Friends of MSF Manchester's Roadmap to a Career in Humanitarianism by FoMSF Manchester

Friends of MSF Manchester’s Roadmap to a Career in Humanitarianism. A guide for applying to MSF and other humanitarian organisations.

This book has been created by Friends of MSF Manchester, a student society that supports the work of MSF UK at the University of Manchester through awareness raising and fundraising.

Contents

Applying for NGO‘s is a competitive landscape and embarking on a career in humanitarian aid is not an easy feat. This booklet aims to support you in your application to an organisation such as MSF, by further understanding:

Introduction

Acknowledgments

Who is MSF?

What is different about MSF?

The recruitment process for MSF

Job roles

UK office-based jobs

Medical

Non-medical

Contents

Building your portfolio

Broad Skills

111

Essential Knowledge

118

Working overseas: and interview with Cara Brook

124

So where do I go from here?

125

Self-reflection

126

Goal Setting

128

Useful resources

130

Frequently asked questions (FAQs)

132

References

Introduction

When looking for advice, a roadmap even, of how to prepare for a career working with an NGO such as Médecins Sans Frontières, we were left with many questions... Realising such a document wasn’t readily available, members of Friends of Médecins Sans Frontières (FoMSF) Manchester, set out to create a concise and comprehensive document to help students and young professionals like us and like you, achieve their dreams. This booklet is for you if you wish to understand more about starting a career in humanitarian or medical aid. We have collated everything you need to know, to create a stepping stone to your career and future. Firstly, this booklet will help you decide if a career with MSF or similar organisations is right for you with our ‘what to expect’ section. Then we provide practical information such as the roles MSF recruit for, the recruitment process, and the skills and experiences you need prior to application. It is full of tips on how to tailor your career to a humanitarian role. And if you still have questions after all that, we have a comprehensive FAQ section so no question goes unanswered. This booklet aims to bring working with MSF alive for you. During the process of writing the booklet we spoke to many MSF professionals. We captured their advice, their experiences and how they came to MSF, which we encapsulated in our ‘career portfolio’ sections to help you map out your career and understand what your future with MSF could look like. We recommend you also take the time to read our interview with Cara Brooks. If you are considering an overseas elective and have questions about the dilemmas of volunteering, then reading Cara’s stories from abroad will fill in many of the blanks for you.

Though this booklet concentrates on the process of applying and working for MSF, it is largely transferable to many other NGOs and provides comprehensive information for anyone considering a future with a relief organisation. This booklet has been produced for you by volunteers of Friends of Médecins Sans Frontières Manchester (FoMSF). FoMSF are student-led societies who support the work of MSF. If you are going to or are currently studying at a UK university, seek out your local society. It is a great first step into working for an NGO. FoMSF aims to raise awareness, encourage people to get involved and to raise funds. Produced by FoMSF Manchester this booklet aims to give you an insight into the important work carried out by MSF an international organisation who provides humanitarian aid in some of the most challenging places and contexts in today’s World. It aims to provide you with a roadmap as to how you might be a part of MSF’s future. We hope to inspire you to volunteer, to raise awareness and funds for MSF to give MSF the freedom to provide medical care where need is greatest. In order to compile this booklet we have used public sources as information but claim any interpretation errors as our own. If you require any further information or it sparks further questions then please feel free to contact us with any questions or feedback at: fomsf.mcr@gmail.com

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©Solen Mourlon/MSF

Who is MSF?

Acknowledgments

This booklet is the product of hours of hard work from members of Friends of MSF Manchester and could not have been published without the determination of all involved. We would like to acknowledge the contributions of: Francesca Moorhead (Co-President 2021-2022), Khalifa Ali (President 20202021), Aminah Abbas (Publicity Offer 2021-2022), Darcy Emery (Phase 2 Representative 2021-2022) and Maymunah Malik (Co-President 2021-2022) We would particularly like to thank kind individuals from outside the society that devoted time to this project; Julia Moorhead, Charlotte Lee, Pam O’Brien, Brigitte Daubeny, Katrina Crampton-Thomas, Cara Brooks, Julianna Smith, Dr Benjamin Black, Dr Conor Moran, Dr Mark Sherlock, Dr Hassaan Zahid, Cristina Ceroli, Andy Dennis, Chris Peskett, Marc Wilkinson, Chris McAller and Simon Tyler.

Who is MSF?

Working for MSF, also known as Doctors without Borders, means working for an international organisation with over 50 years’ experience in humanitarian and medical aid. Now a worldwide movement, it has 67,000 staff from over 150 countries working to provide healthcare and medical assistance to people in distress. MSF works in over 70 countries to provide assistance to those affected by natural disasters, war, hunger, denial of healthcare, population displacements and epidemics. There are 48 offices around the world, overseen by 6 different operational entities in Amsterdam, Barcelona, Brussels, Geneva, Paris more recently in Abidjan– each with autonomous decision-making and different specialities. History: Created in 1971 in Paris by a group of 13 doctors and journalists, this emergency medical aid organisation came together with a collective ambition to provide care for those affected by natural and manmade disasters - regardless of race, religion or ideology. Starting with 300 volunteers, its first mission was in 1972 in Managua, Nicaragua’s capital, which was destroyed by an earthquake that killed over 10,000 people, injured 20,000 and displaced 30,000. Over the next 30 years MSF led missions from Honduras, to Cambodia, Ethiopia, Lebanon, Yugoslavia through hurricanes, refugee crises, wars, famine, genocides and massacres. In 1999 MSF was awarded a Nobel Peace Prize for their pioneering humanitarian work. In his acceptance speech Dr James Orbinski, the then-president of the MSF International Council, used this platform to condemn breaches of humanitarian conduct when he denounced Russia’s violence against the Chechen population. This objector’s voice was heard clearly in the international aid community. Although MSF were accused of straying into political territory, the organisation made it known that they would use their voice for those they pledged to serve and those who didn’t have one.

“Silence has long been confused with neutrality, and has been presented as a necessary condition for humanitarian action. From its beginning, MSF was created in opposition to this assumption. We are not sure that words can always save lives, but we know that silence can certainly kill.” ~ James Orbinski, 15 October 1999, Oslo Today MSF continues to respond to emergencies all around the world, going where they are most needed. MSF continues to provide medical relief to victims of war, disease and disaster (whether natural or man-made) without regard to race, religion or political affiliation. MSF’s actions seek to provide high-quality patient-oriented care, alleviate suffering, save lives, uphold human dignity and principally to do no harm to those affected by conflicts, crises and natural disasters. However, when medical aid is not enough, MSF may seek to provide other aid, in the form of shelter, water, food or sanitation. MSF is a non-profit, self-governed, member-based organisation, bound by the Charter and two core documents - the Chantilly Principles (4 October 1995) and La Mancha Agreement (25 June 2006). The organisation is also guided by the humanitarianism principles of impartiality, independence and neutrality: Independence: over 90% of MSF’s budget comes from private donors enabling MSF to be free from interference from political and economic powers. Impartiality: care is provided on the basis of need. MSF does not discriminate and aims to respect all cultural and religious beliefs. Neutrality: MSF maintains a spirit of neutrality and does not take sides in armed conflicts. MSF pledges to relieve suffering irrespective of background or circumstance.

Who is MSF?

Information from MSF’s 2020 international activity report: see here

Who is MSF?

What to Expect? You may be drawn to humanitarian and aid work for a spectrum of reasons: societal contribution, professional development, cultural understanding, working in a diverse team, development of clinical skills, adventure and travel. But before you proceed, it is important to understand the realities of working for an NGO such as MSF, and consider whether a career in aid is the right fit for you.

to manage stress is an important asset. Though it is worth remembering staff will receive the appropriate training, psychological support, briefings and debriefings from the MSF office to support the challenges of the job.

a long period of time to spend away from home. Consider how you might react to living in an unfamiliar culture with limited contact to your family and friends. You may also consider whether it is the right time for you to be embarking on a career with MSF; have you got responsibilities at home or in family life that might be affected by your decision to apply? Or perhaps you are fresh out of university - have you gained the relevant clinical experience and skills necessary to provide safe care?

Though safety assessments are carried out and relevant safety measures put in place for staff during missions to manage risk and ensure they are able to work as safely as possible, complete safety cannot be guaranteed when working in places of conflict. Due to the nature of the work, the potential risks to safety and security are much higher than most are used to. Some missions have heightened safety and security threats – consider this thoroughly prior to application. Use of MSF clothing may be mandatory to show you are on an MSF mission as it can be argued that independence and impartiality are MSF’s most important assets when it comes to security. However, in exceptional circumstances, its wear is sometimes avoided so as not to cause further conflict. Missions are divided into:

Abuse:

This may not be a factor you have considered; however, it is true that staff of MSF do become In order to honour the principles of MSF and fulfil victims of abuse whilst on missions. Some poputhe aims of a mission there are many challenges lations see MSF’s involvement as unnecessary and you will face. Factors for you to consider are: unwanted – staff must be prepared to face insult and/or discrimination. Time away from home: Missions have a typical duration of 6-12 months, Danger:

Emotional challenges: Any workplace can have its emotional demands but working in the field can present stressful experiences that are emotionally draining. The work often requires travel to areas left in catastrophe by disaster, where the care required greatly exceeds the capacity of local structures. There are many stressors to a job in medical aid, such as witnessing suffering, a heavy workload with limited resources, potential health issues, distance from family and friends, strained relationships with fellow team members and living and working with colleagues, often in a confined place. Being able

Low risk: regulations are fairly relaxed, possibly with no curfew, workers are allowed to use public transport and perhaps take leave in the country during the mission. Medium risk: these form the majority of missions. There may be a curfew, workers may face restric-

Who is MSF?

tions as to whether they can move both inside what you will hold of most value in your career. and outside of a compound. Working hours: High risk: severely restricted movements, specific procedures and instructions to follow, you may be working close to areas with active armed conflict. During these missions, to ensure safety, it may be possible you have to suspend your activities and travel to a safer location.

Hours are variable depending on the project and role, on average MSF staff may have one day off a week, however long hours are often required. Sometimes staff may be required to be available 24/7, especially during emergencies.

See: MSF - Safety and Security

You must be able to adapt to new accommodation, food, weather conditions (sometimes extreme), daily routines and languages when working abroad with MSF. Free time and privacy may be limited. Staff often share living, kitchen and bathroom accommodation. Circumstances in emergency settings may mean you are asked to share a room with your colleagues.

Salary cut: In line with MSF’s not-for-profit ethos, taking a job with MSF may mean a salary cut from your previous job . Pay does increase according to role, responsibilities and number of missions undertaken, but is unlikely to be on a par with salaries in the commercial sector or state-supported organisations, such as the NHS. As Alfa, an MSF project coordinator, expressed “For me it is not money that matters. With MSF, you become more human - you have a certain comfort in your heart not to serve for nothing. You have the satisfaction of bringing your stone to the humanitarian edifice.” To add to the dilemma, you might consider that even a reduced MSF salary may serve as a barrier on the ground or make you a target, as international staff may be perceived as rich in the host country Career delay: Becoming an international worker for MSF may delay career progression in other systems, for example medical doctors wanting to become consultants. By sacrificing time for MSF work, medical and non-medical roles may find that they fall ‘behind’ their peers or former colleagues in the ‘traditional’ career trajectory. This might be something to consider as you endeavour to understand

Living conditions:

Cultural differences: You should expect to experience different cultures, both when working in new countries and also within your own team - MSF has employees from over 150 countries. Despite your own beliefs you must seek to understand and remain respectful of people’s beliefs and cultures to avoid misunderstandings or undermining MSF’s work. Cultural respect is embedded in the ethos of MSF and whilst you may consider this to be a given, it is worth challenging yourself and understanding what this means. For example: • You may expect gender equality but consider you may be working in a country where gender segregation is the norm. • Your home country may support gay marriage – indeed you may be in one yourself – but you may be working in a country where homosexuality is illegal.

Who is MSF?

See our section on cultural sensitivity on page 96 Witnessing different realities: Although unpleasant, whilst working to provide assistance to vulnerable populations you may witness, amongst other things, abuse of human rights, violence and brutality. These are factors of the work you must seriously consider: if and how you could deal with them. However, It goes without saying that working for MSF can be a rewarding and life-changing experience with a plethora of positives: making friends for life, experiencing a range of different cultures, gaining resilience, overcoming challenges and achieving things you never thought possible.

Who is MSF?

To work for MSF all members must honour and fulfil the principles encompassed by the MSF charter:

Médecins Sans Frontières provides assistance to populations in distress, to victims of natural or man-made disasters and to victims of armed conflict. They do so irrespective of race, religion, creed or political convictions. Médecins Sans Frontières observes neutrality and impartiality in the name of universal medical ethics and the right to humanitarian assistance and claims full and unhindered freedom in the exercise of its functions. Members undertake to respect their professional code of ethics and maintain complete independence from all political, economic or religious powers. As volunteers, members understand the risks and dangers of the missions they carry out and make no claim for themselves or their assignments for any form of compensation other than that which the association might be able to afford them.

Personality traits - is this you? • Respectful towards others, their religion, culture and beliefs • Ability to cope with stress and work under pressure • Good interpersonal skills, particularly listening, persuading, influencing and motivating

• Strong communication skills • Good time management and first rate organisational skills • Competence in negotiation • Self-driven and creative with a solution-oriented approach to problem solving problem • Strong team player and able to work in a multi-disciplinary team • A capable multi-tasker • A sense of humour! Perhaps start with an online course like RedR’s ‘So You Think You Want to be an Aid Worker?’

Who is MSF?

What to pack?

Sleeping: sleeping bag and sleeping bag insert Shoes: sturdy walking shoes and flip flops (avoid Birkenstocks as they don’t do well in the rain) Key equipment (role dependent): your tape measure, circuit tester, pinard, harddrive or stethoscope etc - though MSF will provide the majority of equipment Clothes: a couple of pairs of trousers, (MSF will provide tops) and one nice outfit in case you get invited to a formal event (or just want to feel fancy!) Music: iPod and headphones A headtorch Toiletries: shampoo, conditioner, deodorant, hand sanitiser and SPF Decorations: whether it is a string of fairy lights, bunting or some photos - any decorations you fancy to make your accommodation feel more like home Luxuries: coffee, wine, tea, marmite, chocolate for when you need a pick-me-up Home comforts: photo album, diary or your favourite cuddly toy - for when you are missing home Reading material: whether it is your favourite book or Grazia magazine - something to keep you occupied in quieter moments Games: UNO or Cards Against Humanity - depends how daring you want to be! Gifts for the team you are joining: cheese and chocolate are always welcomed!

MSF Logistician Daniel Campbell recommended bringing some bracelets “not only am I a big fan of an armful of bracelets but these inexpensive trinkets can be a really convenient item to have close to hand when visiting cultures where gift-giving is an important part of initial greetings.”: see here

The spirit of MSF

Why is MSF different? The spirit of MSF

Why is MSF different?

