General Objectives

Providing outpatient and/or inpatient medical care to patients/beneficiaries according to adapted and up-dated medical knowledge, National Tuberculosis Programme (NTP), Provincial Tuberculosis Programme (PTP), World Health Organization (WHO) and Médecins Sans Frontières (MSF) protocols, MSF values and universal hygiene standards to improve the patients/beneficiaries’ health conditions; using the medical knowledge and clinical experience in patient care and treatment and implement, monitor and supervise a mixed method drug-resistant tuberculosis study in the project according to MSF protocols, standards, and procedures in order to contribute to mitigating the effects of diseases where MSF is present.

Key Responsibilities:

• Supervising, monitoring and coordinating daily activities related to the project study “Mixed method retrospective and prospective cohort of patients with drug-resistant tuberculosis in Gujranwala project, Punjab, Pakistan”, working in collaboration with Epicentre and the National & Provincial Tuberculosis program (NTP & PTP), while liaising with all relevant institutions (Ethics Committee, laboratories, TB clinic, and Regulatory Authorities) during the study implementation.
• Applying medical knowledge and skills to diagnose and prevention. Carrying out outpatient and inpatient consultations, prescribing the necessary treatment respecting MSF/WHO/MoH protocols.
• Keeping the patient and/or his/her family informed about the illness and providing appropriate explanations about the treatment to follow, checking they have understood.
• Checking and controlling the rational distribution of medicines and equipment under his/her responsibility and taking care the quality, disinfection and sterilization of the medical material. Ensuring general compliance with standing hygiene standards.
• Participating in the collection and analysis of epidemiological data, checking its validity and informing the line manager or project coordinator about any problem or complication of the patients’ illness, medical error and monitoring the proper functioning of the department, equipment or material.
• Ensuring ongoing training of the medical/paramedical multidisciplinary team to optimize the quality of care.
• Knowing and ensuring all MSF/WHO/MoH medical protocols are followed and implemented, checking universal precautions are followed at all times and reducing bio-hazard risks and improving infection control. Ensuring professional/medical confidentiality is respected.

Specific Task:

• Since December 2021, MSF has run a Programmatic Management Drug Resistant Tuberculosis (PMDT) site at Gujranwala Teaching Hospital (GTH), working in close collaboration with Primary & Secondary Healthcare Department, Specialized Healthcare and Medical Education Department and Provincial TB Program (PTP) offering free-of-charge diagnosis, treatment, and care for DRTB patients. Adopting Person Centred Approach (PCA), the objectives of the project are to diagnose and treat DRTB patients in Gujranwala District and surrounding districts and to contribute to global/local scientific knowledge through operational research.

Objective 1:

On contributing to global/local scientific knowledge through operational research:

• Participating in the development of operational research related documents: operational research standard operating procedures (SOPs), registers and other implementation tools.
• Participating in the training of PMDT staff and other on-site study staff (if any) according to the SOPs.
• Supporting day-to-day preparation and implementation of the operational research protocol including patient flow, implementation tools and meetings; following closely the progress of the operational research on site, ensuring the respect of the SOPs with regular checks performed.
• Ensuring the completeness, accuracy and quality of data recorded by PMDT staff, NTP/PTP/MOH staff, and other on-site study staff (if any) in the relevant tools including paper based medical records, registers, electronic medical records and study consents; ensuring an appropriate data flow as well as data security and medical confidentiality; ensuring that databases are sent timely and regularly to the Principal Investigator as agreed with the site.
• Serving as the primary focal point of the Principal Investigator at the site and MSF Epicentre and ensuring adequate communication through emails, calls and written reports as requested by the Principal Investigator and/or the Project Medical Referent/Medical Coordinator.
• Supporting the implementation of the qualitative component of the operational research by contributing to sampling and recruitment of interviewees, organizing data collection encounters, supporting interviewers, data transcript and translation preparation.
• Participating in the recruitment of study staff on site if needed and where appropriate.

Objective 2:

On diagnosis and treatment DRTB patients in Gujranwala District and surrounding districts:

• Outpatient consultation: For walk-in/referred patients, performing clinical management to diagnose/confirm if they have TB/DR-TB. For confirmed DR-TB patients, ensuring them to be prescribed/treated with appropriate regimens and other medications, tests, examinations according to MSF/WHO/MoH guidelines.
• IPD care: Ensuring that patients with complications who require hospitalization are referred to relevant health facilities and are visited regularly as per MSF guidelines.
• Ensuring complicated/special cases including patients with co-morbidities, drug related side effects, treatment failure, non-responders to first line TB medication and hospitalised patients are timely discussed with hospital consultants and MSF TB Referents and clinical decisions are implemented.
• “Test, Avoid, Cure Tuberculosis in Children”/TACTiC: Working closely with the Gujranwala DR-TB project medical team and MoH pediatrician(s) to enhance paediatric TB/DR-TB diagnosis including children screened among household contacts of DR-TB patients.
• Working closely with the outreach team for home-based follow up of patients registered at PMDT Gujranwala, both living within and outside Gujranwala; joining the outreach team for home-based patient follow up and household contact medical screening when required.
• The holder of this position is expected to spend equal share of his/her time to support the project to achieve the above mentioned two objectives.