Doctors Without Borders / Médecins Sans Frontières (MSF) is an international, independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, natural and man-made disasters and exclusion from healthcare in more than 65 countries. MSF offers assistance to people based on need and irrespective of race, religion, gender or political affiliation.
MSF has worked in India since 1999, providing free-of-charge essential healthcare to people in remote areas, and specialist care for people affected by HIV/AIDS, malnutrition, hepatitis C, antibiotic resistance, tuberculosis, Kala Azar and sexual and gender-based violence. We also respond to natural disasters and other emergencies, provide mental healthcare and advocate for the development of more effective and affordable medicines to improve access to treatment for people everywhere.
We currently run projects in the states of Andhra Pradesh, Bihar, Chhattisgarh, Delhi, Jammu and Kashmir, Jharkhand, Maharashtra, Manipur, Telangana, and Uttar Pradesh.
MSF was awarded the Indira Gandhi Prize for Peace, Disarmament and Development in 1996 and the Nobel Peace Prize in 1999.
MSF OCBA in Bihar
MSF has been working in Bihar treating Kala Azar since 2007 with a gradual transition of the project to focus on HIV-Kala Azar co-infected patients. After treating more than 13,000 patients in Vaishali, MSF began focusing on the treatment of Kala Azar-HIV co-infection in partnership with the Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) in Patna in 2016.
Further, MSF has collaboration with the All India Institute of Medical Sciences (AIIMS), Patna and Bihar State AIDS Control Society (BSACS) with whom MSF is conducting two qualitative studies focusing on perception of quality of life by VL-HIV co-infected patients and the stigma which PLHIV group faces at health facilities and in community. Anecdotal evidence from different sources suggests that there is very high level of stigma attached with HIV in Bihar and PLHIV often presents with advanced stage HIV with multiple opportunistic infections. To make the matter worse, these patients do not get adequate and quality healthcare services leading them to no option, but to succumb to their illness at home. Hence, MSF endeavours to start a project for treating life threatening opportunistic infections in people living with HIV in Bihar in collaboration with BSACS and Government of Bihar (GoB).
This seamless partnership over more than a decade between the Government of India, the State Government and other stakeholders has enabled MSF to provide best quality, free of cost treatment to the people of Bihar without any discrimination on the basis of caste, colour, religion or economic status. The major beneficiaries of MSF services have been those who are the bottom of societal pyramid
Working in this area of HIV-VL confection, has led us to realise the systematised discrimination against HIV patients by the community but more so among health care providers in the public and private sector with them often being excluded from healthcare outside of government ART centres. Bihar, with a population of 110 million people is one of the largest states and least economically developed. It has an estimated adult HIV prevalence in the range of 0.21– 0.25% accounting for 150,000 PLHIV and 7,514 deaths (5,794-10,575) annually. Only 20,000 HIV patients were on ARVs in 2014.
As per July 2017 WHO guidelines for those above 5 years of age, Advanced HIV disease is defined as those presenting for care with a CD4 count below 200 cells/mm3 or presenting with an AIDS-defining event, regardless of the CD4 cell count. All children less than 5 years are considered to have Advanced HIV Disease.
The mortality rate of advanced HIV disease is estimated to be between 30 to 40%. In Bihar, within MSF´s existing HIV related project we have a number of observed cases of severe disease where specialized medical care is required including palliative and symptomatic care and end of life care for some of them, including psychosocial support for patients and family members. In such situations, where we have tried to refer the patients into the public or private sector, they have been refused admission or admitted, ignored and ultimately sent home to die.
MSF in collaboration with MoH (BSACS and NACO) has set up an inpatient centre for advanced HIV and palliative care for all admitted patients and those with life threatening conditions.
The main purpose of the program is to provide holistic care for seriously sick advanced HIV patients; to improve quality of life by providing comprehensive HIV care and support and palliative care with the focus on patient rights and dignity.
Referral criteria to MSF care centre
- HIV patients with CD4 less than 100 regardless of opportunistic infections/comorbidities
- Suspected or diagnosed advanced HIV disease regardless of CD4 count (specific conditions for referral will be defined)
- Seriously ill HIV+ patients with danger signs
- Other HIV related life threatening conditions such as IRIS, suspected clinical failure, drug hypersensitivity and so on
- Advanced HIV diagnosis and care package + Palliative care
- Linkage to care (from ART centres and community to MSF care centre)
- Retention in care and health promotion activities in the community
- Direct Beneficiaries: People living with advanced HIV (PLHIV) – estimated to be 10% of the 150,000 diagnosed HIV patients in Bihar
- Indirect Beneficiaries: General population of Bihar through decreased spread and increased awareness, others living with HIV with regards to policy change in India.