One of MSF’s greatest strengths is its extensive

and the International Rescue Committee (IRC)

private support - 90% of funds come from private

organised the ‘March for Survival of Cambodia’.

donors, a proportion that no other international

This protest at the Cambodian-Thai border set

NGO can claim. Through these funds MSF are

the tone, provoking a debate within the humani-

well organised, have in-built capacity and can

tarian community and the press.

move quickly to mobilise its resources to maximum effectiveness as need arises. However, it is

A key part of MSF’s advocacy has been their Ac-

the autonomy that this funding gives MSF that is

cess to Essential Medicine Campaign - set up

perhaps it’s greatest asset. As MSF does not need

in the HIV/AIDS crisis in the early 2000’s. The

to acquire funding from politically motivated ex-

campaign shone a light on the price charged for

ternal bodies, it allows work to be driven exclu-

medicine by pharmaceutical companies. It was

sively by victims’ needs, the extent of suffering

successful in lowering the price for treatment of

and medical assistance needed. This also allows

AIDS down from $15,000 for patented drugs to

MSF independence to be vocal about concerns

less than $200 for generic versions of the drug

within the international community - a key part of

thereby saving thousands of lives. Alongside this

MSF’s character. How is this level of private sup-

movement – there was a shift in focus from cri-

port possible you may ask? Perhaps the reason

sis situations to long-term primary care which re-

private donors are attracted to MSF is due to the

mains today. A recent internal report recognised

honesty and strong character of the organisation.

the importance of partnership with countries’

For example, MSF regularly audits and publishes

ministries of health in strengthening healthcare

total spending budgets and funding for public

structures’ capacity to provide long-term care.

access. Moreover, their ethos promises account-

For example, a current MSF project in Sierra Le-

ability, transparency and a responsibility for their

ona is working alongside the Ministry of Health

actions to their beneficiaries and donors.

and Sanitation to reduce high rates of maternal mortality.

Dr James Orbinski, “As an independent volunteer association, we are committed to bringing direct medical aid to people in need. But we act not in a vacuum, and we speak not into the wind, but with a clear intent to assist, to provoke change, or to reveal injustice.” One of MSF’s core principles is “temoniage” or bearing witness - speaking out, advocating and denouncing situations to improve aid. MSF has a history of using its voice to raise public awareness and openly condemn breaches of ‘international conventions’. For example, in February 1980 MSF

MSF have been labelled with a reputation of being the ‘cowboys of humanitarian aid’ or ‘enfant terrible’, unafraid to go where others would not and say what others could not. What Dr Orbinksi said in his acceptance speech for the 1999 Nobel Peace Prize bears repeating here: “Silence has long been confused with neutrality… We are not sure that words can always save lives, but we know that silence can certainly kill”. Regardless of whether this reputation is true or myth, MSF have continued to inspire change and advocate for the vulnerable and suffering. For example, when in

Why is MSF different?

the 1980’s MSF denounced the Ethiopian gov- willingness to embrace a high proportion of new ernment population resettlement programme, international staff is a distinctive quality of MSF accusing it of killing more people than the famine and is in accordance with its Charter: “to maintain - it led to them being expelled from the country. spontaneity and a spirit of innovation”. Perhaps an illustration of the reckless and cavalier-attitude sometimes attributed to MSF.

MSF’s salary scheme is made public along with

all of its finances. Its structure differs from some Former International President Joanne Liu re- other NGOs: flects: “MSF is most of the time a great responder, a fairly good doer, a very bad partner”.

International management staff’s salary levels are lower than comparable sectors.

MSF is well practiced in and encourages organisation-wide debate.

Joanne Liu called it the National staff’s salary levels are comparably high“dissident voice in MSF”. This trait can perhaps er than equivalent sectors. be traced back to two founding voices of MSF, Bernard Kouchner and Raymond Borel, who fa- This is underpinned by a Board of Directors most mously came head-to-head in 1974 over MSF’s in- of whom are non-salaried and a wide volunteer volvement in the Kurdish revolt against Iraq. The base who make an individual non-lucrative comdisagreement created ripples in the boardroom, mitment to those in need. splitting it down the middle. Eventually ending with Kouchners’ success as he was elected to one of the two highest posts in MSF. Organisation-wide reflection is still encouraged today. MSF is an associative organisation. Whether you are in finance, logistics, administration, communications,

human

resources,

medical

or any other area you are invited to become a member of the MSF association. All members are equal, have the right to contribute opinions and responsibility to guide MSF’s social mission towards innovation. By becoming a member of staff you become an associate, you have a voice. MSF sees international staff as a vital life force bringing new experiences, opinions and skills to the organisation. In return MSF provides opportunities to join the organisation and work up the ranks to become directors and leaders. Thus

Who is MSF?

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©Solen Mourlon/MSF

The spirit of MSF

Recruitment process for working overseas with MSF

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©Mariana Abdalla/MSF

Recruitment process

Recruitment Process 1. Preparation.

2. Application

Prior to application, read as much as possible Applying via an online application form for a speabout MSF, its history, what they do and how they cific job role. This will include a current CV, letter operate. As noted above it is important to consid- of motivation and a skills self-assessment form. er your motivations for applying. There is plenty of information to help you decide whether MSF is Ensure you have an updated, tailored CV and a punchy letter of motivation. Do your research and the right organisation for you. do not be afraid to be different! The letter of motivation should draw attention to relevant experiBefore you apply do you meet the general requirements of all applicants which include:

ence, knowledge and skills that demonstrate you meet the job specifications. It should also explain why you are considering MSF as an organisation.

• You meet the job specifications and have the relevant professional experience • You can commit to a contract for the duration required by your role – mostly minimum of 9 months

3. Feedback The human resources team screen the application and will respond within one month of their receipt

• Have a valid passport, UK residency and right to

of it. If you are a good fit for MSF, you may be

live and work in the UK (all necessities to obtain a

required to undertake a test and/or be invited to

contract through the UK office)

interview. Unfortunately, if you are unsuccessful at

• Have experience in managing, supervising and

the shortlisting stage MSF do not provide feed-

training others • Commitment to MSF’s work and core values • Prepared to work with limited resources

back due to the high volume of applications. 4. Interview

• Able to cope in difficult, unpredictable and often

The interviews typically last one hour, either in the

unstable environments

London office or over Skype if you are unable to

• Able to work in a multicultural and multi-discipli-

attend in person. Some roles also require a tech-

nary team • Able to organise and prioritise workload • Able to work using initiative

nical test, which you will have a chance to prepare for in advance. Note your language skills may be tested at this stage if relevant (or a later stage). This stage will also require a reference check and

• Are in good health

criminal background check. You will need to bring

• Proven fluency in English and/or French

documents, such as a valid passport and your

Sufficient IT skills (Excel, Word, PowerPoint)

NMC PIN number / GMC registration.

Recruitment process

5. Acceptance

You will be provided with a job description and detailed information regarding the project and If you’re successful you will be accepted onto the your responsibilities to ensure you are provided MSF register: a database of professionals who are with available to work on any project. You are not paid whilst in this ‘pool’ until you are offered a posting.

as much information as possible. The HR team will arrange travel and visa and will provide ad6. Finding your first role ministration support pre-departure. Once settled in the host country you will receive a full Firstly, you are put in touch with a HR contact briefing by the national team. where a potential role is sought. Note, there may be a wait to match you with an appropriate

NB: Roles may require differing applications – full information can be found at: https://msf.org. Candidates are matched to a specific position uk/find-job based on skill set, previous experience and composting. This can last from one to nine months.

petencies. Some postings do come with specific language requirements. MSF’s ethos, as set out by its charter, provides assistance to populations in accordance to need, not geographical preference. Therefore candidates must be flexible and willing to work wherever they are needed. 7. Preparation for Primary Departure (PPD) A one-week mandatory course which involves briefings in the office as well as technical training to prepare you for your assignment. This course aims to help you adapt to the clinical realities of the mission, however you should undertake individual preparation to ensure you are educated on the culture of the population, regional epidemics and the health system infrastructure. 8. Your first assignment Though flexible, workers generally depart 1-4 weeks after confirmation of their assignment.

Recruitment process

Roles may require differing applications – full information see here

Recruitment process

Job Roles There are a range of jobs for professionals at MSF UK: medical, non-medical and jobs in the UK Office. Within this MSF allows for many different careers, full time in operations in the headquarters, full time in the field or you can do sporadic projects. Overall MSF employs 68,000 professionals, of which international staff are in the minority, with 55,000 being hired locally. There are role specific requirements. Requirements can also be subject to change depending upon the organisation’s need at the time. At times MSF may also have a full quota for a specific role and may not be accepting applications.

©Aahana Dhar/MSF

Recruitment process

How to navigate this section? Pick a job you think you might be interested in. Look through its description, what the role involves, the specific skills you need to exhibit, essential requirements for the role and assets you might hold to stand out from the crowd! Each section comes with a variety of resources that you may look at to find out more about what it is like to work in that role.

UK Office-based jobs

Page. 27

Medical Roles Anaesthetist Biomedical scientist Epidemiologist Gynaecologist Health promoter Medical doctor Mental health specialist Midwife Nurse Paediatrician Pharmacist Surgeon

Page. 28 Page. 31 Page. 34 Page. 37 Page. 40 Page. 42 Page. 48 Page. 50 Page. 53 Page. 57 Page. 59 Page. 63

Non-medical Roles Communications officer Finance coordinator HR coordinator Human resources officer Logistician Project Coordinator Water and sanitation specialist

Page. 65 Page. 67 Page. 69 Page. 73 Page. 75 Page. 79 Page. 82

UK office-based

UK Office-based jobs MSF employs a significant back office and admin- Access more information at: https://msf.org.uk/ istration staff currently based in London. From uk-office-job-vacancies the coordination of donations to the logistics required to post staff to projects, it is a large undertaking. Staff working in the supporting offices to the Operational Sections make an enormous contribution to MSF. UK office job openings will depend on the organisation’s requirements at the time. Hiring takes place both internally and from outside the organisation. MSF recruits for a range of departments at the UK office including Human resources, Finance, Communications, Logistics, Project and Programme Management, Marketing and Fundraising, IT and Public Health.

©MSF

Medical roles

Medical Roles Anaesthetist Role Names: Anaesthesiologist French: anesthésiste (male/female) Arabic: AkhiSaa’iy (m)/AkhiSaa’iyyat (f) al-takhdeer Role Description: Anaesthetists are specialist doctors required to manage patients’ pain and ensure safe anaesthesia care. Anaesthetists for MSF have a very varied role and must be responsive to the situations they find themselves in. They must adapt to working in both acute and operative settings, in hospitals, local clinics and sometimes outside of health facilities, for example in the confines of an ambulance whilst transferring a critical patient to another health facility. An anaesthetist for MSF may expect to treat a high number of trauma cases from armed conflict and natural disasters. Anaesthetists will be presented with emergency cases which may include crush, burn or gunshot victims, alongside many patients with severely advanced, uncontrolled co-morbidities due to poor healthcare accessibility. Alongside this there will be planned operations, complex obstetrics surgeries and post operative pain to be managed. Their workload is heavy, often high in emergency cases and requiring 24/7 availability, demanding physical and mental stamina. As a result, missions are usually shorter than other MSF professionals.

managing and ordering anaesthesia materials, often for a whole hospital or facility. Skills in provisioning and ordering supplies are essential to ensure patient safety and ensure readiness of service provision. Anaesthetists will likely work with unfamiliar equipment and may encounter equipment problems that require repair and maintenance skills. MSF works in resource-limited facilities that influence how anaesthetists operate. For example, they may lack automated ventilators, preventing intubated anaesthesia or may have unreliable electric supply preventing electronic monitoring. Therefore, anaesthetists must modify skills and techniques to match the equipment, resources and staff expertise. Anaesthetists will likely practice in a very different way to which they have been trained, relying on spinal, general and local intravenous anaesthesia, rather than inhalation, regional and epidural anaesthesia. They may have to avoid the use of opioids and intubation and choice of anaesthesia in developing countries can be different. For example, ketamine being the preferred option for intravenous anaesthesia. A key role of an MSF anaesthetist is to provide support to local staff learning basic anaesthesia. An anaesthetist will be required to plan and facilitate training workshops, alongside mentoring local staff to broaden medical competencies. Specific Skills: • Competency in the variety of clinical skills required in emergency medicine and low resource settings

Anaesthetists must create the conditions in which • Ability to adapt skills with the resources availother professionals can do their work safely by

Medical roles

able to continue to provide life-saving and pain in low resource settings, for example: management patient care • eLearning modules: e-SAFE by the Royal Col• Ability to work autonomously, often as the most lege of Anaesthetists. qualified anaesthetist in the project with little available support from other healthcare profes- • Or the RCoA developing world anaesthesia sionals course: see here Skills in the supply management, provisioning and administration of anaesthesia to ensure main- • Or the BMC Cardiff University course on Essentenance of supply chain and readiness of services tials of Anaesthesia in the Developing World: see here • Flexibility to work in many different settings from clinics to refugee camps, hospitals to trans- Learn more port vehicles Youtube: • Knowledge of common presentations in vulnerable populations, of medical aid interventions Are You MSF? | Oliver – Anaesthetist. and of current public health emergencies e.g. Libya – An Anaesthetist’s Story trauma surgery, burns management, complex obWorking with MSF: Meet anaesthetist Brigid Brown stetric cases MSF On the Road with anesthesiologist, Gerry • The physical and mental stamina required by Bashein (2017): the demands of the project Articles: Essentials: • Trelles Centurion M, Van Den Bergh R, Gray • Consultant level anaesthetist experience H. Anesthesia Provision in Disasters and Armed • Full GMC or Irish Medical Council Registration. Conflicts. Current Anesthesiology Reports. • Availability of 3 months minimum 2017;7(1):1-7. Assets:

• Rössler B, Marhofer P, Hüpfl M, Peterhans B, Schebesta K. Preparedness of Anesthesiologists • Minimum of 3 months’ work experience in low Working in Humanitarian Disasters. Disaster and middle income countries Medicine and Public Health Preparedness 2013 08;7(4):408-412. • Experience in paediatric, emergency and obstetric anaesthesia are particular assets as anaes- • Komorowski M, Fleming S, Mawkin M, Hinkelthetists will be required to support pain manage- bein J. Anaesthesia in austere environments: literment across a range of departments. ature review and considerations for future space • Further training for delivering safe anaesthesia exploration missions. npj Microgravity. 2018;4(1).

Medical roles

Blog: #MyImpactStory | Working for the ICRC as an anaesthetist: see here “NOTHING SHORT OF A MIRACLE”: THE TRAUMA TEAM THAT REFUSED TO GIVE UP: see here AN EMERGENCY IN BURUNDI: “WE WERE HIS BEST AND ONLY HOPE”: see here “LUCKILY, OUR CARE IS FREE”: INSIDE L’ARCHE DE KIGOBE TRAUMA CENTRE: see here “KHOST, THE PLACE I CONSIDER MY SECOND HOME”: see here

Medical roles

Biomedical Scientist Role Names: Microbiologist, biomedical researcher, medical scientist, health scientist French: scientifique biomédical (m/f) Arabic: 3aalim (m) /3aamlimah (f) alTib alHayawy Role Description:

tient outcomes. Or opening up a blood bank to increase a facility’s capacity to treat severely anaemic patients with blood transfusions. Or setting up a point of care testing (POCT) clinic to facilitate rapid testing and diagnosis without the need of a laboratory. Biomedical scientists might then monitor the impact of these projects and interventions through data collection and analysis. Biomedical scientists must also increase local staff’s professional capacity by training and supervising the laboratory technicians and championing their professional development.

