Medical Doctor

Kulob Zero TB Project

Zero TB cities/coalition embraces comprehensive approach aiming at eliminating tuberculosis in geographically contained area = creating “islands of elimination”.  It is unique approach engaging various stakeholders including local community in “search, treat and prevent strategy”. Zero TB focuses on TB prevention and care in households, the places where people seek care and where they work. MSF is  introducing this comprehensive approach in Kulob Rayon to reduce the incidence of tuberculosis in this region.

Clinical :

• Apply medical knowledge and skills for diagnosis and prevention of TB/HIV disease. Carry out outpatient and inpatient consultations, prescribing the necessary treatment respecting MSF and NTP protocols in collaboration with MoH/NTP Partner. Ensuring all patients are followed up as per the protocols and the findings of each follow up visit are recorded in appropriate forms. Informing line manager regarding any patient complications and issues related to patient management.
• Keep the patient and/or his/her family informed about the illness and provide appropriate explanations about the treatment to follow, checking they have understood in collaboration with MoH/NTP MD and counsellors. 
• Follow up the evolution of the hospitalized/IPD patients, through daily visits, consultations and examinations, prescribing the necessary treatment following MSF and NTP protocols, recording whether they can be discharged or transferred to other departments – in collaboration with MoH/NTP doctors- and informing their family about the patient’s evolution. 
• Prepare case summaries for case discussion with TB Advisor and share with line manager.
• Conducting home visits, when deemed necessary to follow up on patients under TB treatment    together with MoH MDs and Nurses. Ensure accurate recording of all findings and outcome of home visits. Ensure appropriate support, in collaboration with MoH /NTP team and mental health team for adherence and retention of care.
• Identify TB patients with malnutrition who require therapeutic food support and ensuring that these patients are managed appropriately as per MSF and NTP guidelines.
• Participating in health education and health promotion session when necessary – in collaboration with MSF and MoH/NTP team members. Provide report on outcomes and observation for such sessions to line manager.
• Conduct contact tracing activity along with the MSF and MOH team. Maintaining accurate records of contact tracing activity and ensure necessary diagnostic investigations are done for those contacts who need it as per the protocol. 
• Participate in active case finding activities along with MoH/NTP team. Recording and reporting accurately the compliance to protocol and findings of the same. Reporting to line manager of any support that MSF needs to extend to the partner.
• Participate and support case presentation in the consilium with MoH/NTP MDs as an active member and advocate for implementation of WHO guidelines for management of patients. Accurately document and report the conclusions and decisions made during consilium.
• Ensure appropriate management and accurate recording of any serious or non-serious adverse events reported by any DS or DR TB patient under care and collaborate with the Data Manager to ensure update of the database for the same. 
• Liaise with HIV Center for appropriate care and follow up of any patient with HIV – TB comorbidity. Maintain records of the HIV related investigations and treatment. Additionally, manage appropriate referrals for other infectious diseases such as Hepatitis B and Hepatitis C ensuring patients are receiving   treatment.
• Liaise with other medical facilities for appropriate care and treatment of any other co-morbidities such as diabetes mellitus, hypertension, psychiatric illnesses etc and organise and follow up referrals to said facilities when necessary.
• Ensure compliance of infection control measures in various MSF supported facilities and report the same to line manager.
• Check and ensure the consumption of medicines is accurate and equipment needed for patient control meets the MSF quality standards and the disinfection and sterilization of the medical material is as per protocol. Assure general compliance with standing hygiene standards. Report any non-compliance to line manager.

Reporting/Data Collection

• Provide monthly reports regarding activities undertaken and discuss with line manager regarding challenges – to contribute in the monthly sitrep and MMR.
• Participate in the collection and analysis of epidemiological data, and inform the line manager about any problem or complication of the patients illness, medical error and monitors the proper functioning of the department, equipment or material. 

Staff Health

• Support PMR and IMS MD as needed for LRS staff health. For example: performing medical assessment of staff as per need, translate, validate and compile medical records and information from and to national health facilities, assess and validate LRS sick leave and perform required administrative tasks in line with national and MSF staff health policy, prepare information for NS health reimbursements as per the national and MSF staff health policy, along with other tasks required by the IMS MD and PMR as per need. 
• Monitor on bi-weekly basis the content of the Emergency/First Aid boxes in the office and cars and submit replenishment orders to the OCA MedCo/Pharmacy manager. Ensure the Emergency/First Aid boxes are being replenished
• Follow the vaccination status of the staff in the mission and completion of their vaccines

General 

• Knows and ensures all MSF medical protocols are followed and implemented, checking universal precautions are followed at all times and reducing bio-hazard risks and improving infection control. Ensures professional confidentiality is respected.
• Ensure professional confidentiality is respected at all times. 
• Flexibility related to assignment – willingness to participate in additional activities (other than TB) if and when necessary, willingness to work outside Kulob District if and when necessary.

• Technical Skills / Clinical Skills
• Commitment
• Flexibility
• Results
• Teamwork