ALIMA programs in Chad:
Chad is one of the poorest countries in the world, ranked 184th out of 187 in 2014 according to the Human Development Index (HDI) and it is currently facing a complicated security situation in view of the regular incursions of the ex Boko -Haram (current Islamic State in West Africa).
ALIMA started its activities in Chad in 2012 in partnership with the Chadian medical NGO Alerte Santé.
In 2012, the project in the N'Gouri health district, in the Lac health region, was implemented with the support of ECHO, UNICEF and WFP. This project continued during 2013 and 2014 during which emphasis was placed on improving the quality of care, a major challenge in Chad given the difficulties in mobilizing qualified medical skills. In 2015, 6,500 SAM children were treated, including 724 children suffering from medical complications, hospitalized at the UNT of the N'Gouri District Hospital. In addition, a pediatric component has also been integrated into AS / Alima's action in N'gouri, making it possible to take care of 8,606 children in pediatric consultation and 419 in hospitalization.
Since April 2013, ALIMA / AS has also been supporting the management of SAM in N'Djamena thanks to the support of ECHO. Before the implementation of this ALIMA / AS project, only the dispensary of Our Lady of the Apostles in the southern district, offered free treatment for malnutrition in the capital. With two years of activity, the project has demonstrated the extent of the problem of malnutrition in urban areas (in N'Djamena the SAM rate reached 2.8%). In 2015, the project took care of 16,490 SAM children on an outpatient basis, including 3,330 in hospital at the Chad-China Friendship Hospital. A workshop on the management of severe acute malnutrition in urban areas was also organized. In 2016, outpatient SAM treatment in 4 UNA and inpatient in 1 UNT will continue.
In these two projects ALIMA / AS are working in collaboration with local and national health authorities and numerous training sessions are organized.
In addition to these two regular projects ALIMA and Alerte Santé also implemented two emergency interventions in 2014 to quickly respond to the influx of refugees and returnees from the Central African Republic. In the Gaoui camp, ALIMA / As provided primary care as well as screening and management of SAM, thanks to the support of UNICEF. On the other hand, community health and water, hygiene and sanitation activities were carried out in the Doyaba camp, with a hospital component to take charge of secondary care at the Sarh District Hospital, thanks to the support of the French Embassy.
Malnutrition consequently weakens the health of children in addition to exposing them to malaria and diarrhea. In N'Djamena, this results in a high proportion of diarrhea among SAM children admitted to structures supported by ALIMA and appears to significantly increase the probability of mortality. Faced with the lack of alternatives allowing a better understanding of the local epidemiology of diarrheal pathogens, ALIMA is considering the very promising option from 2016-2017 to resort to the use of qualitative molecular diagnostics through the Biofire system, in the aim of evaluating the infectious causes of acute diarrhea in SAM children with complications, thus improving drug prescriptions and therefore the treatment of these patients.
Following an assessment carried out by the ALIMA teams from April 25 to May 2, 2018 in Bagassola including the visit of MSF Switzerland mobile clinic sites highlighting the needs in terms of health and nutrition, the gap at the health district level Liwa and the lack of positioning of humanitarian actors able to resume activities, ALIMA proposes to support the DS of Liwa in the field of health and nutrition. The objective of the action is to contribute to the reduction of morbidity and mortality among displaced and indigenous populations of the Liwa health district, through the establishment of a mobile clinic and the medico-nutritional care of children under 5 with SAM.
TYPE OF POSITION
The medical coordinator ensures the relevance and quality of care in current or future ALIMA projects in the country where he is assigned. He personally represents the association with national medical authorities and other health actors acting in the country.
PLACE OF MISSION: N'Djamena - Chad.
The medical coordinator is based in N'Djamena where the country coordination is located, ALIMA representative office in Chad.
It carries out regular field missions in the provinces of intervention and missions to assess and set up new projects in the country.