When clinicians cannot determine a patient’s diagnosis, they order investigations - this is where biomedical scientists come in. Biomedical scientists work closely alongside clinicians to diagnose and treat disease - 80% of MSF’s diagnoses can Specific Skills: be attributed to their work (Baldwin, 2017). • An analytical thinker, tackling complex clinical Biomedical scientists may be familiar with work- conditions by evaluating available information to ing with a range of advanced molecular tech- make an informed decision for patient diagnosis niques, biochemical techniques and imaging technologies. However when working with MSF • An innovator, with the ability to review areas of they may not have access to these luxuries, there- biomedical testing service provision in order to fore highlighting the need for scientists to be design and implement improved testing strateinnovative and adaptive. They must also be pre- gies . For example implementing point of care pared to work with specimens that are often very testing different to what they are used to, for example, tuberculosis, malaria, osteomyelitis and meningi- • Ability to collaborate with all medical profestis. Biomedical scientists also see high levels of sionals to improve patient diagnosis. For exammulti-drug-resistant organisms in MSF projects. ple, working alongside the sexual and reproducMulti-drug resistance is an emerging crisis and tive health unit to provide accurate diagnosis of biomedical scientists must be aware of the recent STIs, such as chlamydia evidence-based research (Tanwar et al, 2014). • Ability to adapt practices in line with limited reBiomedical scientists working for MSF need to source availability, to continue to provide accube innovative, formulating and implementing rate diagnosis and innovate new treatments for plans where biomedical services can improve the disease medical aid MSF provides. For example, creating a screening programme for TB to ensure early • Ability to maintain, repair and organise providiagnosis and treatment to promote positive pa- sion for medical technology, for example oxygen

Medical roles

cylinders

A Master’s degree or Doctor of Philosophy in Biomedical Sciences

• Manage and oversee the work in the laboratory, ensuring that testing is carried out in accordance Biomedical Sciences focused on Infection with quality control methods and Tropical Diseases, such as: the University of Antwerp’s Master of Biomedical Sciences: Essentials: Infectious and Tropical Diseases (Research) (M.Sc.): see here • Diploma in Laboratory Technology or a degree in Microbiology with applied medical parasitol- Learn more ogy and bacteriology, or a Biomedical Sciences Application: degree • Proven knowledge of STDs, virology, TB, blood • Check out the mobile app “Antibiogo” made by the MSF Foundation which works to interband, malaria, HIV/AIDs pret antibiotic susceptibility tests (AST), to help • Competency in the techniques of sample taking clinicians prescribe accurate antibiotics. • Experience working with laboratory software Blog: packages and carrying out surveys • INNOVATION: HOW MY MICROBIOLOGY • Knowledge of laboratory testing quality control TEAM HELPS THE HEALING PROCESS: see here methods • Minimum of 3 months work, volunteering or • HABARI! MY FIRST MISSION IN TANZANIA: travelling experience in low-and-middle-income see here countries • INNOVATION: BREATHING BETTER WITH TECHNOLOGY: see here • Minimum availability of 9 to 12 months • NOT JUST FOR COVID: HOW MODERN TESTING METHODS ARE CHANGING REFU• Experience working with NGOs in low or middle GEE HEALTHCARE IN GREECE: see here income countries • Experience working with tropical diseases and Articles: infectious diseases • Gibbs Jr KD, Griffin KA. What do I want to • Further education in biomedical sciences: be with my PhD? The roles of personal values and structural dynamics in shaping the caAssets:

Medical roles

reer interests of recent biomedical science PhD ternational AIDS Society. 2012 Apr;15(2):17357: graduates. CBE—Life Sciences Education. 2013 see here Dec;12(4):711-23: see here Podcasts: • Stead WW, Searle JR, Fessler HE, Smith JW, Shortliffe EH. Biomedical informatics: changing • The Lancet Voice podcast what physicians need to know and how they • BBC Radio 4: Inside Health podcast learn. Academic Medicine. 2011 Apr 1;86(4):42934: see here • Kippax S. Effective HIV prevention: the indispensable role of social science. Journal of the In-

©Viviane Dalls

Medical roles

Epidemiologist

lated sciences

Role Names:

• Inquisitiveness and ability to think outside the box to hypothesise the cause and or spread of disease

Public health analyst, medical scientist French: épidémiologiste (m/f) Arabic: 3aalim (m)/3aalimah (f) Al-A’wbi’ah Role Description: Epidemiology is defined by WHO as “The study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems.” A MSF epidemiologist must explore and record the patterns and aetiologies of all different conditions and diseases that occur within populations. Their role is indispensable as their findings inform the measures that should be taken by aid organisations, healthcare providers and governments in order to prevent and manage outbreaks. MSF epidemiologists work in country coordination centres or within field projects, leading or working as part of project teams. The work of an MSF epidemiologist is varied and their findings facilitate evidence-based decision-making within projects. A MSF epidemiologist may: set up and collect data from surveys; initiate and carry out surveillance within a community to monitor pathologies; investigate causes and risk factors of diseases; and compile reports to implement project planning and aid responses

Specific Skills: • Proficiency in mathematics, statistics, biostatistics, geodemographic and epidemiologically re-

• Ability to create and implement epidemiological research programmes and design data collection system to monitor/record epidemiological data • Ability to analyse, summarise and interpret complex epidemiological data using appropriate software programmes Essentials: • Degree or Masters’ Degree in Epidemiology, or an MPH with extensive epidemiology training • Proven practical skills in design/implementation / evaluation of quantitative and qualitative epidemiological research methods • Proven practical skills with software for epidemiological database and statistical analysis (Microsoft Excel and at least 1 statistical program) • A minimum of 1 year working in a low and/or middle income country or similar environment • Available for up to 9 months

Medical roles

Assets:

Articles

• Background in a medical or biomedical field to Frérot M, Lefebvre A, Aho S, Callier P, Astruc K, facilitate handling reporting on medical condi- Aho Glélé LS. What is epidemiology? Changing tions definitions of epidemiology 1978-2017. PloS one. • Experience working with NGOs in low- or middle-income countries

2018 Dec 10;13(12):e0208442. See here Kawachi I, Subramanian SV. Social epidemiology

• Experience working with tropical diseases and for the 21st century. Social Science & Medicine. infectious diseases

2018 Jan 1;196:240-5. See here

Learn more:

August E, Burke K, Fleischer C, Trostle JA. Writing

YouTube: Why we need epidemiologists in the field INNOVATION Epidemiology with a smartphone MSF International. Epidemiology the backbone of public health. Blogs “ALL DATA HAS A STORY, AND IT’S AN EPIDEMIOLOGIST’S JOB TO TELL IT”: see here MAPPING THE HOTSPOTS: HOW I HELP TO FIGHT DISEASE IN YEMEN; see here WORKING WITH REFUGEES IN UGANDA: HOW EPIDEMIOLOGY CAN MAKE A DIFFERENCE; see here WE CAN BE HEROES; see here

assignments in epidemiology courses: how many and how good?. Public Health Reports. 2019 Jul;134(4):441-6. See here Bensyl DM, King ME, Greiner A. Applied epidemiology training needs for the modern epidemiologist. American journal of epidemiology. 2019 May 1;188(5):830-5. See here Morabia A. Pandemics and the development of scientific methods in the history of epidemiology. Colombia Medica. 2020 Sep;51(3). See here

Medical roles

Gynaecologist Role Names: Obstetrician and gynaecologist, obs & gynae, women’s health provider French: gynécologue (m/f) Arabic: Tabeeb (m)/Tabeebat (f) nisaa’ wa wilada Role Description:

screening and managing complications of unsafe abortion, which count for 4.7%-13.2% of maternal deaths each year (Say et al, 2014). MSF gynaecologists must expect to run a team of staff and most may run a hospital department, for example a maternity ward. They may also oversee services, such as family planning clinics or cervical cancer screening services. They are expected to provide clinical advice to relevant professionals, from midwives to nurses to anaes-

Gynaecologists are medical doctors that special- thetists. Responsibilities also include ensuring ise in women’s wellbeing and the health of the ongoing high-quality care through increasing the

female reproductive system. An MSF gynaecolo- professional competencies of local staff by progist / obstetrician works within a project to providing training, education and mentorship and vide care for vulnerable women and children in sharing expertise. some of the most difficult contexts in the world. These gynaecologists provide care to individu-

Specific Skills:

als that face a range of difficulties due to their • Experience in diagnosing, assessing, managing settings of conflict, displacement, epidemic and and monitoring, complex and emergency cases poverty. Therefore the cases seen are often com-

plex emergencies, requiring them to be skilled in • Current knowledge of safe gynaecological, obstetric and abortion practices, in order to provide surgery and experienced in care of the critically ill. up-to-date training and practice Gynaecologists are providing care in settings • Understanding of cross-cultural issues surroundwhere maternal mortality remains high, reflecting ing childbirth, for example, the place for tradithe global inequality in health, with 94% of ma- tional birth attendants in some cultures ternal deaths occurring in low-resource settings

• Anticipation and knowledge of the practical isin 2017 (WHO, 2019). Therefore, gynaecologists sues that can be caused by the limited availability need to be highly skilled in performing obstetric of resources surgery and managing complications. A gynae-

cologist may have to manage: severe bleeding • Adept triaging skills - organising and prioritising workload by using decision-making and prob(e.g. post-partum haemorrhage); pre-eclampsia / lem-solving skills, for example, if there are multieclampsia; obstructed labour and uterine rupture. ple obstetric emergencies at once Other complex cases gynaecologists might face include obstetric fistula surgery, cervical cancer Essentials:

Medical roles

• Full GMC or Irish Medical Council Registration

THOSE LIFE-SAVING MOMENTS: OBSTETRICS IN AFGHANISTAN: see here • Proven professional experience after regis- “WE GIVE MORE THAN JUST HOPE”: see here tration a minimum of ST5 experience for Ob & GYNs (in the 5th year of Specialist Training, after TAKING YOUR HAT OFF: A RARE INJURY IN OBFoundation years 1 and 2). STETRICS: see here Youtube:

• Minimum of 3 months availability

• Minimum of 3 months work, volunteering or A Sisterhood of Women in an Afghanistan Hospital travelling in developing countries A Sisterhood Saving Mothers and Babies in Afghanistan

Assets:

• Diploma in tropical medicine or infection dis- Skilling up with MSF: Advanced Obstetrics Training ease, for example from the London or Liverpool School of Tropical Medicine Build a Career with MSF - Rasha Khoury (OB-GYN) • Managerial and supervisory experience

Articles:

• Qualification in global women’s health

Althabe F, Moore JL, Gibbons L, et al. Adverse maternal and perinatal outcomes in adolescent • Experience in abortion care, contraception and pregnancies: The Global Network’s Maternal family planning Newborn Health Registry study. Reprod Health • Experience of care to survivors of gender and 2015;12 Suppl 2:S8 sexual-based violence Say L, Chou D, Gemmill A, Tunçalp Ö, Moller • Experience in gynaecological oncology, colpos- AB, Daniels JD, et al. Global Causes of Maternal Death: A WHO Systematic Analysis. Lancet Globcopy and cervical pathology al Health. 2014;2(6): e323-e333. Learn more: Singh NS, Smith J, Aryasinghe S, Khosla R, Say L, Blanchet K. Evaluating the effectiveness of sexual and reproductive health services during humanitarian crises: A systematic review. PloS one 2018;13(7):1

Podcasts: Precious Baby: see here Blogs: ONCE MORE INTO FRIENDS: see here

THE

BREECH

DEAR

Strategies towards ending preventable maternal mortality (EPMM).Geneva: World Health Organization; 2015.

Medical roles

Health Promoter

ing their beliefs, identifying resistance to change and risky behaviours is key for developing an awareness of the culture. Managing, training and Role Names: monitoring the health promotion team to ensure Health Promoter, public health practitioner, com- safe, high quality health education to vulnerable populations is a key responsibility. Furthermore, munity health worker, public health educator MSF health promoters must build local teams’ caFrench: promoteur de la santé (m/f) pacity in designing and managing health promoArabic: MunSeH (m)/MunSeHah (f) al-SaHah tion campaigns to support long-term behaviour change. Role Description: Health promoters represent the direct link between communities and health centres. They must provide communities with information to promote healthy behaviours, safe practices and inspire change. Community education covers a variety of topics: promotion of medical services, education on malnutrition prevention and promotion of good hygiene to prevent the spread of infectious diseases, for example, practices that decrease risk of HIV transmission. Health promoters often work to the priorities highlighted by the medical team and develop strategies to address certain health issues. They must research and implement appropriate interventions, ensuring campaigns are evidence-based, as well as interactive and engaging. For example, during an outbreak of cholera in a refugee camp, health promoters may work with the community to explain the disease, its symptoms, how it is transmitted and prevented, and when to seek medical assistance. To aid education and increase understanding, health promoters must find an appropriate approach to convey their message. This can vary from role play to songs and visual aids – all techniques must be acceptable to the community. MSF public health projects must be accessible and relevant to the communities they are serving, therefore public health promoters must understand local behaviour and practices. Listening to members of communities, assess-

Specific Skills: • Ability to analyse local behaviour and practices to ensure a culturally valid health promotion approach • Ability to devise and implement public health interventions that meets the needs of the population and remain effective in humanitarian crises and unstable context • Adaptable, creative communication skills to aid evidence-based information giving and promote wide-spread participation • Ability to identify and target vulnerable groups to provide individualised public health education Essentials: • Formal education in Anthropology or Sociology (or relevant social sciences) • 2 years’ post education working in the field of Health Education and Promotion • Experience working with communities • Experience working in developing countries • Minimum 9 to 12 months

Medical roles

Assets:

(NOT ALL) DOCTORS WITHOUT BORDERS: see here

• An anthropology qualification. HEALTH PROMOTION IN PAKISTAN: see here • Masters in health-related degree e.g. MSc Youtube: Global Health • Experience of work as a medical professional Are you MSF? | Mary - Health Promoter e.g. nursing HUMANITARIAN SNAPSHOT | Health Promotion • Familiarity with infectious diseases e.g. Malaria, Supervisor in Lebanon Zika virus, Dengue fever

Article:

• Familiarity of sexual and gender-based violence Warren E, Post N, Hossain M, et alSystematic reservices • Experience in a similar role with another NGO view of the evidence on the effectiveness of sexual and reproductive health interventions in huor unstable environment manitarian crisesBMJ Open 2015;5:e008226. doi: 10.1136/bmjopen-2015-008226: see here Learn more: Books: Michael Marmot – the Health Gap Public Health: A Very Short Introduction (Very Short Introductions) by Virginia Berridge Foundations for Health Promotion – Naidoo and Wills, 4th eds. Blogs: What is a health promoter? see here OF CULTURES AND DINOSAURS: PROMOTING HEALTH, LAUGHS AND UNDERSTANDING IN THE FIELD: see here MY TIME IN PAKISTAN: HOW PLAYING GAMES COULD HELP SAVE LIVES: see here

Medical roles

Medical Doctor

expertise. In whatever setting clinicians should expect a high volume of patients. They must have adept triage Role Names: skills, treating and admitting those based on seMedical doctor, physician, clinician, doctor of verity of illness and medical need. Strong history taking and physical assessment skills become key medicine in medical aid. Doctors must be able to create French: médecin (m/f) rational patient investigation and treatment plans Arabic: Tabeeb (m)/Tabeeba (f) in the context of resource scarcity, whilst maintaining accountability to ensure high standards of Role Description: care are achieved. MSF doctors provide diverse medical care for vulnerable populations determined by the needs and priorities of the project. Doctors should be prepared to provide care for a wide range of illnesses. Common presentations include parasitic diseases, HIV/AIDs, TB, diarrheal illnesses, malnutrition, malaria and its associated infections, pregnancy and obstetrics, and injuries caused by trauma sustained in conflict zones. Doctors may work in a hospital facility, mobile clinic or as a ‘flying doctor’ – travelling between communities to provide essential healthcare. Some projects may have a specific focus, for example, HIV service improvement and doctors may be hired to facilitate this. Doctors must provide life-saving medical aid in low-resource settings that are often vastly different from clinicians’ previous experience in resource-rich settings. MSF projects usually do not have facilities such as ultrasound scans, CT scans or even x-ray equipment. There is often minimal laboratory support, and transfer to higher levels of care may not be possible. With often only rapid diagnostics and basic bloods available there is a combination of a less certain diagnosis alongside a limited treatment availability. Therefore, clinicians must learn to adapt their clinical skills to these limitations and rely on experience and

