General - Gastrointestinal Surgeon - Based in Tabarre (Haiti), Bangui (CAR), Rutshuru (Congo), Aweil (South Sudan)

About us

Doctors Without Borders/ Médecins Sans Frontières (MSF) provides medical assistance to people affected by conflict, epidemics, disasters, or exclusion from healthcare. Our teams are made up of tens of thousands of health professionals, logistic and administrative staff - bound together by our charter. Our actions are guided by medical ethics and the principles of impartiality, independence and neutrality. We are a non-profit, self-governed, member-based organization.

Context

Access to safe surgery and anesthesia in low resource settings remains a significant global health challenge. The greatest need is found among rural and marginalized populations living in low- and middle-income countries where surgery patients are often at higher risk of complications because of underlying, unrecognized medical conditions.

MSF has more than 50 years’ experience of providing surgical care in settings of civil conflict and war, natural disasters, and other humanitarian crises.

Core activities within MSF surgical programs primarily focus on delivering lifesaving and essential surgeries, encompassing trauma, general, orthopedic, and obstetric procedures. These surgical interventions are typically conducted in district-level hospitals, with differing degrees of collaboration with local health authorities, although MSF-managed facilities are also prevalent. Perioperative anesthetic care is an essential component of these services.

A key aspect of MSF's operations involves capacity building in essential surgery and anesthesia care, with a significant emphasis on engaging local healthcare providers

Responsibilities of MSF Surgeon:

·        Coordinates the implementation of MSF clinical policies, tools, guidelines and protocols ( antibiotic prophylaxis, post-operative pain management, thrombo-prophylaxis, caesarean section, blood transfusion, etc) and recommendations (standard hygiene and sterilization rules, prevention to HIV, TB, Syphilis and Hep B exposure) in order to minimize clinical risks.

• Undertake pre-operative consultations, evaluating the surgical risks with the anaesthetist and/or other medical staff involved, and obtaining the patient’s signed consent to operate.
• Carry out emergency and programmed surgical intervention following MSF protocols and policies including swab counts, ensuring appropriate use of surgical equipment and proper OT registry entry/documentation of all OT intervention.
• Carry out post-operative clinical care and ward rounds collaborating with the anesthetist, the Operating Theatre Nurse and ward staff or other Unit Managers to ensure compliance with MSF protocols and rational use of medicines. Attend OPD, emergency room when required.
• In collaboration with the anaesthetist, carry-out the collection and analysis of quantitative surgical- anaesthesia data, using post-operative observation sheets, routine data collected, patient files, operating department register, patient file, etc to monitor quality. Monthly revue data and analyze clinical trends and comment on adverse events / poor clinical outcome. Support organizing the operating program and with OT staff monitor use of material and equipment and advise on instrument needs and coordinates patient referral.,
• Put in place the emergency disaster response plan of the hospital along with the anesthetist and the medical doctor and /or the responsible nurse and run role hospital practical rehearsals, in order to ensure the continuity of the services under any circumstance
• Knows and helps implement the accidental blood exposure policy.
• Plan, evaluate, and supervise the training of the staff (emergency and the out-patient teams) in order to ensure the amount of knowledge required and to improve people diagnosing, triage, and early detection capabilities.
• Supports other medical teams/wards when needed (i.e. midwifes and obstetric teams in the maternity ward, etc.)

Requirements

Diploma

• general surgery, abdominal/gastric surgery
• current matriculation in Medical Council/Board

Experience

• 2 years of professional experience subsequent to obtaining the speciality diploma
• solid surgical skills: caesareans with haemostasis hysterectomies if necessary, abdominal surgery, possibly thoracic and lower limb traumatology surgery

Availability

• 4 to 5 weeks minimum

Languages

• English and French is required
• able to work in multicultural and multidisciplinary teams

 Terms of employment

• Monthly salary is non-negotiable (EURO 1748)
• All logistics are organized by MSF, including flight tickets, visa administration and shared accommodation (including food & housekeeping).
• Initial preparation before your first assignment.
• Security management is handled by an experienced manager in each project location. Each MSF employee must comply with the security rules in place.
• Detailed briefings.
• Psychosocial assistance.
• Coverage, such as medical care and vaccination package, accident insurance, including repatriation.