Guru Govind Singh Hospital, Patna City, Patna.
Purpose of post
- Monitoring mental health related activities in the project, ensuring the quality of care and providing clinical consultation to the Counsellor-Educator/s.
- Mentoring and training of Counsellor-Educator/s.
- When required, provide counselling and/or psychosocial support to patients/clients, following medical and
- mental health MSF protocols and procedures.
Functional and Hierarchical Lines
Hierarchically and functionally accountable to Project Medical Referent
Number of post available: 1
Location: Patna, Bihar
Project: HIV Co-infection
Last application date: 16th May 2019
Starting date: ASAP
Main responsibilities and tasks
- Provide clinical supervision to the Counsellor-Educator/s in counselling strategies and psychosocial support.
- Assist/mentor Counsellor-Educator/s to conduct basic psychological assessments to evaluate clients’ social and emotional status.
- Consult and collaborate with the medical team on psychiatric concerns and medication
- Provide individual, partner, and family counselling if necessary and required; in areas not limited to: stigma and self-esteem, dignity, adaptation to the illness and its consequences, social functioning, advocacy issues, relationships, communication, dealing with death and dying, grief and loss, spiritual distress/well-being, and legacy work.
- Co-facilitate with Counsellor-Educator/s psycho-educational sessions as necessary and appropriate.
- Refer clients when necessary. Advocate and support access to community resources, providing information and guidance.
- Work in collaboration with the medical team to provide holistic, supportive and palliative care for patients/clients in view of their needs.
- In collaboration with the medical team, identify the mental health needs of patients/clients.
- Identify the necessity of referral to psychiatrist for mental health assessment/diagnosis.
- Ensure that mental health activities are performed with regular follow-up in order to provide the most appropriate treatment for patients/clients with psychosocial challenges.
- Ensure the Counsellor-Educator/s is/are calm and neutral during sessions regardless of personal feelings and/or beliefs and that translators are trained about terminology and appropriate behaviour during sessions.
- Review, develop technical materials tools, guidelines and documents, coordinating and ensuring the implementation of all mental health standard protocols and procedures set by MSF in order to provide the most appropriate treatment for patients/clients.
- Participate in mental health data collection and reporting.
- Keep systematic records of work and maintain confidentiality.
- Participate in mental health data collection and reporting.
- Make regular reports of work to supervisor.
- Teamwork and continuing education:
- Take active part in trainings and continuing education opportunities.
- Participate in team meetings.
- Adheres to all standards, practices and policies regarding confidentiality and privacy of information, set forth by employer.
- Ability to organize and prioritize workload & taking initiative when appropriate.
- Maintain good filing system.
- Good spoken & written English; Essential good understanding of local language(s).
- Good communication and social skills to connect with the community.
- Exhibits creativity & innovation.
- Able to work independently as well as part of a team.
- Ability to manage stress in adverse situations.
- Demonstrates flexibility in taking up tasks outside of regular job responsibilities as required.
- Willingness and ability to live and work in a rural setting.
- Understanding of MS Office especially Word, Excel & PowerPoint.
Required working days
The nature of the work requires presence on Sundays and Public Holidays as per duty roster. Sundays are considered as a weekday. Special arrangements are only considered for official Public Holidays (as per Internal Rules and Regulations).
Essential Master’s degree in Psychology with a diploma in Medical/ Clinical psychology OR PhD degree in Clinical Psychology of a recognized university.
- Previous (working) experience in the field of counselling or medical work.
- Must have experience in counselling and/or psychotherapy.
- Previous experience with terminal illness and palliative care counselling an asset.
- Language: English and Local Working Language essential.
Consultancy fee & other benefits
- Consultancy Fee: Rupees 69,784/- per month (10% TDS deduction as applicable).
- 2 months consultancy contract (Extendable based on performance and needs)
To apply please email your CV and motivational letter mentioning why you would be interested to apply for the position with the subject Ref: Consultant Mental Health Activity Manager
Applications that are no completed (CV + Covering letter) will not be considered.
SHORT-LISTED CANDIDATES WILL BE CONTACTED AND INVITED FOR THE INTERVIEW
Médecins Sans Frontières/Doctors Without Borders India is an equal opportunity employer. Women candidates are encouraged to apply.