MSF international are likely to be the most clinically experienced healthcare professional in the project. They act as the consultant in charge, taking ultimate responsibility and therefore must be able to work with autonomy. Interprofessional teaching, education and mentorship is key to building the clinical competency of the local team. It is the responsibility of MSF international to design and facilitate training workshops to aid this. They must also implement treatment protocols and update clinical guidelines, ensuring they are evidence-based and context-specific. Administrative responsibilities of an MSF international include management of local personnel (including HR decisions and rota-making), provisioning of medical supplies to ensure service readiness and statistical reporting on the care MSF provides. Specific Skills: • Ability to work autonomously, often as the acting consultant of departments or an entire project with little available support from other health care professionals • Knowledge of common presentations in vul-

Medical roles

nerable populations, of medical aid interventions • Managerial and supervisory experience. Read the and of current public health emergencies General Medical Council’s advice on leadership and management: see here • Competency in the variety of clinical skills required in emergency medicine and low resource • Experience in community health settings or settings and the ability to adapt skills to maintain remote locations with limited resources high-quality care in the context of resource scarcity Learn more: • Experience in conflict management, prioritisa- Podcasts: tion of care and triage skills The letter that changed me: see here • Ability to prioritise workload using decision-making and problem-solving skills The darkest hour: see here • Ability to monitor, collect data and create re- Blog: ports on medical care Coolest Travel Jobs: What It’s Like to Work for Essentials: Doctors Without Borders: see here • 2 years’ professional experience after registration “I WILL NEVER FORGET HER FACE”: SAVING – a minimum of ST2 level completion LIVES FROM SNAKEBITE: see here • Full GMC or Irish Medical Council Registration • Diploma level training in tropical medicine and/ or infectious disease • Minimum of 9 months availability

SOUTH SUDAN: “PLEASE START CPR, I’M ON MY WAY”: see here “THIS IS WHY WE ARE HERE”: THE RACE TO SAVE A LIFE IN SOUTH SUDAN: see here

• Minimum of 3 months work, volunteering or FIVE MYTHS ABOUT WORKING FOR MSF: see here travelling in low-income countries Assets:

Youtube:

• Surgical, obstetrical, mental health, trauma, Are you MSF? | Javid – Doctor: see here orthopaedics experience Working for MSF as an Emergency doctor: see here • Specialisation in emergency medicine and/or paediatrics. Read the Royal College of Emergen- MY TOP TEN | Tips for working as an MSF Doctor: cy Medicine’s website here: see here see here

Medical roles

SYRIA | Doctor on the Frontline: see here SOUTH SUDAN | The Flying Doctor: see here Articles: Donaldson RI, Shanovich P, Shetty P, Clark E, Aziz S, Morton M, et al. A Survey of National Physicians Working in an Active Conflict Zone: The Challenges of Emergency Medical Care in Iraq. Prehosp Disaster Med 2012 04;27(2):153-61. Castañeda H. Medical Humanitarianism and Physicians’ Organized Efforts to Provide Aid to Unauthorized Migrants in Germany. Hum Organ 2011 Spring;70(1):1-10. Lee JS, Roberts SWP, Götsch K, Moeller U, Hawryluck L. Caring for Critically Ill Patients in Humanitarian Settings. American Journal of Respiratory and Critical Care Medicine 2019 Mar 01;199(5):572-580. Shamasunder S. Sounds of Haiti. Journal of General Internal Medicine 2011 03;26(3):349-50. Hunt MR, Schwartz L, Fraser V. “How Far Do You Go and Where Are the Issues Surrounding That?” Dilemmas at the Boundaries of Clinical Competency in Humanitarian Health Work. Prehosp Disaster Med 2013 10;28(5):502-8

Did you know? Diplomas in Tropical Medicine, Global Health, Humanities and Infectious Diseases are offered by a number of schools including: the Liverpool School of Tropical Medicine, London School of Hygiene & Tropical Medicine, the University of Manchester’s Humanitarian and Conflict Response Institute.

Medical roles

Mental Health Specialist

MSF mental health specialists must manage the local team, which may include counsellors, psychologists and outreach workers. This Role Names: includes education and training of the local team in conducting mental health assessments, Mental health officer, psychiatrist, clinical psychologist, counsellor, therapist, clinical social planning care, interventions and appropriate referral. Mental health specialists must oversee workers the overall mental health programmes both in French: professionnel de la santé mentale (m/f) facilities and the community; ensuring current Arabic: AkhiSaa’iy (m)/AkhiSaa’iyyat (f) protocols, pathways and referral systems are relevant and effective. Monitoring this may inRole Description: clude responsibilities such as data collection Mental health specialists provide care for popula- and writing monthly reports. tions who have experienced trauma (e.g. displacement), individuals suffering disease (e.g. HIV) and Specific Skills: those with mental illness. Responsibilities would involve planning mental health services’ response to disasters, including: survivor identification, referral of vulnerable individuals, individual counselling, group education and support services. Routine mental health services in humanitarian aid still remain uncommon, despite being widely recognised as a significant role in the rehabilitation of vulnerable populations (Loughry, 2019). As an organisation MSF does recognise the wide implications and presentations of those who suffer mental health issues and, as a result, MSF’s mental health service has been noted as markedly exceptional (Ventevoel et al, 2015). Mental health disorders can be both worsened and triggered by extreme stressors, such as loss of loved ones and experiencing traumatic events. The World Health Organization projects that 15-20% of populations suffer mild or moderate mental disorders after exposure to trauma and 2-3% suffer severe disorders (WHO, 2012). It is essential that MSF mental health teams have a thorough understanding of the impact of trauma and disease on the mental health of populations.

• Understanding of the importance of early psychosocial assessment in complex emergencies to ascertain the extent of psychological impact and identify vulnerable groups • Assessment of existing mental health care systems, including evaluation of traditional healer practices • Understanding of evidence-based mental health interventions and ability to apply them throughout the system • Cultural competence in relation to mental health disorders, for example, understanding the differing beliefs between cultures about the cause of mental illness, coping mechanisms and stigma • Ensuring cultural validity of all mental health services by making sure that their measures reflect local priorities and are based on mutual respect

Essentials:

Medical roles

Articles:

• Master’s in clinical psychology, counselling psy- Ethical challenges in providing psychosocial chology, clinical social work (with qualifications in support in emergency settings: Wessells, M. psychotherapy) G. (2008). Do No Harm: Challenges in Organizing Psychosocial Support to Displaced Peo• OR medical degree with psychiatry, with mini- ple in Emergency Settings. Refuge: Canada’s mum 3 years validated in psychiatry (with at least Journal on Refugees, 25(1), 6–14. https://doi. 2 years in adult psychiatry) org/10.25071/1920-7336.21392 • OR counsellors and psychotherapists with pro- Supporting women with HIV: Laura K. Beres, fessional accreditations (e.g. UKCP & MBACP) Manjulaa Narasimhan, Jennifer Robinson, Alice Welbourn & Caitlin E. Kennedy (2017) • Currently licensed to practice Non-specialist psychosocial support interventions for women living with HIV: A systemat• 2 years full time of face-to-face patient treatment ic review, AIDS Care, 29:9, 1079-1087, DOI: 10.1080/09540121.2017.1317324 • Minimum 3 months work, volunteering or travelling experience in low-income countries Mental health support for refugees: Weissbecker, I., Hanna, F., El Shazly, M., Gao, J. and Ventevogel, • Availability for a minimum of 9 months P., 2019. Integrative mental health and psychosocial support interventions for refugees in humanAssets: itarian crisis settings. In An uncertain safety (pp. 117-153). Springer, Cham. https://link.springer. • Experience of working in HIV/AIDS, TB, PTSD, com/chapter/10.1007/978-3-319-72914-5_6 sexual violence, trauma and substance use MSF Blogs: • Experience of counselling in low resource contexts A LITTLE GIRL WHO DID NOT WANT TO TALK: see here • Participants in the planning / updating of menTHE TWO CONFLICTS: LESSONS OF LOSS IN tal health services PALESTINE: see here • Experience of community education, group counselling support and active outreach pro- SEXUAL VIOLENCE IN CAMEROON: VIOLET’S STORY: see here gramme Learn more: Youtube: Are you MSF? see here

MENTAL HEALTH IN PALESTINE: “IT SHOWS STRENGTH TO ASK FOR HELP”: see here “SMALL STEPS TOWARDS HEALING”: TACKLING TB AND ALCOHOL ADDICTION IN BELARUS: see here

Medical roles

Midwife Role Names: Registered midwife, birth attendant, midwife practitioner, health care professional French: sage-femme (m/f) Arabic: Qaabil (m)/Qaabila (f)

dence-based information and empower them to make informed decisions for them and their family. All around the globe pregnancy and motherhood is a window of opportunity to engage women and thus their families in healthcare. Using this gateway, health care professionals can educate communities by advocating healthy behaviours and influence long-term lifestyle change. Role Specific Skills:

Role Description: Midwives provide compassionate care for women and families throughout the antepartum, intrapartum (childbirth) and postpartum period. Though midwives are experts in what is “normal”, at MSF they must be able to facilitate complex care for women and infants. Midwives must be able to recognise deviations from normal physiological changes during the perinatal period, implement plans of care and refer women to the relevant practitioners where appropriate. They must also be able to provide emergency care in the absence of alternative medical assistance or facilities.

• Experience of pregnancy diagnosis as well as the monitoring of women and infant’s wellbeing by carrying out risk assessments in order to prevent and promote the early diagnosis of complications • Ability to recognise deviations from normal, in order to make referrals and facilitate interventions where necessary • Knowledge of evidence-based advice for women seeking information on a wide range of topics e.g. family planning, parenthood information, nu-

Midwives may practice in hospitals, clinics or at home. MSF midwives work in areas of natural disasters, of conflict and within poverty-stricken communities. The midwifery services provided by an MSF midwife are diverse and can include services such as family planning assistance, providing care for survivors of sexual violence and setting up new maternity clinics. It is a midwife’s responsibility to deliver training to local midwives and work alongside birth attendants to promote safe practices to improve maternal and neonatal outcomes.

trition and hygiene care • Experience of providing high-risk midwifery care e.g. managing care for women with pre-eclampsia, epilepsy, cardiovascular complications etc • Experience in diagnosing, managing and treating obstetric emergencies and complicated deliveries e.g. sepsis, antepartum / postpartum haemorrhage, shoulder dystocia, breech delivery, infant resuscitation

• Experience of abortion care and care for survivors The focus of a midwife is to meet the needs of sexual violence of the women they care for using a holistic approach. Midwives must provide women with evi-

Medical roles

Essential Requirements:

• Experience of maternal mental health services and supporting vulnerable women during the per• Nursing and Midwifery Council or Irish Nurs- inatal period ing Board Registration Learn more: • Minimum of 2 years post-qualification practice Youtube: • Experience of obstetric emergencies/complicated deliveries, termination of pregnancy, sexual vi- Are You MSF? | Claire – Midwife: see here olence VLOG | Becoming the only midwife on board the Aquarius: see here

• Availability of 9 – 12 months Additional Assets: • A tropical nursing degree

A midwife’s tale from Nigeria: see here A Midwife-Led Model of Care in Lebanon: see here Midwife Rebecca Ullman: How I Made MSF Work in My Life: see here

• Knowledge of STDs/HIV/AIDs e.g. knowledge of Prevention of Mother-to-Child Transmission Blogs: (PMTCT) care Meet MSF midwife Alice Gautreau: see here

• Experience in family planning / sexual and repro- Yemen: “It’s like delivering babies with your eyes ductive health services closed”: see here • Community midwifery experience

Sierra Leone: Tackling maternal and child mortality in Hangha hospital: see here

• Experience of midwifery care in the developing A MIDWIFE IN SOUTH SUDAN: MABAN VS LONDON: see here world “LIKE ME, HE HAS NEVER SEEN FEMALE GENI• Experience of high-dependency care, neonatal inTAL MUTILATION BEFORE’”: see here tensive care, operative/assisted deliveries SURPRISE TWINS: HOW WORKING FOR MSF • Previous coordination role in healthcare e.g. NHS MAKES ME FEEL CONNECTED TO HUMANITY: see here band 7 role or experience of coordinating wards Articles: • Knowledge of cultural preferences in pregnancy and birth Hays, K.E. and Prepas, R. (2015), The Professionalization of International Disaster Response: It Is • Knowledge of disaster response e.g. mass casualty Time for Midwives to Get Ready. Journal of Midwifery & Women’s Health, 60: 348-359. triage

Medical roles

Nurse Role Names: Nurse practitioner, registered nurse French: infermier (m)/infirmière (f) Arabic: mumariD (m)/mumariDa (f) Role Description:

important educational role, training the local staff and community health providers. Specific Skills: • Ability to plan and manage programmes, whether within an established health programme or a disaster situations, for example designing a malnutrition treatment clinic

Nurses are among the most crucial healthcare professionals in an MSF deployment and are the backbone of MSF operations. The role of a nurse is diverse and exciting. It encompasses all aspects of care delivered to a patient. Nurses for MSF work on all aspects of their deployments from establishing a clinic, to implementing vaccination programmes, to helping a surgeon operating on an emergency. Each setting will have differing needs and thus MSF nurses work with a range of departments, whether that be obstetrics or emergency medicine. Nurses can be based in hospitals or in outreach clinics and offer both inpatient and outpatient care. Nurses at MSF provide vital medical care in the extreme settings of war, natural disasters, epidemics and pandemics through to the delivery of long-term medical programmes which can stretch over decades. They must adapt to low-resource settings to ensure MSF continues to provide high quality, compassionate care to patients through utilising their adaptability, innovation and nursing experience.

