World AIDS Day: Protecting youth in Liberia

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Meet Pauline, a Nurse Counsellor at a Merlin-supported youth centre in Monrovia, Liberia. On World AIDS Day, we chat with Pauline as she carries out her work with young people at risk of HIV.

Pauline Wleh is in her late forties and has been a Registered Nurse for 23 years. She is incredibly committed to her profession. Unlike most, Pauline stayed in Liberia during the hard years of conflict, continuing to work in Monrovia's Catholic Hospital and treating trauma victims of violence. Today she works as a Nurse Counsellor in the Merlin-supported YMCA Youth Centre in Monrovia.

Legacy of conflict

Since the centre opened in 2007, Pauline has seen it develop into a crucial forum to educate Liberian teenagers on sexual health. She explains why:

"Years of conflict here disrupted our formal schooling system and broke up health services so that youths today know very little about HIV and AIDS. Because of the lack of knowledge, there is a lot of stigma and misconceptions surrounding AIDS now. Youths are too scared to talk to their parents and there is a lack of accessible information. But they can discretely drop in on me between basketball games or after a trip to the computer lab to ask questions, access services and get advice."

At the centre Pauline offers counselling and testing for HIV and other sexually transmitted infections (STIs), treats STIs, provides contraception advice, distributes condoms, and gives pregnancy tests. Outside the centre, Pauline also trains college students to become peer educators, and visits schools and urban slums to provide outreach education on safe sexual health.

Fear of knowing

Pauline counsels hundreds of youths every month, but some aspects of her work are harder than others:

"In the two years since the centre opened, I have seen thousands of young people but only given 291 HIV tests. Although people are keen to talk to me, they are rarely convinced to take an HIV test because they are scared."

The majority who opt out of the testing, claim they will 'come back later,' or more honestly 'don't want to know my status, because I don't want to worry.' Pauline explains that knowledge comes with responsibility and a stigma that most teenagers would rather avoid.

Positive steps

But thankfully Pauline is starting to see changes at the centre. She describes how she is seeing more people this year than last and that many of them are accessing a wider range of her services.

"Boys used to visit only for a handful of condoms, but now they are starting to stay for some counselling as well."

The future

After a long six-day week, commuting by shared yellow taxi to and from Monrovia's Paynesville neighbourhood to the Merlin-supported centre downtown, Pauline finally rests on Sunday. She attends church with her family and cooks the Liberian dish of potato greens and rice for dinner. After 23 years of medical service in Liberia, Pauline says she has no plans to retire any time soon.

"I love working with young people. They give me energy every day. They are open and will always come to me - even when they don't talk to their parents."

Pauline now wants to work in a rural youth centre, where she knows the young people have far less access to sexual health education and resources and where there is still much work to be done.

"Today's youths are Liberia's hope for the future. We must keep working together now so that they, and Liberia, have one!"

Fact Box

Today official figures show that 35,000 people are living with HIV in Liberia, although with a lack of data and very low uptake of HIV testing services, this figure is expected to be much higher in reality. Without proper prevention and care, the long-term consequences of HIV in this poorly resourced and fragile context are potentially devastating.

Merlin-supported staff like Pauline currently offer sexual health education in clinics, schools and communities, distributing condoms and working to reduce stigma and discrimination throughout Liberia. Merlin also offers voluntary counselling and testing (VCT) services in several clinics and youth centres in Montserrado, Grand Bassa, Grand Gedeh and Maryland counties. Together with our local partners, Merlin also supports three local youth drop-in centres in Montserrado and Grand Bassa counties, including the centre where Pauline works.