Gynecologic Oncology Surgeons

Médecins Sans Frontières (MSF) is an international medical and humanitarian association founded in 1971 that provides assistance to populations in distress, affected by natural or man-made disasters as well as armed conflicts. MSF is present in more than 60 countries worldwide.

MSF is URGENTLY seeking for **Gynecologic oncology surgeons.**

**Background and Justification**:
Malawi has the highest cervical cancer incidence (76/100,000) and mortality rate (50/100,000) in the world, representing an estimated 3,684 new cases and 2,314 deaths annually. Eastern and Southern Africa, including Malawi, also has one of the highest HIV prevalence, which contributes significantly to the cancer incidence, as HIV positive women are significantly more likely to develop cervical cancer when infected with HPV. Despite ongoing efforts to provide cancer screening and treatment services by the Ministry of Health and international organizations, the coverage remains low in comparison to the scale of the need in the country.

MSF, in response to this need, has implemented a unique comprehensive oncology project in Malawi. The project aims to encompass all components of gynecologic oncology care (mostly cervical cancers) from primary to tertiary prevention through the collaborative work of a multidisciplinary medical team embedded at the Queen Elizabeth Central Hospital (QECH) and community health centers in the Blantyre and Chiradzulu districts in Malawi. The surgical team is a vital component of the program, which will provide diagnosis, treatment, and follow-up services for gynecologic oncology patients at QECH in collaboration with a multidisciplinary team.

Mission

**General Responsibilities**

MSF is seeking a surgeon experienced in gyneco-oncologic care in this rapidly developing project. General responsibilities include organizing and carrying out surgery activities, ensuring pre and post-operative surgical care, in accordance with MSF policies, protocols and universal hygiene standards and in close collaboration with medical staff in the gynecology, oncology, palliative, intensive wards, and operation theatre in order to improve patients’ health conditions.

This is a unique position encompassing the following characteristics:

- Unique opportunities to engage in hands-on clinical activity in a tertiary referral hospital in Malawi among a diverse case-mix referred from district hospitals that combines oncology with tropical medicine (i.e. Malaria, STIs, TB, and HIV)
- Substantial opportunity to engage in surgical coaching, bed-side, and theoretical teaching to medical students, interns, residents, clinical officers, registrars, and nurses in a tertiary academic medical institution in Malawi
- Opportunities to develop strong leadership, management, and negotiation skills in global health while tackling clinical and public-health challenges within a multinational and multidisciplinary team.

The position is an ideal opportunity for a physician with a special interested in providing surgical care to gynecologic oncology patients in resource-limited contexts, offering clinical mentorship and capacity-building of future providers of cancer care in Malawi and engaging in challenging experiences in project management and leadership. As the project is still new in its implementation phase, much flexibility, patience, and diligence will be required. The oncosurgeon will be asked to assist in the set-up of the surgical and associated clinical services for the first months of the mission with the gynecologic oncology referent and the medical focal point. Until the implementation and services are stabilized, the surgeon must be willing to step out of his/her comfort zone, take initiative, and be a proactive and cooperative member of the project launching team, as he/she may be asked to engage in non-surgical activities (e.g. protocol development) during the initial stages.
- The surgical cases will primarily be cervical cancers, but depending on the project development, the surgeon may be asked to perform surgeries for other gynaecological cancers (e.g. vulvar cancer, endometrial cancer, and ovarian cancer). The expected case load will be one to two planned surgeries a day, for five days a week, although these numbers may change.

**Accountabilities**:

- Coordinate the implementation of MSF clinical policies, tools, guidelines and protocols (antibiotic prophylaxis, post-operative pain management, thrombo-prophylaxis, gyneco-oncologic surgeries, blood transfusion, admission and inpatient orders, 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