• Knowledge of common presentations in medical aid e.g. infectious and tropical diseases

At MSF nurses also have a considerable role in management of staff and are often departmental lead in settings ranging from primary care and feeding services to infectious disease management and vaccination programmes. One of the aims of MSF is to develop, support and train local staff to deliver access to healthcare for the long term. It is often nurses who take on this crucially

• Minimum of 2 years post-qualification nursing experience

• Ability to adapt and innovate new nursing techniques with the resources available to provide lifesaving care • Ability to work autonomously, often as the most qualified nurse in the project • Experience in conflict management, prioritisation of care and knowledge of key management systems e.g. mass casualty triaging skills • Expertise in providing relevant education to the community to establish, strengthen and maintain public health Essentials: • Nursing and Midwifery Council (NMC) registration or Irish Nursing Board registration

• Nursing experience in a tropical environment or Diploma in Tropical Nursing • Minimum availability of 9-12 months

Medical roles

Assets:

My Journey Towards Being A Humanitarian Nurse; see here • Further education in humanitarian and disaster COVID-19: HELPING GERMANY’S MOST VULresponse, or courses alike e.g. from the school NERABLE; see here of Humanitarian and Conflict Response Institute (HCRI) in Manchester REFUGEES AND DIABETES: “I WAS CONFRONTED BY THE CHALLENGES THEY FACE”; • Knowledge of STDs/HIV/AIDs e.g. knowledge see here of Prevention of Mother-to-Child Transmission (PMTCT) care THE GAME-CHANGER: HOW ONE MSF TEAM IS SAVING YEMEN’S SMALLEST PATIENTS; see • A variety of nursing experience, including in here high-dependency care, intensive-care, emergency departments, paediatrics, neonatal care units Articles: and community nursing experience Freeman A. Care in crises: Nursing and human• Previous coordination role in healthcare e.g. itarian aid. Nursing. 2018 Jul;48(7):50: see here NHS band 7 role or experience of coordinating wards Barghadouch A, Norredam M, Skovdal M. The care ethics of child health nurses in DanLearn more: ish asylum centers: An ethnographic study. Global qualitative nursing research. 2020 YouTube: Dec;7:2333393620984141: see here Are you MSF? Michael – Nurse; see here

Noguchi N, Inoue S, Shimanoe C, Shibayama K, Shinchi K. Factors associated with nursing activiCourtney Bercan - Nurse for Doctors Without Bor- ties in humanitarian aid and disaster relief. PloS ders; see here one. 2016 Mar 9;11(3):e0151170: see here Building a career at MSF: from nurse to general Williams H, Downes E. Development of a course director; see here on complex humanitarian emergencies: preparation for the impact of climate change. Journal of Creating Change Through Volunteering: Lessons nursing scholarship. 2017 Nov;49(6):661-9: see from a Humanitarian Nurse | Helen Zahos | TEDx- here Robina; see here Ansbro ÉM, Biringanine M, Caleo G, Prieto-MeriBlogs: no D, Sadique Z, Perel P, Jobanputra K, Roberts B. Management of diabetes and associated costs in Nursing in Iraq – an intense story of resilience and a complex humanitarian setting in the Democratic perspective; see here Republic of Congo: a retrospective cohort study. BMJ open. 2019 Nov 1;9(11):e030176: see here

Medical roles

Paediatrician

Medical roles

An aspect of the role of a MSF paediatrician is to train local practitioners, doctors and nurses. Role Names: Equipping local practitioners with basic skills, such as neonatal resuscitation, can have a proNeonatologist, paed, children’s doctor found effect on children’s lives. These skills can French: pédiatre (m/f) be passed down amongst healthcare providers, Arabic: Tabeeb (m)/Tabeebat (f) al a’Tfaal building the overall capacity of paediatric services in humanitarian settings. They must also enRole Description: sure up-to-date evidence-based practices, by assessing and monitoring current services. This may Paediatricians are experts in the care of children. also include collecting data and writing reports, According to the WHO in 2019 5.2 million chilwith the aim of improving the quality of care. dren under 5 years died from largely preventable and treatable causes (WHO, 2020). MSF paediaSpecific Skills: tricians are placed in the field to care for vulnerable children and reduce morbidity and mortality rates. • Autonomous experience in diagnosing, assessPaediatricians will be expected to care for chiling, managing and monitoring, complex and dren affected by a range of illnesses, including: emergency cases malnutrition, TB, HIV/AIDs, Malaria and other tropical diseases. • Ability to maintain high-quality basic paediatric care within emergency settings MSF paediatricians will often be treating children with complex conditions with the added compli• Adept triage skills, prioritising workload using cation that they may present quite late. It is the decision making and problem solving skills, to enrole of the paediatrician to assess, diagnose, treat sure rapid and efficient paediatric care in emerand review all cases. An ability to effectively trigency settings age paediatric cases is essential in this role. This is even more acute where the care is being provided • Assessing current paediatric services, identifyfor children that have sustained trauma from dising areas for improvement, innovating and impleaster and conflict. UNICEF in 2021 reported that menting new services children often account for more than half of those affected in emergencies, which increases the role • Ability to monitor, collect data and create reof the MSF paediatrician. MSF paediatricians ofports on paediatric care ten operate in low resource settings relying on their own clinical judgement to treat patients. Essentials: As well as acute care MSF paediatricians set out treatment plans and provide clinical advice. As in • Full GMC or Irish Medical Council Registration. any context, paediatricians must ensure effective Post registration professional experience, at the communication with families and involve them in very minimum – ST3 level for paediatricians (in the plan of care.

Medical roles

the 3rd year of Specialist Training, after Founda- Lancet Child & Adolescent Health. Elsevier. Available at: see here tion years 1 and 2) • Diploma in tropical medicine and/or infectious disease Erin L. Turner, Katie R. Nielsen, Shelina M. Jamal, Amelie von Saint André-von Arnim and Ndidiama• Minimum of 9 months availability ka L. Musa (2016). Frontiers in Pediatrics: see here Assets:

D.R. Heller, (2006). The role of a paediatrician in a war zone. Current Paediatrics, Volume 16, Issue • Paediatric surgery experience 7, Pages 512-516. ISSN 0957-5839. https://doi. • Obstetric experience, e.g. on a Neonatal Inten- org/10.1016/j.cupe.2006.08.016. See here sive Care Unit Jones LAdversity and resilience: 10 lessons I have learnt from working with children in humanitari• Managerial and supervisory experience. an emergenciesArchives of Disease in Childhood Experience working in developing countries 2019;104:833-836: see here Learn more: Podcasts: The disaster in Idomeni: see here A patient as stubborn as me: see here Youtube:

Umphrey L, Breindahl M, Brown A, Saugstad O, Thio M, Trevisanuto D et al. When Helping Babies Breathe Is Not Enough: Designing a Novel, Mid-Level Neonatal Resuscitation Algorithm for Médecins Sans Frontières Field Teams Working in Low-Resource Hospital Settings. Neonatology. 2018;114(2):112-123. Blogs:

HUMANITARIAN SNAPSHOT | Paediatrician in “WE HOPE THEY WAKE UP”: see here Switzerland: see here Paediatricians: Join the Movement: see here

“LIVING PROOF”: see here

Working for SMF as a paediatrician: see here

THE HYMN: A YOUNG LIFE IN THE BALANCE IN THE ICU: see here

Articles:

HAUWA AND FALMATA: STRENGTH AND RELisa Umphrey,Alexandra Brown,Laurent Hiffler,- SILIENCE IN MAIDUGURI: see here Nadia Lafferty,Daniel Martinez Garcia,Nikola Morton,Oluwakemi Ogundipe. (2018). ‘Delivering AFGHANISTAN: ON THE WAY: see here paediatric critical care in humanitarian settings’,

Medical roles

Pharmacist Role Names: Chemist, pharmacist French: pharmacien (m/f) Arabic: Saydalaany (m)/Saydalaaniyya (f) Role Description:

up supply chains for medication and equipment across different teams and locations • Understanding of tropical and infectious diseases to help innovate new treatments for disease within limited resource availability • Understanding of the high-levels of multidrug-resistant-organisms that MSF face and how to tackle them

Pharmacists at MSF have a responsibility for managing the ordering, storage, transportation and supply of medications and medical equipment across missions. This is especially vital during periods of outbreak of infectious diseases such as HIV/AIDS, cholera and tuberculosis where the transportation and distribution of medication is urgent.

Essentials:

Pharmacists are not usually field based but base themselves in the capital cities or larger towns in order to effectively carry out their role supervising the storage and supply of medication. They must also be proficient in budgeting and stock analysis to ensure adequate project resources. However, pharmacists can have a more direct role in patient care such as the management of drug therapy, supervising dosage adherence and interactions with food. An MSF Pharmacist would also be expected to train local healthcare workers in safe pharmaceutical practices to provide sustainable healthcare provision in the community.

• Available for a minimum period of 9 months

Specific Skills:

• Qualification as a pharmacist and significant post qualification experience, ideally in hospital pharmacy management • Experience of volunteering or travelling in lowor middle-income countries for at least 3 months

Assets: • Masters in pharmacy • Experience in managing a pharmacy facility • Evidence of continued pharmaceutical education and training to ensure knowledge of new drug therapy and administration • Experience in nutrition, vaccinations, refugee health or infectious diseases Learn more:

• Efficient planning skills, in order to arrange uninterrupted provision of medication and equipment Youtube: to where it is needed Are you MSF | Barbara – Pharmacist; see here • Ability to manage resources, in order to set

Medical roles

What are the skills pharmacists need for humanitarian work?: see here Pharmacists: Join the Movement; see here Recruitment Webinar: Working as a pharmacist & Lab Technician with MSF; see here Blogs: “NOTHING WILL STAND IN MY WAY”: PHARMACIST, STUDENT AND PREGNANT IN A PANDEMIC; see here “I’M AN MSF PHARMACIST AND TOGETHER, WE SAVE LIVES!”: see here PAKISTAN: FIRST TIME IN THE FIELD; see here CAR: THE MEDICINE WOMAN; see here Cold chains and cool heads: why humanitarian aid needs pharmacists; see here Articles: Connor S, Forrister D, Karir V, Kauffman Y, Sochacki M. Improving equitable access to essential medicines: Learning from the experience of pharmacists within Médecins Sans Frontières (Doctors Without Borders). Journal of the American College of Clinical Pharmacy. 2020 Aug;3(5):930-4; see here Gupte, J. Extreme pharmacy: Frontline pharmacy. AJP: The Australian Journal of Pharmacy. Australian Pharmaceutical Publishing Company Ltd. 2013; see here Vardanyan H, Mosegui GB, Miranda E. Capacity Building of Pharmacists in Humanitarian Aid, Brazil. Prehospital and Disaster Medicine. 2017 Apr;32(S1):S85-6; see here

Medical roles

Surgeon Role Names: Surgeon French: chirurgien (m/f) Arabic: (JaraaH (m)/JaraaHa (f) Role Description:

provide life-saving care. This lack of resources also requires surgeons to rely on their clinical skills underlining the need for highly experienced and skilled applicants. In addition to the absence of resources these settings often lack specialised and experienced personnel. Furthermore MSF surgeons will face challenges and presentations not seen before in their career. For these reasons MSF surgeons must be clinically autonomous.

Surgeons are doctors qualified to perform medical operations and procedures on patients. As part of MSF a surgeon’s work is incredibly varied. It includes major and minor surgeries, emergency and planned medecine. A surgeon is required to work through all age groups from birth to geriatric care as needed by that MSF deployment. Presentations for surgery at MSF facilities between 2008 and 2012, in order of most to least common, were: fetal-maternal (39.1%), abscess (15.2%), trauma (11.3%), vehicle collision (8.5%), gunshot (8.1%), burns (5.1%) and obstetrical haemorrhage (3.9%) (Wong et al, 2014).

Training, mentoring and supervising local staff is a vital part of a surgeon’s responsibilities, focusing on developing the teams’ medical skills and ability to provide life-saving care. Reviewing current provision of care and integrating evidence-based solutions with current practice is also a key to this role. Finally, in an emergency situation MSF must aim to prepare for the transition of provision of care back to the local health system once stability has been achieved. It is key that surgeons support this.

The majority of humanitarian missions are in areas affected by conflict or disaster. Therefore a surgeon’s main focus may be expected to be predominantly emergency surgery. An MSF surgeon must have knowledge of general practice, orthopaedic, paediatric, trauma, plastic and obstetric surgeries. Caesarean sections are amongst the most common surgeries performed by MSF, therefore obstetric experience is desirable.

• Knowledge of common presentations and interventions in medical aid e.g. trauma surgery, burns management and obstetric surgery

MSF Surgeons must expect to work in austere environments, with low resources. For example many areas lack basic diagnostic resources such as an X- Ray machine. Therefore a MSF surgeon must be adaptable and innovative utilising what is available on the ground to solve problems and continue to

• Ability to work autonomously, often as the most qualified surgeon in the project

Specific Skills:

• Competency in the variety of surgical skills required in emergency and low resource settings Ability to adapt and innovate new surgical techniques with the resources available to provide lifesaving care

• Experience in conflict management, prioritisation of care and triage skills • The physical and mental stamina required by

Medical roles

the demands of the project Essentials:

Are you MSF: John -Surgeon: see here Surgeons: Join the Movement: see here

• Full General Medical Council or Irish Medical MSF Surgeons Webinar: see here Council registration Surgery in Aleppo: “We Often Have No Space in Any Operating Theater”: see here • Consultant level surgical experience • Higher surgical training, including the Articles: Post-Certificate of Completion of Training or Anneliese Willems, Bruce Waxman, Andrew K. Fellowship of the Royal Colleges of Surgeons Bacon, Julian Smith & Simon Kitto (2013) Inter- to evidence the ability to work autonomously professional non-technical skills for surgeons in disaster response: a literature review, Journal • Ability to perform general surgery, including of Interprofessional Care, 27:5, 380-386, DOI: experience in Paediatrics and Obstetrics (e.g. 10.3109/13561820.2013.791670 caesarean sections) Komorowski M, Fleming S, Mawkin M, Hinkelbein • Minimum of 4 to 8 weeks availability (depending J. Anaesthesia in austere environments: literature review and considerations for future space exploon MSF’s needs at the time) ration missions. npj Microgravity. 2018;4(1). Assets: • Experience in emergency surgery (e.g. A&E) • Experience in orthopaedic surgery

Blog: BREAKING DOWN THE WALL: TRAUMA SURGERY IN HAITI: see here

YEMEN: A DANGEROUS DIAGNOSIS: see here • Royal College of Surgeons’ Surgical Training for Austere Environments (STAE) aims to provide DAY 5: GOATS AND GUNSHOTS: see here experienced surgeons with the essential general surgical skills needed to work abroad in low re- SOUTH SUDAN: WITH BRAIN INJURIES, IT’S NOT source settings. MSF strongly recommends this LUCK THAT COUNTS - IT’S PREPARATION: see here course to all surgeons that want to work abroad with them. Learn more Learn more Youtube: Saving Kids: Bringing Paediatric Surgical Care to Liberia: see here

Non-medical roles

Non-medical jobs Communications Officer Role Names: Digital communications officer, media and communications officer Role Description: MSF Communications Officers form a critical bridge between MSF staff, patients and key stakeholders during projects. The role of the communications manager is to inform, explain, gather stories and to liaise with local media and stakeholders. A MSF communications officer must have excellent communication skills and empathetic listening skills. The role can be listening to patient stories and sharing these stories to highlight significant hardships, illustrate the work of MSF and advocate for change. A MSF Communications Officer must use their excellent written communication and media skills to create engaging content that accurately portrays peoples stories. Stories are a powerful vehicle for MSF but care must be taken to protect the lives of those whose stories are being told. The role is also to explain and promote the work of MSF to populations where a project has been set up or is ongoing. Designing the communications strategy for the project alongside HQ is an important responsibility. The strategy should include developing new and progressive strategies to create channels of communication between MSF and the project’s population. For example, engaging with people through social media platforms such as Facebook and Whatsapp. The Communications Officer must

also create written reports on the landscape of the local media, identifying opportunities, future priorities and risks to MSF communications. Reporting responsibilities also include outlining an annual communications budget that will sufficiently support the communications strategy. The Communications Officer must work alongside local and foreign media to promote MSF content. They may also act as the MSF spokesperson during a period of heightened media pressure, for example during emergencies. They must work to ensure accurate communication with the press and to diffuse any media scrutiny. It is their responsibility to liaise with international media sources to promote the MSF’s work and help them understand the realities of life for people in the project’s country. This might include facilitating media visits to projects and when appropriate organising a media interview with MSF staff or patients. Communications Officers must be able to run an ethically responsible communications team founded on the principles of humanitarianism: neutrality, impartiality, humanity and independence. They must have the ability to maintain the truth of a story whilst respecting the privacy of the story-tellers. They must also facilitate the informed choice of staff and patients, ensuring they know the benefits and disadvantages of telling their story. Specific Skills: • Excellent written communication and compassionate verbal communication skills and a drive to understand fully what is important to people and ability to accurately and honestly portray dialogue within content • Ability to effectively manage people and diplo-

Non-medical roles

matically negotiate between individuals and stakeholders • Ability to design and create engaging media content, including adequate audiovisual (photo, video and editing) skills, to create blogs, visual graphics and short films

editing) • Further qualifications, look out for online courses such as BOND’s Powerful storytelling and ethical content gathering: see here Learn more:

• Experience in managing social media platforms to promote content and communicate with the local Youtube: media HUMANITARIAN SNAPSHOT | Communications • Fluency in additional languages is highly desirable Officer in Lebanon: see here to increase communication capacity with staff, paZWA NGO BIEN (look at me well) | Lexxus Legal, tients and the media Sista Becky & Jeunesse Espoir: see here • An understanding of media ethics and an ability Blogs: to champion respectful and informed story-telling “LOOK AT ME WELL” - HOW WE MADE A VIRAL MUSIC VIDEO TO FIGHT HIV IN KINSHASA: see • Previous working experience of at least four here years in communications or journalism Essentials:

TRAPPED BETWEEN EUROPE AND COVID-19: • Previous working experience in producing comTHE FAMILIES STUCK IN GREEK CAMPS: see here munications content • Experience with MSF or other international “WE FEEL LIKE WE’VE BEEN TAKEN FROM NGOs in low- and middle-income countries HELL”: ROHINGYA REFUGEES LEFT TO STARVE AT SEA: see here • Experience working in an international environment “I CANNOT EVEN LOOK OUR PATIENTS IN THE EYES ANYMORE”: see here • Available for a minimum of nine to 12 months Fluency in English and French (MSF working lan- Podcast: guages) Assets:

Everyday Emergency. S2 E6: How We Rescued 560 People on the Mediterranean: see here

• Degree in Journalism, Communications, Human- Everyday Emergency S1 E3: see here itarian Affairs, Political Sciences or related subject • Proficient audio-visual skills (photo, video and

Non-medical roles

Finance Coordinator

Accountant, financial administrator, finance coordinator, HR & finance coordinator

analysis of sales receipts, processing invoices and preparing cost reports for contractors. Generally finance coordinators must provide support to the international HR and finance managers of the project. They must also coordinate and manage staff in their finance department.

