo an HIV test before he/she is considered for employment. An employee cannot be dismissed, retrenched or refused a job simply because he or she is HIV positive. 7. A SAFE SCHOOL AND INSTITUTION ENVIRONMENT 7.1 The MEC should make provision for all schools and institutions to implement universal precautions to eliminate the risk of transmission of 9 all blood-borne pathogens, including HIV, effectively in the school or institution environment. Universal precautions include the following: 7.1.1 The basis for advocating the consistent application of universal precautions lies in the assumption that in situations of potential exposure to HIV, all persons are potentially infected and all blood should be treated as such. All blood, open wounds, sores, breaks in the skin, grazes and open skin lesions, as well as all body fluids and excretions which could be stained or contaminated with blood (for example tears, saliva, mucus, phlegm, urine, vomit, faeces and pus) should therefore be treated as potentially infectious. (a) Blood, especially in large spills such as from nosebleeds, and old blood or blood stains, should be handled with extreme caution. (b) Skin exposed accidentally to blood should be washed immediately with soap and running water. (c) All bleeding wounds, sores, breaks in the skin, grazes and open skin lesions should ideally be cleaned immediately with running water and/or other antiseptics. (d) If there is a biting or scratching incident where the skin is broken, the wound should be washed and cleansed under running water, dried, treated with antiseptic and covered with a waterproof dressing. (e) Blood splashes to the face (mucous membranes of eyes, nose or mouth) should be flushed with running water for at least three minutes. (f) Disposable bags and incinerators must be made available to dispose of sanitary wear. 7.1.2 All open wounds, sores, breaks in the skin, grazes and open skin lesions should at all times be covered completely and securely with a non-porous or waterproof dressing or plaster so that there is no risk of exposure to blood. 7.1.3 Cleansing and washing should always be done with running water and not in containers of water. Where running tap water is not available, containers should be used to pour water over the area to be cleansed. Schools without running water should keep a supply, e.g. in a 25-litre drum, on hand specifically for use in emergencies. This water can be kept fresh for a long period of time by adding a disinfectant, such as Milton, to it. 7.1.4 All persons attending to blood spills, open wounds, sores, breaks in the skin, grazes, open skin lesions, body fluids and excretions should wear protective latex gloves or plastic bags over their hands to eliminate 10 the risk of HIV transmission effectively. Bleeding can be managed by compression with material that will absorb the blood, e.g. a towel. 7.1.5 If a surface has been contaminated with body fluids and excretions which could be stained or contaminated with blood (for instance tears, saliva, mucus, phlegm, urine, vomit, faeces and pus), that surface should be cleaned with running water and fresh, clean household bleach (1: 10 solution), and paper or disposable cloths. The person doing the cleaning must wear protective gloves or plastic bags. 7.1.6 Blood-contaminated material should be sealed in a plastic bag and incinerated or sent to an appropriate disposal firm. Tissues and toilet paper can readily be flushed down a toilet. 7.1.7 If instruments (for instance scissors) become contaminated with blood or other body fluids, they should be washed and placed in a strong household bleach solution for at least one hour before drying and re-using. 7.1.8 Needles and syringes should not be re-used, but should be safely disposed of. 7.2 All schools and institutions should train learners, students, educators and staff in first aid, and have available and maintain at least two first aid kits, each of which should contain the following: (a) two large and two medium pairs of disposable latex gloves; (b) two large and two medium pairs of household rubber gloves for handling blood-soaked material in specific instances (for example when broken glass makes the use of latex gloves inappropriate); (c) absorbent material, waterproof plasters, disinfectant (such as hypochlorite), scissors, cotton wool, gauze tape, tissues, containers for water and a resuscitation mouth piece or similar device with which mouth-to-mouth resuscitation could be applied without any contact being made with blood or other body fluids. (d) protective eye wear; and (e) a protective face mask to cover nose and mouth. 7.3 Universal precautions are in essence barriers to prevent contact with blood or body fluids. Adequate barriers can also be established by using less sophisticated devices than those described in 7.2, such as (a) unbroken plastic bags on hands where latex or rubber gloves are not available; (b) common household bleach for use as disinfectant, diluted one part bleach to ten parts water (1:10 solution) made up as needed. 11  (c) spectacles; and (d) a scarf. 