Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organization created in 1971 that delivers emergency aid to people affected by armed conflict, epidemics, healthcare exclusion and natural disasters. MSF offers assistance to people based only on need and irrespective of race, religion, gender or political affiliation. The French section is present in around thirty countries.
As part of a temporary field position, we are looking for a COVID-19 support – Medical department.
Since the beginning of the COVID-19 pandemic, a lot of work has been done to contribute to the COVID response in countries where OCP is working, including navigating the exponentially increasing literature and rapidly developing research on COVID, developing protocols on all aspects of COVID19 case management for the field (requiring frequent reviews/updates), regular review and feedback on Ministry of Health national guidelines across all OCP projects, and supporting the cells & the field to provide care for COVID-19 patients. As the pandemic progresses, there remain further challenges in supporting COVID-19 response in countries, with ongoing limitations in access to diagnostic tools, oxygen, drugs (and probably to vaccines in the future).
Although the volume of field requests and general sense of urgency has reduced in the COVID19 clinical team in recent weeks, it is important to note that there is still a significant ‘behind the scenes’ workload that remains and there exists many uncertainties about the pandemic and the operational support needs in future.
Overview of the OCP COVID19 multidisciplinary medical team’s responsibilities:
The COVID19 multidisciplinary medical department team currently comprises: the OCP medical director & deputy medical directors, the Epidemic Response Clinical Lead, the Tropical Infectious Disease Advisor, the Covid19 Support Advisor, the Infection Prevention & Control (IPC) advisors, a Pharmacy/Supply advisor and Anaesthetics/Oxygen Therapy advisor who currently meet on a weekly basis to coordinate the Medical support to operations.
Although the more urgent field challenges have temporarily at least reduced in some countries where OCP works, there remains significant uncertainty about the evolution of the pandemic in the months to come, and potential risks of 2nd (or even 1st) waves in many of our settings. There is an ongoing need to continually monitor evolving evidence in the literature, update clinical guidelines according to rapidly evolving evidence, and conduct in depth COVID briefings for field staff. Some of our settings that were prepared for a big influx early in the epidemic, but which never arrived (e.g. Burkina Faso and Uganda) are now reporting a slower but steady increase in infections and it is quite difficult to predict how the situation will evolve in such settings, so we need to remain prepared and vigilant. This includes helping prepare projects for potential “second waves” together with the Operations Department, and giving feedback on project specific e-prep plans. There are also upcoming tasks involved in the capitalisation of the work we have done so far in this epidemic, to formulate the lessons learned and create medical frameworks to guide operations.
Additionally, the COVID19 team liaise regularly with Epicentre and PRAXIS/DHIS (Health Management Information System team) to monitor and review COVID19 data, to assist in improving the quality and consistency of data collection. When requested, on a case by case basis, the COVID19 clinical team also give technical advice/support to the OCP staff health team on clinical issues related to COVID19 infection in staff members.
In the next months, we envisage an increased amount of time committed to reviewing research and formulating guidelines and frameworks for the use of novel COVID19 therapies and potential vaccines, and advocating for equitable and timely access to these. Various operational research questions and protocols are already underway within OCP, addressing a wide variety of clinical questions, and it is quite likely more operational research questions and protocols will arise in the coming months, in order to assess the impact of COVID19 on patients and healthcare workers in MSF settings (particularly with a focus on vulnerable groups that are as yet poorly documented in the literature).
In addition, COVID19 has significantly impacted on many countries’ abilities to maintain essential preventive healthcare including routine immunisation, and there is a real risk of impending large epidemics of vaccine preventable infectious disease (such as measles, diphtheria etc.) in MSF settings. Thus it is prudent to plan for additional medical department support in the short term to ensure capacity is strengthened until we have a better understanding of the epidemiology and likely course of this pandemic and its flow-on effects on other health indicators.
The Tropical Infectious Disease Advisor working on the COVID team is based remotely in Australia at present, and having the presence of a dedicated COVID referent onsite in Paris allows for timely face to face meetings with some operational cells, and greater flexibility & ability to more easily connect with clinical networks outside of MSF in Europe and Africa. The Tropical infectious Disease Advisor will remain the lead COVID19 medical focal point for intersectional COVID19 clinical care meetings, discussions with Epicentre/HMIS team on data management, and final review of all medical COVID19 protocols and guidelines. However she will also now recommence her work on other portfolios (malaria, VHFs, NTDs) which were either temporarily reassigned or completely put on hold during these first months of the COVID19 response. Finally, with the complete restructuring of the ‘response to epidemics’ team from September 2020, it is important to have a dedicated COVID19 support role in the medical department in the short term to ensure continuity & quality of support for COVID19 in OCP operations.
Specific responsibilities/key duties of the covid19 support advisor position:
The proposed COVID19 support advisor will be working closely with the Tropical Infectious Diseases Advisor who leads the COVID-19 technical support within the Medical Department.
The COVID19 Support advisor will:
- Keep up to date on research & developments on novel therapeutics & supportive care for COVID19,
- Contribute to regularly review & updating of OCP COVID19 clinical guidelines according to emerging & evolving evidence,
- Assist in providing medical technical field support/advice to ensure quality clinical care of patients in MSF settings (this direct medical support is currently split by MSF operational cells and the responsibility is shared with the Tropical Infectious Disease Advisor),
- Assist with briefing and debriefing the international medical staff involved in the COVID-19 response on the field, including regularly reviewing and updating COVD19 briefing materials to ensure they remain in line with OCP COVID19 protocols and guidelines (briefings/debriefings are currently also split by operational cells and this responsibility shared with the Tropical Infectious Disease Advisor),
- Provide input into the multidisciplinary COVID-19 response by liaising with the various medical referents to inform OCPs written protocols & guidelines and also to guide direct advice given to projects on clinical questions. This includes discussions where necessary with: IPC referents, hospital management team, laboratory/diagnostics referents, pharmacy, critical & emergency care referents, and specialist paediatrics, women’s health and TB/HIV/NCD teams,
- Liaise with the BASIC team (spearheaded by the Emergency Care Referent) to ensure that e-training modules on COVID-19 remain up to date with the available evidence,
- May liaise with the OCP critical care team (ICU & Emergency care referents, Anaesthetics/Oxygen therapy referent) in order to improve provision of oxygen therapy and non-invasive ventilation for COVID19 projects,
- Participate when available, along with the Tropical infectious Disease Advisor, in regular intersectional COVID19 clinical care working group meetings in order to share knowledge/ clinical experience.
Experience / Training
Medical doctor with specialist qualifications in infectious diseases, or extensive clinical experience in infectious diseases,
Field experience with MSF or other NGOs in low resource settings,
Experience in COVID-19 clinical management.
Languages: Mandatory: French and English (spoken and written).
Skills and aptitudes:
Competencies in reviewing evolving evidence and in critical appraisal of medical literature.
Diplomatic, good communication skills.
Organized, flexible and autonomous.
50-80% FTE position (flexible, depending on applicant availability), based in Paris; field visit as needed/feasible.
3-month minimum commitment, until 31 December 2020 (potential extension depending on evolution of the epidemic and medico-operational needs).
Conditions: 48.8€ gross per year based on 13 months. 22 days RTT per year. Health insurance covered 100% by Médecins Sans Frontières. Restaurant vouchers of 9€ (covered 60% by Médecins Sans Frontières). Reimbursement of 50% of the public transport ticket.
Expected starting date: As soon as possible.
How to apply
Please submit your application (CV and cover letter) online.
Deadline for application is September 21, 2020.
Please note that only selected candidates will be contacted.