Role Description:

Specific Skills:

Finance coordinators are integral to the smooth running of operations. It is the role of the finance coordinator to provide financial support to every department in the project, ensuring they have the funds and supplies they need to function smoothly. Finance coordinators must approve all project expenditure according to the budget. It is their responsibility to meet the financial obligations and challenges that each project requires. For this, in depth knowledge of the country’s current economic climate is key to ensuring effective finance administration. Developing and implementing finance policies as per MSF standards is important, alongside ensuring that finances are managed in line with the country’s financial structures.

• Ability to develop, manage and forecast a budget and ensure all expenditure aligns within it

Role Names:

Finance coordinators must be forward-thinking and forward-planning. They must ensure financial preparedness for MSF’s expeditious response to emergencies. It is their responsibility to develop project budgets that allow for adjustment depending on the needs and challenges of the project and community. Responsibilities differ according to the project and sometimes MSF employs people under the role of HR & Finance Coordinator. Nevertheless some day-to-day responsibilities include: ensuring staff get paid, organising accounts payable and receivable, completing bank reconciliations,

• Forward thinking and preparedness skills to avoid project pitfalls and facilitate successful, expeditious response to disasters • Knowledge of international and national accounting principles and procedures • A methodical approach and attention to detail, to ensure accuracy of financial records • Excellent IT system knowledge and competency on software programmes e.g. Excel Essentials: • Training - minimum higher vocational level e.g. CFA® (Chartered Financial Analyst) professional qualification) • Demonstrable experience with administrative organisation • Experience with human resources management and policy principles • Minimum of 3 months travel or work experience in low- and/or middle-income countries

Non-medical roles

• Available for a minimum of 9 to 12 months Assets:

A FEW DAYS IN THE LIFE OF A FINCO... BUT DON’T WORRY, NO BUDGETS: see here

Article: • Knowledge of guidelines of major funding institutions (e.g. ECHO, OFDA, etc.) for budget- MAULIDDINA Y. The role of supply chain finance ing and reporting in humanitarian aid relief: see here • Previous experience with MSF or other international NGOs Learn more: Youtube: Who We Need: see here HR and Finance Coordinator Ann Kane: Learning It In The Field: see here Meet Matt Gosney: HR & Finance professional with MSF: see here HR and Finance Coordinator Ann Kane: Software Programs Used in the Field: see here Live Recruitment Webinar: Working as a Finance & HR Professional with MSF: see here Blog: WHAT I DO: see here HOW I BECAME A DOCTORS WITHOUT BORDERS FIELDWORKER (EVEN THOUGH I’M NOT A DOCTOR): see here ROHINGYA CRISIS: INSIDE THE WORLD’S LARGEST REFUGEE CAMP: see here

Non-medical roles

HR Coordinator Role Names:

issues. Listening, persuading, influencing and motivating members of staff are also important skills to sustain a harmonious working environment within projects.

HRCOs, human resources coordinator, HR administrator, HR manager, HR professional, HR policy specialist

MSF works in countries that have very different HR practices, therefore coordinators must adapt their practices to best suit the project. It is paramount that the HR coordinator ensures that MSF is Role Description: complying with local labour laws and the national The HR Coordinator’s role is to ensure the right requirements of the project country. They have a people are in the right place at the right time. responsibility to review and develop national staff They support the project’s staff to ensure re- HR policies and ensure their implementation. sourcing needs are met so that the project can run effectively. They need to be able to work Specific Skills: under-pressure, for example recruiting a large amount of staff in a short amount of time to cope with an increase in activities during an emergency. MSF HR coordinators must be able to manage an ever-changing portfolio of staff and must be able to effectively manage change.

• Good time management combined with strong organisational and multitasking skills

• Excellent interpersonal and communication skills, with a passion for building and maintaining good relationships with people from diverse HR coordinators must ensure a safe and fair backgrounds workplace, ensuring excellent employee conditions. They must be able to manage, train and • Ability to demonstrate creative solutions to supervise recruited HR staff. Management of problems and effectively manage change international staff may include organising their arrival and departure, including negotiating their visa with the countries authorities. Management of local staff may include organising annual leave and wages. HR coordinators have a role in championing staff’s professional development, for example by helping them work towards their career goals by organising opportunities for them to accrue skills.

• Experience in reviewing and creating new HR policies and an understanding of the national and local labour laws • Understanding of workplace rights, ethics and what a fair work environment is • Accountability of all HR administration and legal issues within the mission

Conflict management skills are important, HR coordinators must work alongside the senior man- Essentials: agement team to provide advice on a variety of HR issues, including disciplinary and employment • Educated to degree level and CIPD qualified (or

Non-medical roles

What is CIPD?: see here equivalent). • Significant experience in a generalist HR role

PAKISTAN: THE TRUE SPIRIT OF MSF: see here “THE ENDURING HUMAN SPIRIT”: MY VISIT TO A ROHINGYA REFUGEE CAMP: see here HELLO IRAQ: see here

• Demonstrable experience in conflict manageBooks: ment Magone C, Neuman M, Weissman F, editors. Hu• Experience in training, coaching, mentoring and manitarian negotiations revealed: the MSF expesupervising a team rience. Oxford University Press; 2012 Feb 28. • Available for a minimum of 9 to 12 months

Articles:

• Minimum 3 months’ work, volunteering or travelVan Gelder P, van den Berkhof R. Psychosocial care ling experience in developing countries for humanitarian aid workers: The Médecins Sans Frontières Holland experience. InSharing the Front Assets: Line and the Back Hills 2018 Oct 26 (pp. 179-185). Routledge: see here • Previous experience with MSF or other international NGOs Rosewell A, Bieb S, Clark G, Miller G, MacIntyre R, Zwi A. Human resources for health: lessons • Significant experience within a multicultural from the cholera outbreak in Papua New Guinea. context and multidisciplinary teams Western Pacific surveillance and response journal: WPSAR. 2013 Jul;4(3):9: see here Learn more: Youtube: Are you MSF? | Anna - HR Coordinator: see here HUMANITARIAN SNAPSHOT | Human Resources Coordinator - Sierra Leone: see here Blogs: PAKISTAN: UNSEEN BAJAUR AND ME: see here “JUST HUMAN BEINGS” - JOINING THE TEAM IN PAKISTAN: see here

Check out Cara’s interview on working overseas on page 118.

Non-medical roles

Humanitarian Affairs Officer Role Names:

population. They must review and implement new data collection systems to ensure up-to-date information on populations.

HAO, humanitarian affairs advisor, advocacy advisor Humanitarian affairs officers must establish partnerships with organisations, agencies and officials. They must serve as a liaison between local authorRole Description: ities, UN agencies, and human rights organisations Humanitarian affairs officers most embody the to promote MSF priorities and concerns. HumaniMSF principle of témoignage - to bear witness - by tarian affairs officers also travel around projects to listening to communities affected by disaster. It is lead discussions with MSF staff to raise awareness their role to listen to victims, document their testi- of current humanitarian issues and consolidate monies and advocate for those impacted by con- important MSF principles, humanitarian law and flict by amplifying their voices. Humanitarian affairs medical ethics to ensure all staff are working under officers must identify communities that are exclud- the same principles. ed from medical care, by talking to communities and carrying out surveys. It is their role to ensure MSF maintains access to individuals in need of aid by understanding their needs, concerns and the barriers they face accessing healthcare. Humanitarian affairs officers are key spokespersons for MSF and its founding principles within the project populations. They must build good relationships with communities to increase MSF’s reach. Development of advocacy strategies, definition of advocacy messages and creation of methods to access communities are key responsibilities. Excellent accurate written communication is key for instance to prepare letters and proposition papers for internal and external use. Issues of note may include security protection issues or quality of medical assistance.

Specific Skills: • Excellent interpersonal and communications skills. Ability to develop and maintain honest communication with the community, local authorities and international stakeholders • A passion for advocacy, lobbying and championing the testimonies of others • Ability to maintain a neutral and impartial approach to témoignage • Excellent research and analytical skills to ensure accurate data collection and surveying

• Excellent written communication skills to aid reHumanitarian affairs officers make numerous rec- porting on humanitarian affair topics and developommendations and proposals for emergency ment of project advocacy strategies interventions. To decide this they must perform targeted research and data analysis to report on • An understanding of the importance of unbiased the local climate to inform operational planning. reporting and remaining impartial when voicing a Running surveys is also important to monitor the variety of issues effectiveness of MSF activities within a specific

Non-medical roles

• A thorough understanding of MSF principles, hu- Learn more: manitarian principles and medical ethics Youtube: • An understanding of current humanitarian debates and of the dilemma/compromise nature of Three Questions with Alex Dunne, Human Affairs modern humanitarian interventions Officer in Yemen: see here Essentials:

Blog:

• Academic background to Master level in one of REACHING THOUSANDS WITH A CLICK: HOW the following fields: anthropology/social/political THE ROHINGYA HELPED GUIDE COVID-19 sciences, law, gender studies, protection AWARENESS: see here • Training in writing and research in the field of “WE SEE A LOT OF SUFFERING”: THE AFTERhumanitarian affairs MATH OF SOMALIA’S DEVASTATING FLOODS: see here • 1 year of experience working in a low- to middle income countries I HELPED TO RESCUE PEOPLE FROM THE MEDITERRANEAN. THIS IS WHAT THEY TOLD ME: see • Experience in humanitarian advocacy here • Available for a minimum of 9 to 12 months Assets: • Previous activism or lobbying experience • Experience in targeted research and data analysis • Further experience in humanitarian affairs and emergency relief management, for example a Humanitarian Affair Officer position with OCHA (United National Office for the Coordination of Humanitarian Affairs): see here Further qualifications such as BOND’s online course in ‘Developing an advocacy strategy’: see here

Non-medical roles

Logistician MSF Website link to jobs role: All Round Logistician: see here Supply Logistician: see here Technical Logistician: see here Role Description: Humanitarian logistics is critical to delivering disaster relief. Humanitarian logistics is key to mitigating the negative impact of natural disasters in terms of loss of life and economic costs. Humanitarian logistics plan, deliver and reflect on all aspects of disaster relief: the effectiveness of suppliers and transportation providers, the cost and timeliness of response, the appropriateness of donated goods and the management of information. Thus, this role is critical to the performance of both current and future operations and programs. There are three different types of logistician that MSF recruit: All-round logistician Technical logistician Supply logistician All-round logistician All-round logisticians are known as the jack of all trades. Needless to say, logisticians tend to be the person that all departments refer to when they have queries, questions and needs. They come from a variety of backgrounds, whether it be construction management of a hospital, project management of a local NGO or managing the supply chain of a supermarket.

ments, they provide all teams with the support they need to ensure the project runs smoothly. Their role and responsibilities are project dependent but may include: • Managing radio operators to ensure communication is maintained within and between sites • Supervising drivers, repairing transport vehicles and maintaining aeroplane runways • Managing warehouses, bunkers and accomodation • Overseeing security, ensuring that the precautionary measures are adequate, efficient and keeping staff and patients safe • Construction and maintenance of facilities, this might include providing new beds or building temporary facilities for hospitals • Supply management, ensuring all departments have the resources they need, for example, managing the cold-chain process to ensure a sufficient supply of patient medication • Ensuring patients have clean drinking water and that waste is being managed and treated appropriately to support hygiene promotion • Managing food supplies and supporting kitchen staff who provide food for the patients and staff Conduct or play a supportive role in exploration missions

The role of an all-round logistician is diverse and they must work with flexibility to fit the needs of departments and patients. They must also overAll-round logisticians are a life-line for all depart- come the challenges that the context they work

Non-medical roles

in presents them. For example, working with the country’s climate might involve ensuring that the project has enough supplies for 6 months during the rainy seasons, when transport is made difficult by the weather. On the other hand, some projects might battle extreme heat which can interfere with the cold-chain process and damage pharmaceuticals. In this case the logistician may work to insulate the pharmacy to maintain a temperature that is safe for the pharmaceuticals. Technical logistician Technical logisticians are logisticians that specialise in electrics, mechanics and plumbing. In maintaining the supply chain and transport of supplies their role may focus on the maintenance of vehicles and supervising drivers. In a hospital or clinic a technical logistician takes responsibility for ensuring that the project and/or hospital has a reliable power supply - this may be through the maintenance of generators or through other energy sources such as solar power. A technical logisitican’s plumbing expertise may also be used to support WATSANs role in providing safe drinking water and ensuring safe disposal of waste.

also work with their team to modify supply strategies to avoid these challenges in the future. Supply logisticians must also communicate with the nearest supply centre, which may be in the country or in a neighboroughing country, to acquire supplies and organise transportation for them. Due to the remoteness of projects, the transport of supplies may be in any form, from a boat to a car, to a plane or truck. Supply logisticians must be able to forecast the supply needs of a project. They must communicate with medical, domestic and construction teams to plan in advance what supplies they may need and when, to avoid supply shortages. Forecasting of supplies helps the project ensure it has everything it would need in an emergency. Supply logisticians must also have excellent communication skills to negotiate with their suppliers and interact with local authorities to ensure MSF is working in accordance with local protocol. Construction logisticians

At times MSF recruits specifically for construction logisticians - usually when a new project is being started or an old one rehabilitated or expanded. Construction logisticians may design the structure Supply logistician and will have to prepare all resources required (i.e. labour, budget, materials) as well as supervising A supply logistician is the backbone of many the progress of construction work. projects. They focus on acquiring services and goods, to ensure the project has the supplies it Specific Skills: needs and would not be able to function without. Their role, like any in MSF, includes managing • Logistical skills, including, legal, facility manageexpected and unexpected activities. This means ment, transportation management, inventory manthey need to be able to anticipate challenges and agement, warehousing, forecasting, purchasing use their problem-solving skills to provide creative solutions to overcome them. For example, and procurement if a truck carrying important supplies gets stuck, then it is the supply logisticians responsibility to • General management skills, including in project, have a plan B for acquiring the goods. They must change, supplier, risk, finance, human resource

Non-medical roles

and security management • Minimum of 3 months’ work, volunteering or • Excellent communication skills that support ne- travel experience in low-income countries gotiation, liaison with other organisations, lead- Assets ership, and customer relationship and people management • Experience of overseas building projects • Experience negotiation with local authorities • Proficient problem-solving skills including prob- • Experience with cold chain maintenance and lem identification, analysis and management procedures • Organisation, planning and forecasting skills to Learn more: support a project’s emergency preparedness Youtube: • Ability to design and implement logistics policies to ensure safe and fair working conditions Working in supply chain at MSF: see here • Training and supervising staff to build their capacity Are you MSF? | Daniel - All-round Logistician: see here Essentials Are you MSF? | Anup - Supply Logistician: see here The essential requirements differ for each role and can be found on the MSF website. However HUMANITARIAN SNAPSHOT | Logistician in South a general overview of the requirements include: Sudan: see here • Experience in some of the following: logistics, The Logistics of Disaster Response: see here HR, construction, sanitation, IT and finance TEDxNOLA - Lynn Fritz - Humanitarian Logistics: • Experience in maintenance of equipment includ- see here ing transport, energy and communications equipment (e.g. HF, VHF, V-SAT and satellite-phones) Articles: • Experience in supervising and training staff in- Human Logistics: Enabling Disaster Response: see volved in maintenance, construction and renovation here • Experience in management of contracts and dai- Websites: ly labourers Humanitarian Logistics Association: see here • Experience in supply chain management and supply storage skills (e.g. warehouse management skills)

Non-medical roles

Project Coordinator

Non-medical roles

nancial administration is essential to an effectively functioning project.

