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 70 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, 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 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 the perception of quality of life by VL-HIV coinfected patients and the stigma which PLHIV group faces at health facilities and in the community. Anecdotal evidence from different sources suggests that there is a very high level of stigma attached to 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 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 the 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 the societal pyramid.
Working in this area, 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 specialised 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.
In this situation, MSF in collaboration with MoH (BSACS and NACO) tends to set up a program as inpatient centre for the advanced HIV and holistic care for all the admitted patients and those with life-threatening conditions.
The main purpose of the program is to provide holistic centre for seriously sick advanced HIV patients in order to improve the quality of life by gaining comprehensive HIV care and support and palliative care with the focus of 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 the decreased spread and increased awareness, others living with HIV with regards to policy change in India.
Guru Govind Singh Hospital, Patna City, Patna
Number of posts available: 1
Location: Patna, Bihar
Project: Advanced HIV
Availability: Minimum 1 year, annual renewal of the contract
Last application date: 18th March 2019
Starting date: ASAP
Purpose of Post
Counsellor provides psychosocial support and counselling for people from vulnerable groups.
Functional and Hierarchical Lines
Hierarchically accountable to IEC Health Promotion Activity Manager and Functional accountable to Project Medical Referent.
Main responsibilities and tasks
- Actively promotes the availability of counselling services.
- Provide client-centred care to clients, families and caregivers during the illness phase through to bereavement.
- Provide individual, partner, and family counselling as necessary and required.
- Provide counselling to clients and families 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, legacy work and culturally-based needs.
- Conducts basic psychological assessments to evaluate clients’ social and emotional status.
- Consults and collaborates with the medical team on psychiatric concerns and medication.
- Refers clients, when necessary. Advocates and supports access to community resources, providing information and guidance.
- Conducts psycho-educational sessions as necessary and appropriate
- Oversees community social activities involving volunteer social workers.
- Keeps systematic records of work and maintains confidentiality.
- Makes regular reports of work to the supervisors.
Teamwork and Continuing Education
- Takes active part in trainings and continuing education opportunities.
- Participated in regular clinical supervision and team meetings.
- Actively participates in operational research, if necessary.
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 arrangement are only considered for official Public Holidays (as per Internal Rules and Regulations)
- Essential Bachelor Degree in counselling, Psychology [or] clinical Social Work [or] equivalent degree
- Desirable in Masters in counselling, Psychology [or] Clinical Social Work.
Essential Work Experience
- Previous (working) experience in the field of social work or medical work is an asset
- Must have experience in counselling and/or psychotherapy.
- Previous experience with terminal illness and palliative care counselling an asset.
- Adheres to all standards, practices and policies regarding confidentiality and privacy of information, set forth by the employer.
- Ability to organise and prioritise 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.
HR & Benefits
- Salary: Rupees 26,917 gross/month
- Benefit of 13th Month Salary
- PF and Gratuity are applicable as per law.
- Total Leaves: 18 days annual leave; 12 days paid leave as per the specified list of holidays; Sick/Casual leave of 12 days as per the calendar year (pro-rated based on hire date).
- Wide Medical coverage (Employee + Direct Relatives), as per organization policy.
To apply please email your CV and a motivational letter mentioning why you would be interested to apply for the position with the subject Ref: Counsellor Educator to firstname.lastname@example.org AND email@example.com on or before 18th March 2019.
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.