RR-TB MEDICAL OFFICER: Khayelitsha

RR-TB MEDICAL OFFICER: Khayelitsha

Job title: RR-TB Medical Officer

Work Location: Khayelitsha, Western Cape

Duration: 12 months

Start date: 01 June 2017 or as soon as possible thereafter

Reports to: RR-TB Clinical Manager

Country Context

South Africa's health, humanitarian, and socio-economic problems are characterized by extreme inequalities and uneven distribution 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 gender based violence. Migrants are at increased risk of violence and have limited access to health care.

Médecins Sans Frontières (MSF), also known as Doctors Without Borders, currently runs 4 projects in South Africa: 1. Piloting innovative models of HIV care towards increased testing, linking, successfully treating (undetectable viral loads) and retaining in care people with HIV/TB, including rifampicin-resistant TB (RR-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.

Purpose of the post

The decentralized RR-TB programme was implemented in Khayelitsha in 2007 in collaboration with the Provincial Government of Western Cape and Cape Town City Health to provide patient-centered, community-based care for patients diagnosed with RR-TB. The programme succeeded in increasing RR-TB case detection, initiating >90% of diagnosed cases on second line treatment and (in conjunction with GeneXpert rollout) reducing time to treatment initiation from 72days in 2007 to 6 days in 2015. Following wider adoption of the decentralized model in the Western Cape, the responsibility for management of the programme was handed over to department of health in 2013. Since then, MSF have continued to pilot new initiatives in Khayelitsha, focusing on both clinical and patient support aspects of RR-TB care, with the overall aims of improving RR-TB treatment outcomes, reduce transmission of RR-TB within the community, increase community awareness of TB infection control, and to disseminate lessons learnt. Patient support pilot programmes include the ‘Treatment Interrupter’ and ‘Self Administered Treatment’ initiatives, while the clinical focus is on improving RR-TB treatment regimens (shorter, more effective, less toxic) and advocating for access to new TB drugs. The current MSF RR-TB team includes a Clinical Manager, Patient Support Manager, Epidemiologist, Data Manager, two data collectors, three counselors and a community awareness officer. There is currently a need for an additional medical officer to support the RR-TB Clinical Manager to identify and assess RR-TB patients who may be eligible for new drugs and better RR-TB regimens, to facilitate access to new or improved second line TB treatment, to monitor each patient’s clinical progress across all facilities within the existing health care system in Khayelitsha, to identify and report all adverse events and to continue giving mentoring and training to the subdistrict MOs and assure our participation at the Province and National MDR-TB clinical committees.

Requirements:

·  A medical degree/ MBChB degree

·  Current registration with the Health Professions Council of South Africa (HPCSA)

·  South African citizenship or a valid work visa

Additional/Desired skills, attributes and experience:

·  At least two years’ experience in managing HIV/TB and MDR 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)

·  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 RR-TB

·  Strong interpersonal and communication skills and the ability to work in a team

·  Prior experience with MSF or similar NGO will be an added advantage

·  English (fluent, spoken / written)

·  Xhosa (advantageous)

PRINCIPLE ACTIVITIES and RESPONSIBILITIES:

·  Work with the MSF team as well as partners across the Khayelitsha RR-TB Network to identify potentially eligible RR-TB patients for new / improved treatment regimens.

·  Assist Clinical Manager in accessing these new drugs and regimens – including reviewing or completing application forms and submitting to DoH (through national clinical access programmes) and / or international advisory committees (MSF and/or pharmaceutical companies compassionate use programmes) as well as South African regulatory authorities.

·  Liaise with MSF counselors and local primary and secondary care staff to assess, work up and consent eligible patients and initiate treatment with new drugs / regimens in all Khayelitsha facilities (10 primary care clinics, one sub-acute inpatient facility and Khayelitsha District Hospital).

·  Monitor clinical progress of patients receiving new drugs / regimens in all Khayelitsha facilities, and 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 RR-TB in Khayelitsha on behalf of MSF.

·  Assist the rest of the MSF RR-TB team with activities related to monitoring and evaluation, operational research and RR-TB psychosocial support.

·  Contribute to advocacy activities within the MSF RR-TB team, and Khayelitsha project as a whole.

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

TO APPLY: please email a one page application letter, your comprehensive CV with details of 3 contactable referees to: Closing date: 21 April 2017. Only short listed applicants will be contacted. For full details of position visit www.msf.org.za