7.4 Each classroom or other teaching area should preferably have a pair of latex or household rubber gloves. 7.5 Latex or household rubber gloves should be available at every sports event and should also be carried by the playground supervisor. 7.6 First-aid kits and appropriate cleaning equipment should be stored in one or more selected rooms in the school or institution and should be accessible at all times, also by the playground supervisor. 7.7 Used items should be dealt with as indicated in paragraphs 7.1.6 and 7.1.7. 7.8 The contents of the first-aid kits, or the availability of other suitable barriers, should be checked each week against a contents list by a designated staff member of the school or institution. Expired and depleted items should be replaced immediately. 7.9 A fully equipped first-aid kit should be available at all school or institution events, outings and tours, and should be kept on vehicles for the transport of learners to such events. 7.10 All learners, students, educators and other staff members, including sports coaches, should be given appropriate information and training on HIV transmission, the handling and use of first-aid kits, the application of universal precautions and the importance of adherence universal precautions. 7.10.1 Learners, students, educators and other staff members should be trained to manage their own bleeding or injuries and to assist and protect others. 7.10.2 Learners, especially those in pre-primary and primary schools, and students should be instructed never to touch the blood, open wounds, sores, breaks in the skin, grazes and open skin lesions of others, nor to handle emergencies such as nosebleeds, cuts and scrapes of friends on their own. They should be taught to call for the assistance of an educator or other staff member immediately. 7.10.3 Learners and students should be taught that all open wounds, sores, breaks in the skin, grazes and open skin lesions on all persons should be kept covered completely with waterproof dressings or plasters at all times, not only when they occur in the school or institution environment. 12  7.11 All cleaning staff, learners, students, educators and parents should be informed about the universal precautions that will be adhered to at a school or an institution. 7.12 A copy of this policy must be kept in the media centre of each school or institution. 8. PREVENTION OF HIV TRANSMISSION DURING PLAY AND SPORT 8.1 The risk of HIV transmission as a result of contact play and contact sport is generally insignificant. 8.1.1 The risk increases where open wounds, sores, breaks in the skin, grazes, open skin lesions or mucous membranes of learners, students and educators are exposed to infected blood. 8.1.2 Certain contact sports may represent an increased risk of HIV transmission. 8.2 Adequate wound management, in the form of the application of universal precautions, is essential to contain the risk of HIV transmission during contact play and contact sport. 8.2.1 No learner, student or educator may participate in contact play or contact sport with an open wound, sore, break in the skin, graze or open skin lesion. 8.2.2 If bleeding occurs during contact play or contact sport, the injured player should be removed from the playground or sports field immediately and treated appropriately as described in paragraphs 7.1.1 to 7.1.4. Only then may the player resume playing and only for as long as any open wound, sore, break in the skin, graze or open skin lesion remains completely and securely covered. 8.2.3 Blood-stained clothes must be changed. 8.2.4 The same precautions should be applied to injured educators, staff members and injured spectators. 8.3 A fully equipped first-aid kit should be available wherever contact play or contact sport takes place. 8.4 Sports participants, including coaches, with HIV/AIDS should seek medical counselling before participation in sport, in order to assess risks to their own health as well as the risk of HIV transmission to other participants. 8.5 Staff members acting as sports administrators, managers and coaches should ensure the availability of first-aid kits and the adherence to universal precautions in the event of bleeding during participation in 13 sport. 8.6 Staff members acting as sports administrators, managers and coaches have special opportunities for meaningful education of sports participants with respect to HIV/AIDS. They should encourage sports participants to seek medical and other appropriate counselling where appropriate. 9. EDUCATION ON HIV/AIDS 9.1 A continuing life-skills and HIV/AIDS education programme must be implemented at all schools and institutions for all learners, students, educators and other staff members. Measures must also be implemented at hostels. 