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 in 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; treatment and care for people affected by HIV/AIDS, malnutrition; hepatitis C, tuberculosis, kala azar, and sexual and gender-based violence; an important subject for our action is containing the effect of antibiotic resistance. MSF also responds to natural disasters and other emergencies, provides mental healthcare and advocates for the development of more effective and affordable medicines to improve access to treatment 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 the 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 a very high level of stigma attached to HIV in Bihar. Data collected from health structures show that PLHIV often seeks for health services with advanced HIV bearing multiple opportunistic infections and complications. To make the matter worse, these patients do not get adequate and prompt healthcare, this leaves them with no option but succumbs to their illness at home. Hence, MSF strives to implement a project for treating life-threatening diseases in people living with HIV in Bihar in collaboration with BSACS and Government of Bihar (GoB).
This seamless partnership for over more than a decade with the Government of India, the State Government and other stakeholders has enabled MSF to provide the best quality of care, 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 the most vulnerable and the most in need.
Working in HIV-VL co-infection has led us to realise the systematised discrimination against HIV patients by the community and even by health care providers 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. By March 2018, 46047 PLHIV were on ART in Bihar, a number representing under 50% of all diagnosed PLHIV in the state, this is far from the global goal of having on ART the 90% of all diagnosed as HIV infected.
As per July 2017 WHO guidelines for those above 5 years of age, Advanced HIV disease is defined as 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 bearing severe disease where specialized medical care is required including palliative and end of life care for some among 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, ignored, and ultimately sent home to die.
In this situation, MSF in collaboration with MoH (BSACS and NACO) has planned to set up a program as inpatient centre in a district hospital to provide care and treatment for patients in advanced HIV disease with special attention for those with life-threatening conditions. Patients in critical lethal conditions will be able to access to palliative care.
The main purpose of the program is to provide care for seriously ill patients living with HIV in order to decrease mortality and improve the quality of life, paying special attention to patient´s rights and dignity and providing holistic care including medical and psychological support.
Referral criteria to MSF care centre
- HIV patients with CD4 less than 200 plus a threatening condition other than the ones WHO clinical staging
- Suspected or diagnosed advanced HIV disease regardless of CD4 count
- Danger signs (seriously ill patients) in PLHIV, independently of previous CD4 and or WHO clinical status
- Other HIV related life-threatening conditions such as IRIS, suspected clinical failure, and drug hypersensitivity.
Guru Gobind Singh Hospital, Patna.
In the event of a potential emergency situation, be available to work in other States within India and/or the region.
Purpose of Post
To provide day-to-day medical care in IPD, OPD and Palliative patients under MSF care, working collaboratively with doctors, health promotion team, colleagues, the patient's family and other team members, that focuses on treating illness to improve quality of life.
Functional and Hierarchical Lines
Hierarchically and functionally accountable to the Nursing specialist Supervisor.
Number of post available: 3
Location: Patna, Bihar
Project: HIV Co-infection
Availability: Minimum 1 year, annual renewal of the contract
Starting date: ASAP
Main Responsibilities and Tasks
- To provide and ensure correct nursing care of the HIV patients who are under treatment with MSF and assist doctors in the care, procedure and treatment of the patients
- To provide correct nutritional screening, drug dispensary, give IV fluids and injections to advanced HIV patients according to prescriptions and protocols
- To attend and ensure the implementation of correct protocols concerning follow up of the HIV/VL patients
- To provide instant emergency treatment to critically ill cases in consensus with doctors.
- Participate actively in medical rounds and provide the updated information about patients’ status
- To observe and ensure correct follow-up of patients.
- Perform rapid laboratory tests according to MSF and other protocols (MOH, international recommendations) when needed and confirm the result with doctors on duty.
- Record the required medical data accurately and collaborate in the reports.
- Keep proper records and ensure their safe custody.
- Respects the principles of aseptic technics and sterilisation.
- To respect and promote absolute confidentiality of any information related to HIV patients.