Role Names:

Project coordinators must have an up to date understanding of the ever-changing international Field coordinator and local humanitarian climates. Understanding current debates and crises will aid analysis of how Role Description: MSF can operate in the area. Gaining this knowlMSF project coordinators are the glue between edge includes working with the locals to underall departments. It is their role to oversee project stand their interpretation of current events and operations as well as coordinating the medical, following national and international news. logistical, financial and human resource teams. Working as a liaison and arbitrator to ensure co- Project coordinators are a spokesperson for MSF, herence between the different departments is a they must represent the organisation on project key responsibility. The project coordinator must issues towards the local communities, authorities, also ensure all teams have the resources they UN agencies and other NGOs. Therefore project coordinators must have excellent interpersonneed to function effectively. al skills to develop and maintain good relationConducting exploration missions is an important ships with a variety of individuals and stakeholdresponsibility, to identify those most in need of ers. They are responsible for championing MSF’s medical aid and ensuring MSF are distributing identity within the project, ensuring that project their services appropriately. It is the role of MSF decisions and actions are consistent with MSF’s project coordinators to then plan the project, de- principles. fine its objectives and oversee its activities. They must ensure that the projects are meeting the Specific Skills: needs of the people. To confirm this, they must support the team in analysis of medical data, im- • Excellent negotiation, diplomacy and conflict pact of MSF’s activities and the quality of care be- management skills ing provided. • Excellent problem-solving skills and a hands-on approach As projects often take place in unstable environments managing security measures to ensure safe • Excellent organisational skills and the ability to working conditions is essential. Reviewing and multitask in high-pressure environments updating policies such as the team health policy is important to ensure consistency, accountability • Strong people management and communicaand provide clarity on best working practices. As tion skills to support the management of a diwell as preparing monthly reports, project pro- verse multidisciplinary team. posals and evaluations is important to improve future decision-making . Overseeing the HR man- • Excellent leadership skills and the ability to inagement of the multidisciplinary team and the fi- spire commitment and excellence from all project members.

Non-medical roles

• Deep understanding of humanitarian principles

Youtube:

Essentials:

Are You MSF? | Kate - Project Coordinator: see here

• Significant professional experience in a project Role of an MSF Project Coordinator: see here management capacity, international and/or healthHUMANITARIAN SNAPSHOT | Project Coordinacare/medical management preferred tor in Lebanon: see here • Significant professional experience in a low-reMSF On the Road with project coordinator, Magsource or emergency setting gie Wideau (2018): see here • Proven ability in being responsible for delegatOonagh Curry - MSF Project Coordinator, Sudan: ed security management is essential see here • Extensive experience (professional or travel) outside of your home country Blog: • Demonstrable experience in supervising, man- PAKISTAN: “EVERY END IS A NEW BEGINaging, coaching and training others NING”: see here • Proven affinity with humanitarian and medical SOUTH SUDAN: CHALLENGING TIMES IN OLD issues in complex crisis situations FANGAK: see here • Available for a minimum of 9 to 12 months Assets:

“WE’RE BEING ATTACKED IN THE EBOLA TREATMENT CENTRE”: REFLECTIONS AFTER THE FIRE: see here

• Extensive travelling experience in remote and “WE NEED YOU TO GO THERE STRAIGHT AWAY” : LIFE IN THE EMERGENCY UNIT IN low-resource settings DRC: see here • Additional experience working in a different capacity e.g. logistician for MSF or other interna- A WEEKEND IN THE LIFE OF A FIELD WORKER: see here tional NGO • Higher education e.g. a Masters in Conflict Res- Podcast: olution, Crisis and Disaster Management, Public Health for Development Everyday Emergency. S2 E7: From Conflict Zones to Curtain Shops: see here • Further qualifications - look out for online courses such as BOND’s Project Management (Project DPro Foundation) Certification: see here Learn more:

Non-medical roles

Water and sanitation specialist

posal WATSANs are in charge of siting, constructing and managing latrines and other sanitation facilities. Vector control is key in infection control Role Names: practices. Vectors are agents that spread disease pathogens such as mosquitoes, mice and flies, WATSAN, W&S for example removing stagnant water that home mosquitos. To support their work WATSANs must Role Description: supervise, train and manage a team of waste zone MSF water and sanitation specialists are respon- operators, hygiene promoters and WATSAN assible for sourcing and distributing an accessible sistants, with a focus on developing organisationsupply of clean drinking water to civilians and al capacity. hospital facilities in disaster-stricken countries. Clean water supply is a primary need that people Specific Skills: cannot survive for more than three days without. Access to water can prevent diseases and take • Practical and problem-solving skills, making comthe burden off other MSF facilities, for example plex solutions a reality to ensure clean water supply by reducing the numbers of acutely dehydrated to communities and hospital facilities in need patients. Without clean water, diseases spread rapidly, for example diarrhea, which is a particular mortality risk for children under 5. Ensuring water is chlorinated is an important part of preventing the spread of cholera. WATSANs have an educational role in health promotion amongst these communities, to promote good hygiene practices, for example by teaching communities how to add chlorine to their water to prevent water contamination. WATSAN responsibilities include working alongside epidemiological findings to identify communities most at risk of being affected by a disease outbreak, studying their water and sanitation sources, then designing and implementing sources of clean water supply to prevent further outbreaks. Sanitation responsibilities include supporting infection control, for example, in the outbreak of Ebola, decontaminating quarantined homes. This includes managing disposal or different types of waste: used water waste, human waste and medical waste. As regards waste diS-

• Ability to source and manage materials and supplies, in order to ensure the appropriate resources to facilitate WATSAN projects • Future project preparation planning to ensure outbreak preparedness to support future responses and build national sanitation capacity • Monitoring of water quality at water points in high risk areas for outbreak • Organisational and accurate record keeping skills, to ensure accurate accounts of WATSAN projects and supplies • Knowledge of basic hygiene and health promotion practices, to ensure improved and sustainable community sanitation Essentials: • Degree in Civil Engineering, Water and Sanitation, Land and Water Management or similar

Non-medical roles

• Significant work experience in water and sanita- TOOLKIT TO FIGHT CHOLERA AND TYPHOID tion FEVER; see here • Minimum of 3 months’ work, volunteering or Water and sanitation essential in MSF response to travel experience in developing countries Myanmar cyclone; see here • Availability for a minimum of 9 months

Water: source of health and dignity; see here

Assets:

“TIME IS OF THE ESSENCE”: PREPARING FOR COVID-19 IN A REFUGEE CAMP; see here

• An international degree in Civil Engineering, Water and Sanitation, Land and Water Manage- WATER IN NIGERIA: DIARY OF A ‘FLYING’ ment or similar WATSAN; see here • Further higher education in water and sanitation Articles , for example, Cranfield Universities’ Masters in Water and Sanitation for Development. Chowdhury MA, Hasan GM, Karim MA. A study on existing WATSAN condition of two tea gar• Further qualifications such as RedR’s ‘The Drill- dens in. Journal of Environmental Science and ing Course - Developing Groundwater’: see here Natural Resources. 2011;4(2):13-8: see here Learn more:

Yanore, G. Sustainable rural watsan management in Bolgatanga. 1995: see here

Youtube Njiru, Cyrus; Sansom, Kevin. Managing watsan Are You MSF? | Cokie - Water & Sanitation Expert; services in small towns. Loughborough University. see here Conference contribution. 2002: see here Who We Need: Flying Watsan; see here An introduction to WATSAN; see here ROHINGYA CRISIS | “Providing water for nearly one million people; see here MSF Canada - Watsan Julie; see here Blogs A

WATER,

SANITATION,

AND

HYGIENE

Lange, R. D. et al. Research protocol - Addressing water and sanitation needs of displaced women in emergencies. Semantic Scholar. 2013: see here

Non-medical roles

©MSF

The spirit of MSF

Building your portfoliobroad skills & essential knowledge

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Broad skills

Introduction to Broad Skills So, what are MSF looking for from future applicants? There are certain skills, experiences and knowledge that you may target in your professional development to make you shine amongst

Varied experience in your field is essential to develop your competency, confidence and acumen in your area of expertise. For example, MSF recommends medical staff gain a variety of experience in different specialisms to supplement a the international market of applications. wide knowledge base so that they can adapt to the needs of the population and role. Time and In this section we have focused on the skills that experience are inextricably linked. Be patient, we believe all candidates need to gain experithere is no fast-track. You do not want to be unence in as they begin their journey to working prepared. for an NGO. In addition to this list of key skills, professional autonomy and independence are Whilst working towards professional autonomy paramount. These are important skills as MSF aid and independence throughout your studies and workers are often the most experienced profescareer, there are some further key skills that we sionals within their area of the project, therefore view to be important to build on. The following it falls to them to execute difficult decisions withsection is a guide to what skills are important to out senior assistance. Though MSF has channels a humanitarian aid worker, why and how to gain of support that allow workers to seek additional them. advice, expertise and guidance, these are not available 24/7. Unlike in other working environments, additional assistance is time and location dependent, for example it might not be easily accessible when working in remote locations. Therefore workers must be confident in their role, competencies and ability to solve problems to continue to provide high-quality care in the most austere of environments. Some roles require a certain level of training or specific number of years of experience e.g. medical doctors must have completed ST2 level. However there is no standard measure or qualification for autonomy. Therefore it is up to an individual’s judgement to assess and decide when they are ready to apply. MSF’s focus is to help others, therefore it is paramount this decision is made when applicants feel they are able to competently carry out their role and not according to their own plans for professional development and/or challenge.

Broad skills

How to navigate this section? Pick a skill that you feel you need to improve. First gain understanding on what this skill involves before following our advice on how to gain experience in this competency. Each section holds a variety of useful resources - check them out. Broad skills: Adaptability ←

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Communication (verbal and written)

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Cultural Sensitivity

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Language skills

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Leadership

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Management

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Mentorship

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Resilience

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Teamwork

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Broad skills

©Aahana Dhar/MSF

Broad skills

Adaptability Skill names: Flexibility, versatility, malleability, plasticity, adjust-ability, agility What is it? “An ability or willingness to change in order to suit different conditions” - Cambridge Dictionary Why is it important? Adaptability is an important skill in humanitarian aid organisations as their work by its very nature involves change and uncertainty on a daily basis. MSF workers must be able to adapt their professional capabilities to fit in low-resource and emergency settings, whilst ensuring care is still carried out according to the population’s priorities and goals. The requirements of the appointment may include carrying out diverse tasks and roles that fall out of an individual’s usual scope of practice. This can be either due to the lack of resources, personnel or the fast moving nature of the project. The ability for a humanitarian aid worker to be adaptable is key to both the health of the aid worker and the delivery of the project.

overall vision. Adaptive individuals are aware of changes to their circumstances and can respond positively to changing ideas, strategies, evidence and responsibilities. Forward-thinkers with creative problem-solving skills should work well to adapt to challenges and continue to thrive during times of unpredictability. They provide a willingness to change and demonstrate intellectual flexibility, approaching change with an open mind. Aid workers must be able to adapt to the constraints of their circumstances, to look for and grasp opportunities within their environment. They are able to show leadership and see the potential for greatness in unstable times. Self-reflection supports self-awareness and an open mindset enables them to see opportunities in different methods and options. Adaptive individuals must be curious, able to learn and educate themselves as to the best research.

Aid organisations often talk about ‘disaster preparedness’ of which adaptability is an important part. Managers must be prepared for changes in the mode of aid delivery, changes to resources whether human or financial and must be prepared to lead alterations in response planning. To support this, managers must incorporate flexibility into their plans, for example in a communications strategy or financial budget, to adapt alongside Working in austere environments is likely to in- the changing needs of populations. volve the loss of home comforts, sharing accommodation and adapting to a new culture. For all Experiences to Acquire: of these reasons Individuals must be able to accommodate the realities of humanitarian work. • Travel and push yourself outside of your comHumanitarians must also consider their ability to fort zone to become adaptable to new cultures, re-adapt to their usual life once they finish their environments and situations mission. The process of repatriation or ‘reverse culture shock’ can sometimes be harder than the • Develop self-awareness through self-reflection first adaption process. • Gain experience in work environments that are Working flexibly is key for humanitarian aid to unpredictable and ever-changing, where you meet the needs of the people. Aid workers must have to think on your feet and provide solutions be able to implement rapid changes without sac- to problems to continue working effectively rificing momentum and whilst maintaining the

Broad skills

©Andrew Quilty

Broad skills

Communication Skills Skill names: Interpersonal skills, Social skills What is it? Communication is “the imparting or exchanging of information by speaking, writing, or using some other medium” or “means of sending or receiving information, such as phone lines or computers” - Simpson and Weiner, 1989, The Oxford English Dictionary Why is it important? Communication is the backbone of MSF projects and is a skill that all disciplines need to master. Good communication skills are useful when representing MSF, collecting testimonies, in conflict resolution, negotiating with key stakeholders, leading a team and producing communications content. Peller et al (2013) recommend that finding common ground and connection with the community should be the first step when working in austere environments, good communication can help develop and foster relationships.

events such as misdiagnosis, medication errors and delayed treatment - putting patients’ safety at risk (Foronda et al, 2016). The significance of this skill is summarised by Foronda et al (2016) who conclude “improving the effectiveness of communication in healthcare is a global priority”. Improving communication skills: Working on self-awareness Individual self-awareness supports good communication as it allows the recognition of both poor and positive behaviours and it opens up the opportunity for improvement via action. Self-awareness also supports team consciousness which can be used to assess the prevalence, pattern, context and impact of individual behaviours on the team. Understanding communication and gaining confidence with what communication is. Albert Mehrabian, a professor of psychology, identified three core elements in communication - creating the 7/38/55% rule. This model breaks down communication into: 7% spoken word; 38% tone of voice; and 55% body language. This identifies non-verbal communication as more important than verbal communication. Which is supported by Maya Angelou, an American writer, poet, director, playwright and civil rights activist, who famously said “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel”. Therefore prioritising non-verbal communication is key, for example by maintaining eye contact, a calm tone of voice and open body language.