9.2 Age-appropriate education on HIV/AIDS must form part of the curriculum for all learners and students, and should be integrated in the life-skills education programme for pre-primary, primary and secondary school learners. This should include the following: 9.2.1 providing information on HIV/AIDS and developing the life skills necessary for the prevention of HIV transmission; 9.2.2 inculcating from an early age onwards basic first-aid principles, including how to deal with bleeding with the necessary safety precautions; 9.2.3 emphasising the role of drugs, sexual abuse and violence, and sexually transmitted diseases (STDs) in the transmission of HIV, and empowering learners to deal with these situations; 9.2.4 encouraging learners and students to make use of health care, counselling and support services (including services related to reproductive health care and the prevention and treatment of sexually transmitted diseases) offered by community service organisations and other disciplines; 9 2.5 teaching learners and students how to behave towards persons with HIV/AIDS, raising awareness on prejudice and stereotypes around HIV/AIDS; 9.2.6 cultivating an enabling environment and a culture of nondiscrimination towards persons with HIV/AIDS; and 9.2.7 providing information on appropriate prevention and avoidance measures, including abstinence from sexual intercourse and immorality, the use of condoms, faithfulness to one's partner, obtaining prompt medical treatment for sexually transmitted diseases and tuberculosis, avoiding traumatic contact with blood, and the application of universal precautions. 9.3 Education and information regarding HIV/AIDS must be given in an accurate and scientific manner and in language and terms that are understandable. 14  9.4 Parents of learners and students must be informed about all life-skills and HIV/AIDS education offered at the school and institution, the learning content and methodology to be used, as well as values that will be imparted. They should be invited to participate in parental guidance sessions and should be made aware of their role as sexuality educators and imparters of values at home. 9.5 Educators may not have sexual relations with learners or students. Should this happen, the matter has to be handled in terms of the Employment of Educators Act, 1998. 9.6 If learners, students or educators are infected with HIV, they should be informed that they can still lead normal, healthy lives for many years by taking care of their health. 10. DUTIES AND RESPONSIBILITIES OF LEARNERS, STUDENTS, EDUCATORS AND PARENTS 10.1 All learners, students and educators should respect the rights of other learners, students and educators. 10.2 The Code of Conduct adopted for learners at a school or for students at an institution should include provisions regarding the unacceptability of behaviour that may create the risk of HIV transmission. 10.3 The ultimate responsibility for the behaviour of a learner or a student rests with his or her parents. Parents of all learners and students: 10.3.1 are expected to require learners or students to observe all rules aimed at preventing behaviour which may create a risk of HIV transmission; and 10.3.2 are encouraged to take an active interest in acquiring any information or knowledge on HIV/AIDS supplied by the school or institution, and to attend meetings convened for them by the governing body or council. 10.4 It is recommended that a learner, student or educator with HIV/AIDS and his or her parent, in the case of learners or students, should consult medical opinion to assess whether the learner, student or educator, owing to his or her condition or conduct, poses a medically recognised significant health risk to others. If such a risk is established, the principal of the school or institution should be informed. The principal of the school or institution must take the necessary steps to ensure the health and safety of other learners, students, educators and staff members. 10.5 Educators have a particular duty to ensure that the rights and dignity of all learners, students and educators are respected and 15 protected. 11. REFUSAL TO STUDY WITH OR TEACH A LEARNER OR STUDENT WITH HIV/AIDS, OR TO WORK WITH OR BE TAUGHT BY AN EDUCATOR WITH HIV/AIDS 11.1 Refusal to study with a learner or student, or to work with or be taught by an educator or other staff member with, or perceived to have HIV/AIDS, should be preempted by providing accurate and understandable information on HIV/AIDS to all educators, staff members, learners, students and their parents. 11.2 Learners and students who refuse to study with a fellow learner or student or be taught by an educator or educators and staff who refuse to work with a fellow educator or staff member or to teach or interact with a learner or student with or perceived to have HIV/AIDS and are concerned that they themselves will be infected, should be counselled. 11.3 The situation should be resolved by the principal and educators in accordance with the principles contained in this policy, the code of conduct for learners, or the code of professional ethics for educators. Should the matter not be resolved through counselling and mediation, disciplinary steps may be taken. 12. SCHOOL AND INSTITUTIONAL IMPLEMENTATION PLANS 12.1 Within the terms of its functions under the South African Schools Act, 1996, the Further Education and Training Act, 1998, or any applicable provincial law, the governing body of a school or the council of an institution may develop and adopt its own implementation plan on HIV/AIDS to give operational effect to the national policy. 