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Ref.
2023/MGRDRAR/9568

Job offer type
Experts

Type of contract
Service contract

Activity sectors
Health systems

Deadline date
2023/09/30 23:59

Duration of the assignment
Long term

Contract
Freelancer

Duration
12 mois

Mission description

The gastroenterologist treats all diseases or functional disorders of the digestive tract, from the esophagus to the anus, including the associated organs: liver, gallbladder and pancreas. He screens for digestive tract diseases such as colon cancer, particularly in at-risk individuals, as well as any hereditary digestive diseases.

It also educates patients in the prevention of pathologies, particularly those linked to smoking, alcoholism and poor nutrition.

Working at the Ruhengeri hospital, located in the northern province of Rwanda, he/she will be responsible for:

a) Diagnosis, Management and Follow-up

- Screen, diagnose and treat all diseases of the digestive system (chronic inflammatory bowel diseases (such as Crohn's disease), liver and biliary tract diseases, hepatitis, digestive bleeding, pancreatic diseases, digestive cancers, etc.);

- Carry out all examinations, consultations and procedures required for patient diagnosis, management and follow-up (general abdominal clinical examination, digestive endoscopies (esophagus, stomach, duodenum, small intestine, colon), echo-endoscopy, proctological examination, rectal examination, rectoscopy, abdominal ultrasound, biopsy, digestive fibroscopy, endoscopic excision, colonoscopy), in compliance with health and safety protocols and best practice rules;

- Monitor the patient's health at all times, and plan any necessary consultations and/or interventions with the patient;

- Take charge of several types of inpatients in the same unit on a daily basis: short-stay, weekday and day hospitalization;

- Where necessary, collect and process medical information on patients under care;

- Interpret histological results as part of the diagnosis and management of the patient;

- Prescribe complementary or alternative examinations, if necessary, depending on the diagnosis made;

- Prescribe drugs during hospitalization;

- Evaluate the quality of practices and the results of prescribed and adapted treatments, as well as their effectiveness, in liaison with the patient's attending physician where appropriate;

- Perform delayed follow-up, checking for persistence or recurrence of pain or lesions that could lead to a change in diagnosis;

- Write consultation and hospitalization reports and make them available to the departments involved in the patient's follow-up and care;

- Monitor and manage patients with digestive cancer(s), in collaboration with oncologists and as part of a multidisciplinary approach;

- Monitor and manage acute and chronic alcoholics and patients with addictive behaviors (alcohol, tobacco, etc.), in collaboration with the relevant medical and paramedical professionals;

- Inform the medical profession, patients and the general public about the different levels of risk for digestive cancers; raise awareness of the role of screening tests and colonoscopy, or refer patients directly to an oncologist if the risk of cancer is very high;

- Manage patients admitted to palliative care after digestive pathologies, where appropriate;

- Implement measures and care for patients who are contagious, in respiratory isolation or carriers of multi-resistant germs;

- Communicate with patients and their families as part of a supportive relationship;

- Participate in the management of medical emergencies in the department;

- Participate in operational on-call duty and specialty on-call duty.

 

b) Department coordination and teamwork

- Collaborate with the entire facility's medical team to ensure that the patient's condition is monitored and cared for in the best possible conditions;

- Coordinate and collaborate with the department's paramedical team and other paramedical staff working with patients on the department;

- Ensure the prevention of digestive diseases among patients and work in collaboration with nutritionists and dieticians to ensure the follow-up of digestive pathologies linked in particular to malnutrition and undernutrition;

- In collaboration with nurses, dieticians and nutritionists, provide care, education and dietary monitoring for patients and their families;

- Collaborate with patients' attending physicians (information on condition and follow-up, drafting discharge letters, etc.);

- Plan and organize his/her time and that of his/her colleagues as part of teamwork;

- Participate in staff meetings and multidisciplinary consultation meetings with other medical and paramedical professionals within or outside the hospital;

c) Training and Research

- Participate in the training of gastroenterology interns and interns studying at the Faculty of Medicine in Kigali;

- Participate in post-graduate teaching in the specialty and in the continuing education of professionals in the specialty;

- Contribute to the development of gastroenterology research within the establishment;

d) Hospital life

Participate, where appropriate, in consultation and concertation bodies within the establishment.

