South Africa’s health, humanitarian, and socio-economic problems are characterized by extreme inequalities and misdistribution of resources. Thirteen per cent of the population lives in “first world” conditions, while nearly 50% live in poverty, characterised by poor housing and limited access to basic services, such as water, sanitation, electricity and primary education. Worldwide, South Africa has the highest number of people living with HIV – at 6.8 million – and the largest antiretroviral therapy programme, the highest incidence of tuberculosis – with an increasing drug resistant TB epidemic –, and the highest recorded rate of rape. Migrants are at increased risk of violence and have limited access to health care.
MSF currently runs 4 projects in South Africa: 1. Piloting innovative models of care towards increased testing, linking, successfully treating (undetectable) and retaining people with HIV/TB, including DR-TB, in Khayelitsha; 2. Reducing HIV and TB incidence, morbidity and mortality via combination prevention in Eshowe & Mbongolwane; 3. Responding to Sexual & Gender Based Violence within a Large Migrant Population in Rustenburg; and 4. the Stop Stock Out Project monitoring stock outs of essential medicines in South Africa (as a member of a civil society consortium). In addition to medical service delivery, MSF conducts operational research, training and mentoring, and advocacy towards policy change in the areas of HIV, TB, sexual violence, vulnerable migrants, and patent law reform in South Africa.
Based in Khayelitsha: To act as Medical Officer and team leader for the planning and roll out of the new Welcome Back to Care Services.
Antiretroviral therapy roll out in South Africa over the last 15 years has saved lives. However, providing health care for people living with HIV creates new emerging challenges as the epidemic evolves: treatment fatigue (physical and psychological), disengagement from care, HIV resistance; advanced HIV disease in those already known to be treatment experienced, but not disengaged from care. Additionally, providing care in an era of test and treat generates increasing stresses on strained health systems and health care workers.
MSF plans to create the Welcome Back to Care Services Model in health facilties in Khayelitsha.
The aims are:
- to create a welcoming environment and staff approach in health facilities and in community care
- to reduce morbidity by rapid clinical diagnostics and interventions in advanced disease with POCT testing (CD4, TB LAM, Cryptococcal antigen)
- to facilitate rapid ART switch when indicated, and rapid ART re- start when needed
- to improve return to care, treatment outcomes, and retention in care for those who have struggled to manage their HIV
- to use a multi-disciplinary approach across the Welcome Back to Care Services
To achieve this, we are working with patients, epidemiologists, health care workers, facility managers, peer support organisations, and NGOs. Aspects of the program will be operational research, in particular to investigate feasibility of rapid ART switch and use of dolutegravir in indicated clinical scenarios.
The post of Medical Officer will lead the development and roll out of the Welcome Back to Care Services in Khayelitsha. They will work with an MSF team – program medical referent, HIV medical activities manager, nurse specialist mentor and educator counselor- to engage researchers, health care workers, managers, patients, community support workers, NGOs and peer support workers in establishing the service. The MO will work alongside medical staff, and in clinics seeing patients.
The MO will provide outpatient and/or inpatient medical care to patients/beneficiaries according to adapted and updated medical knowledge, MSF protocols, values and universal hygiene standards to improve the patients/beneficiaries health conditions.
Education & Registrations
- Medical Doctor diploma, Desirable diploma in Tropical Medicine
- A medical degree/ MBChB degree
- Current registration with the Health Professions Council of South Africa (HPCSA)
- South African citizenship or a valid work visa
- At least two years’ experience in managing HIV/TB care and treatment preferable in a in a lower socio-economic context (essential)
- Proven experience in patient management in primary care based facilities in South Africa (preferred)
- English (fluent, spoken / written)
- Xhosa (advantageous)
- Word, Excel, PowerPoint and all other basic office software (essential)
- Excellent organizational skills.
- Ability to analyze and interpret data and write written reports
- Strong interest in the care and treatment of people with HIV
- Strong interpersonal and communication skills and the ability to work in a team
PRINCIPLE ACTIVITIES and RESPONSIBILITIES:
- Apply medical knowledge and skills to diagnose and prevention. Carry out outpatient and inpatient consultations, prescribing the necessary treatment respecting MSF protocols.
- Keep the patient and/or his/her family informed about the illness and provide appropriate explanations about the treatment to follow, checking they have understood.
- Follow up the evolution of the hospitalized/IDP patients, through daily visits , consultations and examinations, prescribing the necessary treatment following MSF protocols, deciding whether they can be discharged or transferred to other departments – in collaboration with other doctors- and informing their family about the patient’s evolution.
- Check and control the rational distribution of medicines and equipment under his/her responsibility and take care the quality, disinfection and sterilization of the medical material. Assure general compliance with standing hygiene standards.
- Participate in the collection and analysis of epidemiological data, checking its validity and informing the line manager or project coordinator about any problem or complication of the patient’s illness, medical error and monitors the proper functioning of the department, equipment or material.
- Ensure ongoing training of the medical/paramedical multidisciplinary team in order to optimize the quality of care.
- Knows and ensures all MSF medical protocols are followed and implemented, checking universal precautions are followed at all times and reducing bio-hazard risks and improving infection control. Ensures professional confidentiality is respected.
- Manage the team under his/her direct responsibility according to MSF HR policies and procedures, supervising their performance, organizing and scheduling shifts and rotations, directly participating in emergencies and on calls if necessary.
Context Specific Accountabilities
- Overall responsibilities of HIV Welcome Back Services (WBS) Medical Officer:
- Work with the MSF team as well as CIDER and health care partners across the Khayelitsha HIV health facilities and community to identify potentially eligible HIV patients for the Welcome Back Services
- Assess patients as to eligibility for rapid clinical POCTs and interventions
- Assess patients as to eligibility for ART switches, including dolutegravir, in Welcome Back services model, including completing application forms and submitting to DoH
- Assess patients as to need for rapid or delayed ART start or re-start.
- Monitor clinical progress of patients with advanced HIV, re-engaging in care, and after ART switches, starts and re-starts in Khayelitsha facilities,
- Provide medical support to clinicians and other facility staff in the management of these patients.
- Identify and document all adverse events in all Khayelitsha patients started on new drugs / regimens, even if subsequently managed outside of Khayelitsha (but within Cape Metro).
- Complete and file reports on all Serious Adverse Events to DoH, MSF, pharmaceutical companies and SA regulatory authorities for all Khayelitsha patients on new drugs/regimens.
- Attend clinical meetings related to HIV in Khayelitsha on behalf of MSF.
- Assist the rest of the MSF HIV WBS team with activities related to monitoring and evaluation, operational research and RR-TB psychosocial support.
- Contribute to advocacy activities within the MSF HIV-WBS team, and Khayelitsha project as a whole.
- Develop and undertake training in advanced HIV and the multidisciplinary approach to HIV patients
- Objectives of the HIV Welcome Back Services:
- Assist the HIV Medical Activities Manager to prepare Khayelitsha facilities for the WBS model of care
- Support and mentor staff and colleagues in development and rollout out of WBS model
- Support the OR and programatic use of Dolutegravir in Khayelitsha
- Contribute to efforts to improve services for the WBS target patient group
- Establish comprehensive monitoring (MSF) for all patients in WBS
Job Advantages and Career opportunities:
- Experience in a well-known and professionally recognized international medical humanitarian organization
- Salary package comparable to other non-profit organizations
- 100% medical aid
- 13th Cheque
- 10% pension allowance
Please email a one page application letter, your comprehensive CV with details of 3 contactable referees to: [email protected]