- Participate in meeting and conferences when required, to facilitate - medical/nursing training sessions, both internally and externally.
- Participate and give correct health education messages to patients and their attendants. Specifically giving appropriate information about HIV, TB and Kala Azar among other HIV related diseasesː signs & symptoms, correct treatment; follow up, nutrition, and prevention.
- To respect and promote medical ethics.
- Give support to the laboratory activities when needed.
- Give support to the pharmacy activities when needed.
- Manage unconscious patients.
- Help the patients to meet their daily needs.
- Maintain privacy to the patients and keep confidentiality of the patients
- Able to go for home visits to provide palliative care along with the medical and supporting teams.
- Filling in the register book/patient card, noting every pertinent information that happened during the shift and any changes in prescription or patients to be followed up
- Ensuring to give oral/written handover at every shift change, drawing attention to any notable events during the shift
- Participating in departmental and project meetings.
- Collaborate in the reports as needed
- Participating in data collection for the operational research studies executed in the project
Managing Medicines and Departmental Material
- To understand, maintain and improve the MSF medical stock management systems.
- Handing over stock cards of medicines and material at every shift change
- To ensure that the daily consumption is in line with stock and place an order if necessary
- To guarantee the proper sterilisation process is being done
- Filling out registers and health files correctly
- Participating in data collection with the departmental manager
- Performing any other professional tasks as required by the Supervisors.
- Maintains a flexible approach and responds to the needs of the project even outside of this job description.
- To assist in the assessment of humanitarian needs and emergency interventions arising in the region and if needed, showing flexibility, adaptability and commitment.
- To respect MSF internal regulations, the contract and the present job description
Required Working Days
The nature of the work requires presence during night shifts, weekends 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: General Nursing & Midwifery (GNM) with active registration under INC or state nursing council.
- Desirable: BSc Nursing or Post Basic B.sc Nursing
- >1 year of experience in hospital
- Experience in critical care unit
- Experience in paediatric and neonatal cases.
- Experience with HIV patients is an asset
- Experience in Emergency or ITU
- Experience in NGO
- Ability to organise and prioritise workload & taking initiative when appropriate
- Good spoken & written English; Essential good understanding of local language(s)
- Able to integrate into a multi-cultural team and cooperate with co-workers
- Able to work independently as well as part of a team
- Ability to manage stress
- Demonstrates flexibility in taking up tasks outside of regular job responsibilities as required
- Willingness and ability to live and work in a rural setting
- Punctuality and ability to act with responsibility
- Understanding of MS Office especially Word, Excel & PowerPoint
- Must be proficient in medical nursing procedures including IV Cannulation, administering IV, IM, SC injections; use of IV fluids etc.
- Management of unconscious and palliative care patients.
- Better knowledge about end of life care.
- Absence of prejudices against HIV infected patients
- Good knowledge of MoH policies and general system of health management
- Knowledge of MSF principles
- Work experience with at least one MSF project
HR & Benefits
- Salary: Rupees 26,917 gross/month. NON NEGOTIABLE
- Benefit of 13th Month Salary.
- PF and Gratuity are applicable as per law.
- Total Leaves: 18 days annual leave; 12 days holidays as per organization public holiday list
- Sick/Casual leave of 12 days as per calendar year (pro-rated based on hire date).
- Relocated staff will be provided with Accommodation allowance & Shifting allowance. (Only for out of state candidate).
- Wide Medical coverage (Employee + Direct Relatives), as per organsation policy.
To apply please email your CV and motivational letter mentioning why you would be interested to apply for the position with the subject Ref: Nurse to firstname.lastname@example.org AND email@example.com
Applications that are no completed (CV + Covering letter) will not be considered.
ONLY SHORT-LISTED CANDIDATES WILL BE CONTACTED AND INVITED FOR INTERVIEW.
Médecins Sans Frontières/Doctors Without Borders India is an equal opportunity employer. Women candidates are encouraged to apply.