12.2 A provincial education policy for HIV/AIDS, based on the national policy, can serve as a guideline for governing bodies when compiling an implementation plan. 12.3 Major roleplayers in the wider school or institution community (for example religious and traditional leaders, representatives of the medical or health care professions or traditional healers) should be involved in developing an implementation plan on HIV/AIDS for the school or institution. 12.4 Within the basic principles laid down in this national policy, the school or institution implementation plan on HIV/AIDS should take into account the needs and values of the specific school or institution and the specific communities it serves. Consultation on the school or institution implementation plan could address and attempt to resolve complex questions, such as discretion regarding mandatory sexuality education, or whether condoms need to be made accessible within a school or institution as a preventive measure, and if so under what circumstances. 16  13. HEALTH ADVISORY COMMITTEE 13.1 Where community resources make this possible, it is recommended that each school and institution should establish its own Health Advisory Committee as a committee of the governing body or council. Where the establishment of such a committee is not possible, the school or institution should draw on expertise available to it within the education and health systems. The Health Advisory Committee may as far as possible use the assistance of community health workers led by a nurse, or local clinics. 13.2 Where it is possible to establish a Health Advisory Committee, the Committee should: 13.2.1 be set up by the governing body or council and should consist of educators and other staff,, representatives of the parents of learners at the school or students at the institution, representatives of the learners or students, and representatives from the medical or health care professions; 13.2.2 elect its own chairperson who should preferably be a person with knowledge in the field of health care; 13.2.3 advise the governing body or council on all health matters, including HIV/AIDS; 13.2.4 be responsible for developing and promoting a school or institution plan of implementation on HIV/AIDS and review the plan from time to time, especially as new scientific knowledge about HIV/AIDS becomes available; and 13.2.5 be consulted on the provisions relating to the prevention of HIV transmission in the Code of Conduct. 14. IMPLEMENTATION OF THIS NATIONAL POLICY ON HIV/AIDS 14.1 The Director-General of Education and the Heads of provincial departments of education are responsible for the implementation of this policy, in accordance with their responsibilities in terms of the Constitution of the Republic of South Africa, 1996, and any applicable law. Every education department must designate an HIV/AIDS Programme Manager and a working group to communicate the policy to all staff, to implement, monitor and evaluate the Department's HIV/AIDS programme, to advise management regarding programme implementation and progress, and to create a supportive and nondiscriminatory environment. 14.2 The principal or the head of a hostel is responsible for the practical implementation of this policy at school, institutional or hostel level, and for maintaining an adequate standard of safety according to this 17 policy. 14.3 It is recommended that a school governing body or the council of an institution should take all reasonable measures within its means to supplement the resources supplied by the State in order to ensure the availability at the school or institution of adequate barriers (even in the form of less sophisticated material) to prevent contact with blood or body fluids. 14.4 Strict adherence to universal precautions under all circumstances (including play and sports activities) is advised, as the State will be liable for any damage or loss caused as a result of any act or omission in connection with any educational activity conducted by a public school or institution. 15. REGULAR REVIEW This policy will be reviewed regularly and adapted to changed circumstances. 16. APPLICATION 16.1 This policy applies to public schools which enroll learners in one or more grades between grade zero and grade twelve, to further education and training institutions, and to educators. 16.2 Copies of this policy must be made available to independant schools registered with the provincial departments of education. 17. INTERPRETATION In all instances, this policy should be interpreted to ensure respect for the rights of learners, students and educators with HIV/AIDS, as well as other learners, students, educators and members of the school and institution communities. 18. WHERE THIS POLICY MAY BE OBTAINED This policy may be obtained from The Director: Communication, Department of Education, Private Bag X895, Pretoria, 0001, Tel. No. (012) 312-5271. This policy is also available on the Internet at the following web site: http://education.pwv.gov.za 18