*More details on MSF General - Gastrointestinal Surgeon*

Surgeons are responsible for surgery intervention and post-operative surgical care in line with MSF protocols. They work in close collaboration with the operating theatre staff and interact with doctors and nurses from the emergency, intensive care surgical departments and/or other medical departments. They provide guidance to and oversee training for the surgical team. Surgeons account for their work to the medical advisor, the hospital director or the project coordinator depending on the programme's organisation.

The humanitarian surgery practiced by MSF for the last 40 years often rolls out in war contexts. It is in constant evolution, developing solutions better adapted to field realities and integrating ever more demanding standards of medical practice.

In 2021, 40,820 interventions were performed on 17,888 patients. 2021 is a record year in terms of interventions, exceeding 2019, which also passed the 40,000 procedures. MSF Surgical activities take place in 14 countries with 1 to 5 surgical projects per country.

There are 119 departures in 2021, including 37 first assignments (FA) (compared to 82 departures in 2020, including 22 FA). The international surgeons come from 29 countries, representing the 5 continents.The detailed statistics by specialty are as follows: 49 departures of general surgeons (including 8 FA), 28 orthopedic surgeons (including 12 FA), 1 vascular surgeon, 8 plastic surgeons (including 1 FA), 9 pediatric surgeons (including 3 FA), and 24 obgyns (including 4 specializing in oncology and 13 FAs among all gynecologists).

ACTIVITIES

A night duty roster ensures 24/7 care.

Pre-operative consultations

• provides surgical consultations,
• informs the patient about his condition and the surgery proposed,
• obtains the patient's signed agreement to surgery,
• evaluates the risk of operating, in collaboration with the anaesthetist.

Surgery

• performs emergency and elective surgical procedures in line with MSF protocols,
• coordinates surgical activities and takes responsibility for the quality of interventions,
• oversees the rational use of surgical supplies and instruments during procedures,
• draws up a post-operative report following each procedure.

Post-operative patient follow-up

• checks that patients are re-allocated to the appropriate hospital department depending on the different pathologies (infected, non-affected, orthopaedic, burns, etc.),
• conducts rounds and follow-up rounds in the surgical and intensive care departments in collaboration with the anaesthetist, the operating theatre nurse and the department supervisor,
• ensures the application of MSF protocols (antibiotherapy, dressing protocols, etc.) and rational medicine use.
• ensures proper pre and post-operative prescription follow-up in liaison with the anaesthetist,
• follows up patients hospitalised in associated departments (gynaecology-obstetrics, eg) in collaboration with the healthcare team.

Hygiene

• oversees and monitors his own and his colleagues' adherence to hygiene rules concerning the protection of patients and staff in the operating theatre (decontamination, sterilisation, etc.)
• knows the steps to take in the event of accidental exposure to blood (AEB).

Data collection

• collaborates with the anaesthetist in the collection of quantitative surgical and anaesthetist data, check the quality of the data encoding,
• participates in drawing up and analysing morbidity-mortality reports with the anaesthetist, the medical advisor and/or the hospital director or project coordinator.

Collaboration with the other departments

• participates in medical meetings, notably the peri-operative morbidity-mortality meeting,
• works in close collaboration with the emergency, intensive care etc. departments,
• provides support to other departments if needed.

Management/training

• provides ongoing guidance and training to the surgical team in line with MSF guidelines and protocols,
• can be asked to support training projects (e.g.: first aid, etc.)

He upholds medical confidentiality in all areas of his activity.

He is vigilant at all times and informs his line manager in the event of medical error.