Project or context description

Expertise France

Expertise France is a public agency for the design and implementation of international technical cooperation projects. The agency focuses on four priority areas:

 • Democratic, economic and financial governance

 • Peace, stability and security

 • Climate, biodiversity and sustainable development

 • Health and human development

In these areas, Expertise France carries out engineering and implementation missions for capacity building projects, mobilizes technical expertise and acts as an aggregator of projects involving public expertise and private know-how.

Context 

Rwanda's National Strategic Plan for the health sector (2018 - 2024) which has been defined by the Ministry of Health aims to improve four identified key areas of health development by 2024:

- Increase lifelong social protection ;

- Expand access to essential health services to combat communicable and non-communicable diseases;

- Strengthen health systems;

- Strengthen health security and health system resilience.

In addition to this strategic plan, there is a program to train human resources in the health sector, with the aim of training some 6,000 medical and paramedical professionals over a 10-year period (up to 2028).

In June 2021, the Government of Rwanda submitted a request for funding to AFD for the first phase of the rehabilitation of hospital of Ruhengeri. The hospital's current capacity is 320 beds, and the aim of the project is to build a modern 600-bed structure to offer a wide range of activities: medical imaging, outpatient consultations (dentistry, surgery, maternity and neonatology, physiotherapy, pediatrics and ENT), inpatient services and patient rooms, emergency services, gynecology and obstetrics, intensive care, infection prevention and control services.

The hospital in Ruhengeri, located in Musanze district, is a referral hospital for the population of the North and part of the population of the West region. The hospital also receives Congolese patients, as it is located close to the border with the Democratic Republic of Congo. The catchment area for the Ruhengeri hospital is substantial, and there is a growing need for healthcare services, particularly specialized health services.

Following AFD's identification mission in February 2022, the authorities validated the opportunity to support the Rwandan authorities in this project. This support will take the form of a loan dedicated to the rehabilitation of the hospital.

In addition to the loan, AFD’s financing is being mobilized to improve access to quality healthcare throughout the country. In this context, a funding has been granted to Expertise France to implement a project to strengthen human resources in health at national level and in the Musanze district.

Project description

The general objective of the project is to improve access to healthcare for the population of Rwanda, and specifically in the Northern Province.

The specific objective of the project is as follows:

OS1: Improving the availability and quality of human resources in health care in Rwanda, particularly in the province of Musanze (Ruhengeri hospital).

To implement this project, three main activities will be deployed:

Mobilizing medical and paramedical trainers from French university hospitals

Medical and paramedical trainers from French university hospitals will be mobilized in Rwanda to train and share best practices with their Rwandan colleagues. A program of monthly or bimonthly training sessions will be organized in the following medical specialties: emergencies; gynecology-obstetrics; adult and pediatric cardiology; neonatal resuscitation; bacteriology; medical and interventional imaging; endocrinology; pneumology; immuno-virology; medical biochemistry; neurology.

Interventions will be divided between Ruhengeri Hospital and the central level in various health structures (CHU K, King Faisal Hospital, Military Hospital and CHU Butaré).

Mobilization of French trainers within IRCAD-Africa

IRCAD-Africa is a training center for minimally invasive surgery, and aims to train African surgeons in laparoscopic surgery.

Completion of the IRCAD building is scheduled for the end of May 2023. Seven disciplines will be taught at IRCAD-Africa:

  • General surgery
  • Urology
  • Gynecology
  • Neurosurgery
  • Orthopedics
  • Anaesthesia
  • ENT

Mobilization of a gastroenterologist at Ruhengeri hospital

The request from Ruhengeri management concerns the provision of a gastroenterologist within the hospital.

The Ruhengeri hospital in brief:

  •  320 beds divided into 4 sectors: medicine, surgery, maternity/neonatology and pediatrics
  • More than 6,000 deliveries per year;
  • 1 intensive care unit;
  • 5 operating theatres (3 surgical and 2 obstetrical);

It is in this context that the gastroenterologist will be mobilized. The doctor will have a consultation office, in which an endoscope is installed. The consultation office, located on the second floor of the main building of the Ruhengeri hospital, is functional.

The gastroenterologist will be available 5 working days a week, with on-call duty limited to once a week. The doctor will also be able to visit the interventional gastroenterology department at Kigali University Hospital.