He regularly takes part in ordinary and extraordinary humanitarian coordination meetings (clusters, technical groups, task force, etc.) in capital and, if necessary, in the provinces.
The medical coordinator ensures the assessment of needs, the design of projects, the relevance and quality of care in the various projects in the country. Coordinates the implementation of projects in support of the project coordinators. He represents Alima with the national medical authorities and other health actors acting in the country.
He also participates in working meetings or training at the headquarters of the NGO in Dakar, Senegal
FUNCTIONAL AND HIERARCHICAL LINKS
- The medical coordinator supervises the assistant medical coordinator and the project coordinators in the medical field.
- He works closely with the logistics coordinator and the financial and HR coordinator.
- He reports to the Head of Mission (hierarchical superior) and to the Medical Desk Referent (Technical Referent.)
MAIN MISSIONS AND ACTIVITIES
Analysis, reflection and definition of objectives and strategies for ALIMA / Health Alert projects
- it offers the Country Representative / Doctor Desk a choice of data collection and medical indicators with the management of the Headquarters medical department.
- It regularly collects data from all the activities and all Country Representatives, local resources, ALIMA / Health Alert medical projects in the country from medical referees.
- It organizes the assessment of local health resources quantitatively (HR, Structures, equipment, etc.) and qualitatively (maintenance, skills of actors, protocols, water and hygiene, organization).
- It ensures the establishment of a health information system adapted to the context, relying on international and national ALIMA resources. **
- It collects indicators for monitoring the state of health of the population. It takes into account the opinion of local health actors.
- With the Country Representative, he decides and organizes an assessment mission or requests expertise if necessary (e.g. medical department,) to deepen the analysis of a situation, the interpretation of these effects on the health of the population or help with decision making.
Analysis, interpretation and proposals for action
- It interprets the data collected and describes the evolution of the phenomenon (s) affecting the population, the state of health of the population and the performance of care activities under the responsibility of ALIMA.
- It follows the evolution of the epidemiological situation of the country, in particular that of diseases with epidemic potential.
- He closely observes migratory phenomena and the potential humanitarian risk.
- He shares his interpretation with the field teams and insists on their role in the development of results.
- He discusses with the head of mission an adaptation of the means or strategies to improve the ALIMA / AS response in existing projects.
- He writes regularly (every month) argued reports on the objectives, the results of the activities and the adaptations of the ALIMA / AS projects for the local authorities, the coordination in the capital, the field teams and the head office
- He reports and discusses regularly with the Country Representative and with the program manager, the evolution of the health status of the population, in particular that to which the ALIMA services are offered
- He writes up the proposals for medical interventions, in conjunction with the Country Representative who analyzes the opportunities and environmental constraints. He collaborates with the other coordinators (logistics and finance / Human Resources as well as "reporting") who also participate in the drafting of the project in their field.
- The coordination projects (adaptation or new intervention) are proposed to headquarters for discussion and decision.
- It responds to requests for clarification and takes into account the remarks of the head office in the drafting of the final draft.
- He draws up the budget with the coordination team: He informs the financial / Human Resources coordinator of the medical means necessary for the implementation of the projects. The medical coordinator takes into account in his project the assumptions in financial and human terms.
- He participates in strategic meetings at headquarters
From the country's medical authorities and other medical organizations
- He represents the association with national medical authorities. As such, he describes the projects and argues the choices on the basis of proven evidence (evidence-based programming)
- Where appropriate, when there is a difference of views on diagnostic or therapeutic medical practices between the medical authorities and the ALIMA teams, it negotiates based on the opinions and advice of the medical management (head office)
It strengthens collaborative links with other medical organizations: regular contacts, exchange of useful information, etc.
Implementation of ALIMA programs
He organizes the implementation of medical activities according to the project description, in particular with regard to:
- Time planning
- The provision of material and human resources
- The provision of diagnostic and therapeutic procedures
- Respect for good practices
For material resources, in support of caregivers, doctors in particular
- It controls the implementation, the correct use and the maintenance of diagnostic, clinical and therapeutic tools necessary for the care of patients.