The gastroenterologist reports directly to the hospital's Clinical Director.

He/she will work in functional liaison with a Project Manager and a Project Assistant at Expertise France headquarters in Paris (Health Department/ DEPSAN), and more specifically with the Expert "Healthcare provision in emerging and developing countries" at Expertise France headquarters.

Required profile

Qualifications/ Technical skills

  • State diploma of Doctor in Medicine, supplemented by validation of gastroenterology specialty (DES de Gastro-entérologie et Hépatologie)
  • University diplomas in abdominal ultrasound and chronic inflammatory bowel diseases Participation in gastroenterology learned societies (SNFGE, ECCO etc.)
  • Additional qualifications (specialized master's degree, continuing education) in public health would be an asset.
  • Knowledge of the Rwandan health context and of specific issues related to the prevalence of digestive pathologies in the country is an asset.

Professional experience 

  • A minimum of fifteen years' experience as a gastroenterologist in a public health institution, private clinic, multidisciplinary nursing home or private practice;
  • Significant experience in team coordination and management in hospital projects;
  • Significant experience in project facilitation, participatory work tools and techniques;
  • Experience in coordinating or managing humanitarian projects, particularly in sub-Saharan Africa.

Professional skills 

  • Control the technical gestures contributing to diagnosis and treatment;
  • Interpret the results of various examinations (endoscopy, colonoscopy, ultrasound, etc.) and histological findings; Synthesize information to make a diagnosis; Prescribe appropriate treatment and explain it to the patient. ) and histological results;
  • Synthesize information to make a diagnosis;
  • Prescribe the appropriate treatment and explain it to the patient;
  • Comply with strict hygiene and safety rules;
  • Plan patient follow-up;
  • Make rapid medical decisions in emergencies;
  • Develop a mode of communication adapted to the patient(s);
  • Respect patient privacy;
  • Keep abreast of developments in the profession and keep abreast of new advances in his/her field of expertise;
  • Excellent observation, analysis and synthesis skills;
  • Excellent written and oral communication skills;
  • Excellent organization, planning and anticipation skills;
  • Strong coordination and teamwork skills;
  • Drafting specifications, scorecards, technical reports, analysis documents, reports, activity reports, definition of terms of reference, etc.
  • Excellent ability to conduct dialogue with technical and financial partners and other national and international partners, as well as with technicians in the field;
  • Ability to mobilize, maintain, coordinate and lead networks of players (experts, institutional players, civil society, local and national authorities, etc.);

Skills

·         Thoroughness and precision;

·         Ability to listen, good people skills;

·         Strong sense of diplomacy (and pedagogy), very good interpersonal skills;

·         Team spirit;

·         Discretion and respect for confidentiality;

·         Scientific curiosity;

·         Spirit of initiative and autonomy.

Additional information

Mission location: Ruhengeri, Rwanda

Duration of assignment: 12 months

Desired starting date: September 2023 at the latest. The candidate must be able to present sufficient guarantees of availability to take up the position.

Remuneration: according to profile/experience

Applications must include:

  • CV
  • Covering letter
  • Three professional references including e-mail and telephone contacts.

Candidates interested in this opportunity are invited to submit their application as soon as possible, but no later than 30/09/2023.

Expertise France reserves the right to pre-select candidates before this date. 

The selection process will take place in two stages:

  • Initially, a shortlist will be drawn up freely by Expertise France;
  • The short-listed candidates will then be invited to an interview with Expertise France.

The selected candidate will be accompanied by Expertise France, through an integration phase.

If you do not hear from us within three (3) weeks, please consider that your profile does not correspond to the needs of our organization.

Selection criteria for applications

The selection process for candidates will be based on the following criteria :

  • Candidate’s training/diplomas related to the expert assignment

Deadline for application : 2023/09/30 23:59

Expertise France is the public agency for designing and implementing international technical cooperation projects. The agency operates around four key priorities :

  • democratic, economic, and financial governance ;
  • peace, stability, and security ;
  • climate, agriculture, and sustainable development ;
  • health and human development ;

In these areas, Expertise France conducts capacity-building initiatives and manages project implementation, leveraging technical expertise and acting as a project coordinator. This involves combining public sector expertise with private sector skills to drive impactful results. 

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