- He sends orders for materials and consumables to the referring doctor at the desk, based on consumption monitoring and in compliance with supply constraints. He develops international medical orders, in collaboration with the project teams and the logistics department
- He ensures the quality of transport and storage as well as the return to the head office and the logistics center of any defect found on receipt of orders.
- It organizes the monitoring of consumption and the management of the project pharmacy.
- In the event of a local purchase, he ensures that the procedures defined by the head office supply department are followed.
Ensures that the comfort and safety of patients and health personnel are respected, in support of the project coordinator and the doctor responsible for the activity.
- It monitors and explains the case fatality rates as well as the other indicators of the project
- He participates in the risk assessment for staff, patients and accompanying persons.
- It participates in the collection of information useful for monitoring staff and patient protection measures
- He ensures the updating of the skills of the medical staff according to the evolution of the technical platform and the protocols made available to the mission
- He formulates requests to the Country Representative and to the logistics coordinator to adapt the infrastructures to the needs of the medical activity in complete safety.
- It ensures compliance with medical ethics and remains attentive to any questions on the restrictions and limits of the practice of care in the project environment (including abuse and medical errors).
- He assesses (or delegates to a doctor from the team the assessment of) the quality of the services offered in the referral structures.
- It documents the side effects of treatments. He discusses them with the healthcare teams for each project and with head office.
National epidemiological watch and monitoring of alerts
- Regularly participates in epidemiological surveillance meetings at NATIONAL level
- Perform the weekly IDS analysis and follow up on reportable diseases based on alert thresholds or epidemiological thresholds
- Monitors the sentinel watch system on the provinces in collaboration with the contacts and offers evaluations as needed
Supervision, human resources management and training of medical personnel
Composition of teams and staff recruitment, in support of the project coordinator and the doctor in charge of the activity
- With the coordination team, he defines the team composition and job descriptions. Managerial positions are discussed with the head office human resources manager.
- It validates the skills profiles (training and experience sought) and the recruitment procedure. He participates in the recruitment of medical staff and is responsible for the final choice. He ensures that their role is presented to the hired nursing staff and that they are informed about the general and specific objectives of the ALIMA project
- He organizes the briefing and debriefing of all expatriates arriving in the mission
- It ensures the establishment of medical coverage and social protection for staff adapted to the risks identified in the project environment
Skills assessment and progression
- He participates in the supervision of project coordinators and assists them in the management of healthcare teams.
- It establishes formal individual reports of those responsible for medical activities with the project coordinators. He can delegate this task but will approve or comment on the conclusions of the balance sheet.
- It organizes access and fluidity of medical information to all ALIMA members.
- He regularly updates his knowledge of the association's medical policies and explains them to the mission teams.
- It offers an individual development path consisting of access to training offered by ALIMA, possibly local training and mobility on other projects in the country or missions in other countries.
- He plans training if necessary
- He trains and supervises any direct employee who is assigned to him.
- He shares his experience and trains potential staff in positions of medical responsibility by mentoring
Relations and communication
- Regularly informs the coordination team of the evolution of the various medical activities and gives medical feedback (statistics).
EXPERIENCES AND SKILLS
- Degree in medicine
- Specialization in Public Health or Tropical Medicine appreciated
- Several conclusive experiences in medical coordination in a recognized international organization
- Experience in emergency and security contexts
- Experience of working in the Sahel and working in partnership
- Experience in reproductive health, pediatrics, nutrition and surgery is an asset.
Qualifications of the candidate:
- Solid knowledge in the management of health services in developing countries and in health economics
- Experience in team management and supervision
- Autonomy and rapid decision-making at the medical level
- Understanding of the issues related to the emergency response of NGOs
- Knowledge of the different phases and obligations related to project management
- Good resistance to stress and good understanding of risky environments
- Computer and statistical knowledge
- Fluency in French essential
- English is an asset