Effective communication supports good teamwork, leadership, mentoring, adaptability, resilience, cultural sensitivity and language skills. Good communication skills lead to positive outcomes such as enhanced employee morale, improved information flow, more effective interventions, improved patient safety, satisfaction and decreased length of stay (O’Daniel, 2008). Developing listening skills - communication starts with listening. Active listening makes people feel Miscommunication can lead to the loss of critical more understood in interactions and is key in iniinformation or the misinterpretation of informa- tial interactions (Weger et al, 2014). Active listention, which can jeopardize the smooth running of ing includes expressing interest in the speaker’s a project, for example by interrupting the supply message, asking questions, offering unconditionchain leaving MSF without key resources. Inef- al acceptance, offering unbiased reflection to fective communication can also lead to adverse confirm understanding and build empathy.

Broad skills

Encouraging group interaction both formal and informal. Group interaction supports open dialogue and interdisciplinary collaboration. An example of formal group interaction is the implementation of preoperative and postoperative team meetings. These reflective meetings open up the opportunity to identify things that went well and those that did not through collective idea-sharing and communication.

endorsed by US Forest Service firefighters. • Further communication strategies and tools can be found in the TeamSTEPPS pocket guide: see here

Creating a specialist task force that discusses communication problem areas. For example, by appointing a Communication Champion who can promote effective communication skills and hold interventions when there is a breakdown in communication. They can also assess the prevalence, pattern, context and impact of harmful individual behaviours on the team. They can also promote cultural humility and stress the value of diversity, which are key to lifting barriers in communication (Foronda et al, 2016).

Culturally sensitive communication - knowledge of the diversity in cross-cultural communication and the ability to adapt communication to appropriately fit within the host’s culture. Some differences in communication between cultures include (Gerritsen, 1998):

Implementing behaviour policies and procedures to support project-wide effective communication and build individuals’ understanding of the professional standards expected by the organisation. This also means when miscommunication does occur, there are clear procedures to follow to help address the issue and therefore prevent any more serious consequences. Implementing standardised communication tools to help professionals structure critical conversations and support effective exchange of information. These tools should be easy-to-remember and should set expectations between members of the team for what will be communicated and how: • SBAR (Situation, Background, Assessment, Recommendation) Tool developed by the US military in Kaiser Permanente, Colorado in, 2002. • STICC (Situation Task Intent Concern Calibrate)

Using interprofessional simulations to improve teams communication skills, which Foronda et al (2016) found have high levels of participant satisfaction.

• A focus on detail or on intention • A direct or indirect communication style • A reliance on verbal, non-verbal communication or written word • Binding agreements are based on written word (contracts) or on personal promises • Differing views on silence: a respected and communicative view or a view of silence that is non-communicative and produces anxiety • Differing non-verbal communication. For example, in northern Europe it is impolite not to look at people, whereas in China and India it is impolite to look at people. Furthermore, to beckon people, in West and Northern Europe it is the palm of the hand upwards, whereas the palm of the hand is used downwards in southern Europe.

Broad skills

Improving communication across language barriers and using an interpreter effectively. Ali and Watson (2017) found that using an interpreter increases risk of communication errors and makes establishing rapport more difficult. By using an interpreter in medical environments there is an impact on confidentiality and can make patients feel uncomfortable when dealing with private issues. This can be avoided if MSF professionals have fluency in the host’s language. However, understanding this is not always possible, Felberg and Skaaden (2012) found that medical professionals often rely on ad-hoc solutions such as translating using a friend or relative, for example in cultures where using a male for a female’s care interpreter would be seen as inappropriate. Nonetheless it is important that translators act impartially to allow accurate exchange of information and that there is a trust between the interpreter and professionals, in order for professional integrity to be maintained during translation. Juckett and Unger (2014) highlight the importance of using a trained interpreter that meets an organisation’s requirements. Ineffective translation can lead to wrong diagnosis or treatment of a patient, or the wrong medicine being ordered - all of these with catastrophic events.

• When using a trained interpreter Junket and Unger (2014) recommend sentence-by-sentence interpretation and prioritising key points to avoid error. The clinician should address the patient directly in the first person, which can be supported by the interpreter sitting next to or slightly behind the patient. Avoiding jargon or humour is also key to avoiding cross-cultural miscommunication. A post-translation reflection with the interpreter can also be used to gain further details and identify areas for improvement.

• Felberg and Skaaden (2012) also bring attention to the nodding problem - where nodding is accepted as confirmation of understanding. However, they show that nodding is used as a coping mechanism for people with insufficient understanding in complex situations. Therefore ascertaining, confirming and clarifying understanding is important when communicating across a language barrier. This can be facilitated with the ‘show me or teach me back’ method, to ensure patient comprehension.

• Intraprofessional and interprofessional rivalries

Barriers to communication as defined by O’Daniel (2008): • Personality differences and differing personal expectations • Culture, generational and gender differences • Differences in language • Hierarchy • Use of jargon

• Fears of diluted professional identity • Differences in professional schedules • Varying levels of preparation, qualification or skill. • Disruptive behaviour • Emphasis on rapid decision making

Broad skills

Experiences to Acquire: • Developing self-awareness through reflection Understand the 4 types of communication and work towards improving them: verbal, nonverbal, visual and written. See here • Improve your listening skills by learning active listening • Asking others for honest feedback, to help identify the areas you can improve. • Participating in communication workshops and interdisciplinary simulations e.g. MDT training Test your interpersonal communications skills: see here Understanding your communication style: see here Online courses: Communication and Interpersonal Skills online course by the University of Leeds. See here University of Cambridge Communicating for Influence and Impact: see here

Broad skills

Written Skills Skill names: Written correspondence, written exchange What is it? Written communication is the process of conveying a message through the written word. This may be in an email, letter, proposal, fax, contract, reports, job descriptions, news releases and lab reports and patient documentation. Written communication can be in the form of pen and paper, or by electronic means. Improving written communication: Due to its permanence, written communication should aim to be accurate, clear and concise. Its accuracy is important for legal and ethical reasons, for example, when documenting a patient’s consent before a procedure. Clear written communication is also important to avoid misinterpretation of documentary evidence. Written communication is a useful way to define goals, report problems and outline solutions and strategies. It is an important way to document project actions and provide evidence for affairs to managing bodies. MSF professionals must have excellent written communication for creating new policies, reporting on project activities, analysing epidemiology data or creating proposals for new projects. Excellent IT skills are important to facilitate written communication. Proficiency with usage of programmes such as Microsoft Word, Excel and Powerpoint are key. Improving written communication: In order to increase written communication skills practise and use some of these techniques: • Think and plan before you start writing

• Start writing to practise your skill e.g. daily journalling • Read your writing out loud during the proofreading process - this can help improve the flow of your writing and identify missed mistakes • Leave a pause before editing your first draft which can help you see your writing through new eyes • Avoid jargon and excessive wording • Read! This will help you write more concisely, improve your vocabulary, grammar and spelling. Reading will also help you structure sentences and write more creatively

Broad skills

Cultural Sensitivity

awareness. For example after the 2004 tsunami there were reports that the aid was politically driven without consideration for the donor countries Skill names: needs. This can create hostility towards humaniCross-cultural sensitivity, cultural awareness, cul- tarian aid organisations. turally conscious To combat this, cultural awareness needs to beWhat is it? come systematically embedded in humanitarian organisations, who should tailor their aid inCultural sensitivity is the ability to be aware of, terventions to the needs of the local culture to understand and respect other cultures and oth- ensure appropriate humanitarian assistance. ers’ cultural identities. This requires organisations to undertake ‘needs assessments’. However academics such as Joke Why is it important? Madut Jok argue these assessments are largely outdated and based on misunderstandings of the Culture can be defined in many ways, Ismail culture of war-affected communities highlight(2021) offers this interpretation of culture, a “sys- ing the need for further research. Organisations tem of meaning, norms of behaviors, and power must therefore incorporate cultural relativism to relations”. Culture can be demonstrated with the their assessments - the concept that cultures have classic iceberg model, where only the tip of an vastly differing needs, priorities and particularities iceberg (culture) is visible above the waterline. that they consider important (Tošovská, 2021). Only the visible part of culture, such as behaviours For example, humanitarian organisations mainand some beliefs, can be taught. The rest is learnt ly focus on the alleviation of suffering and prointrinsically and includes values and thoughts that viding populations with basic needs for survival. can only be taught through active participation However the affected population might consider in the culture. Humanitarian aid workers must un- rebuilding a house of worship as their most imderstand the complexities of culture. portant priority. Communication with local NGOs and humanitarian organisations has great value in In 2015 the UN General Assembly made a pledge aiding understanding of the local context and creto focus on cultural awareness and sensitivity: ating a culturally appropriate strategy. Approaching the local community through their culture, for “We pledge to foster intercultural understand- example through music or theatre performance, ing, tolerance, mutual respect and an ethic of is also an effective way of collaborating with comglobal citizenship and shared responsibility. We munities. acknowledge the natural and cultural diversity of the world and recognize that all cultures and civili- MSF employees are a mix of international and zations can contribute to, and are crucial enablers national staff, this increases the need for cultural of, sustainable development.” sensitivity between co-workers to support a reThis pledge is something that humanitarian organisations might seek to include in their agendas moving forward, as cultural appropriateness is paramount to a project’s effectiveness and success. Humanitarian organisations’ have been criticised in the past for having a lack of cultural

spectful work environment. The diversity of professionals also fosters opportunities for the widening cultural understanding through the sharing of perspectives. Though MSF will provide specific training to improve cultural awareness before embarking on a humanitarian mission, aid work-

Broad skills

ers should seek to educate themselves with basic information about their host country. With this information they should be able to adapt their behaviours, practices and approaches to build a relationship with the local population and meet their needs. Transparency of communication is a key tool to build rapport, for example, offering the opportunity for locals to give advice on how you might improve your understanding of their culture. Also maintaining accountability and acknowledging when you get things wrong is key to gain respect and avoid the possibility of further offense. Aid workers must also promote and champion cultural sensitivity in the workplace, for example by speaking up about violations to ensure proper staff conduct.

Experiences to acquire: • Use your communication skills to talk to people from different cultures to your own and identify your differences in values, beliefs and practices • Always inquire sensitively and do not be defensive if you are corrected • Pay attention to detail for differences between cultures when travelling, working and living in different environments • Educate yourself on a culture’s customs, for example, on the history of different cultures and their traditional celebrations and holidays

Culturally sensitive individuals reject assumptions. • Challenge your own assumptions about a culIsmail (2021) recommends rejecting the prob- ture, remain non-judgemental and keep an open lematic assumption that everyone in the project mind community will want aid and the outdated belief that externally organised intervention can solve all issues. In Reis and Bernath’s (2016) study one participant argued “compassion, common sense, respect and tolerance are, most of the time, more important than a Master’s degree”. Culturally sensitive competencies also inform effective communication. This awareness includes understanding how culture informs body language, speech patterns and customs. This understanding allows individuals to better work alongside national coworkers, affiliates and beneficiaries. For example in western culture a handshake is acceptable and sometimes expected. However in Thailand, it is not, instead a wai is offered, a bow with the hands palm to palm at chest level and you should return it (Sieck, 2021). Furthermore, Sieck (2021) found those who are more culturally competent are usually better negotiators, which is important for conflict resolution and for example when negotiating with local contractors.

Broad skills

Language Skills Skill names:

plicant. It also allows aid workers to learn more about the local culture, interact and build rapport with natives more intimately.

4. Reading Documents - a slightly less flashy reason, but knowing another language allows Why is it important? workers to read local documentation. Most MSF languages are in English and/or French, therefore Humanitarian organisations work in many coun- the ability to read these can help individuals carry tries around the world - MSF currently has mis- out their job more smoothly. sions in more than 70 countries. So it is no surprise that being able to speak the language of What level of language skills are required? the country where the mission is sited is an incredibly important skill. The level that you will be required to speak and Language skills, foreign language skills

Why learn a new language? Although learning a new language is a large time commitment, it is absolutely worth the effort, here we have outlined some of the reasons why:

which language will depend on your role and the country you will be working in. In all cases the more fluent you are the better. Familiarity with the local colloquialisms, dialects, or accents all play a significant role in human rights work and will help you form stronger bonds with the locals. Some MSF job descriptions outline what level of language skill is required for example a minimum C1 level in French. Such language needs can differ over time as the needs of missions change.

1. Employability - unsurprisingly knowing another language is something that makes an applicant’s CV shine. Not only does it show determination to learn, but it increases your value to the team on the ground. The Common European Framework of Reference for Languages (CEFR) defines six levels of lan2. Networking - speaking another language guage ability: A1, A2, B1, B2, C1 and C2 (with A1 means wider opportunities to communicate and being a basic user to C2 being a proficient user). network with a range of individuals from local For some roles MSF might require you to take a stakeholders to UN advisors. This opens up op- CEFR test to test your language ability. Check out portunities, whether you are looking for career CEFR here: see here development or trying to raise awareness and funds for the humanitarian organisation you are Which language? working for. When trying to choose which language to learn, 3. Communicating with people - making con- there are many different factors to consider: nections with communities that you are serving is incredibly important. Humanitarian aid organ- • How many countries speak that language? isations often work in emergency settings where there is no time to gain a skilled interpreter, mak- • How many speakers are there? ing communication difficult and miscommunication more likely. Therefore negating the need for • How difficult is it to learn? Are there enough a translator by understanding and speaking the resources? host country’s language is a huge asset to any ap-

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• This will of course be different for everyone as the difficulty of a language is measured by how different it is to language/s already spoken and how quickly an individual finds it to pick up a language. Which language am I most interested in? Do I like the sound of the language? Am I interested in the culture?

something you will regret. • Listen to audiobooks, watch films, read magazines and books in the language that you want to speak. • Use language learning mobile applications such as Busuu, Speachling and DuoLingo.

• Learning a new language is a big commitment, • Find someone that wants to speak your lanso being interested in it is key to maintaining it in guage better and you can exchange lessons! the long run. Language learning should be fun, not a chore. • Carry a pocket dictionary or a notebook where you write down useful words and phrases. This It might also be of interest to know that English way - when you have 5 minutes sitting on the bus and French are MSF’s official languages. Howev- or waiting in a queue you can entertain yourself in er, fluency in another language will also enhance a productive way. your application and the possibility of placement. At the time of writing, demand is high for flu- • Practice, practice, practice! It doesn’t matter if ent French and Arabic speakers, but you should you get it wrong check the MSF website for what is in demand at the time. They also say that ‘Applicants who can speak Russian, Spanish, Hindi or Urdu will also be at an advantage’. Also the six official languages of the United Nations are Arabic, Chinese, English, French, Russian and Spanish, where English and French represent the official working languages. Experiences: Decide what language you would like to speak and then set out a SMART goal (see page 126) to help you achieve it. Start by setting out just 5 minutes a day and then build it into your routine, to make it a habit! • Go and work, travel or volunteer in a new country/culture and immerse yourself in a new language - this is undoubtedly the best way to learn. • Seek out language schools and classes in the language that you have chosen to speak in. Or if you are able to get a one-to-one tutor, investing money into your professional development is not

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Leadership: Skill names: Guider, orchestrator, visionary, innovator Why is it?

• Situational leadership is a theory where the leader adjusts their style to fit the development level of the followers they are trying to influence. It is an adaptive style that best fits the goals and circumstances at the time.

• Transactional leadership is a style that motivates Leadership is a dynamic two-way process based followers by employing rewards for success and on a leader-follower relationship - Malakyan punishments for failures. It is a reactive leadership (2014). style that prioritises the efficiency of the organisation and the achievement of its goals. Why is it important? Though leadership and management are intertwined, they are not mutually exclusive. Anyone can be a leader, it has nothing to do with one’s position, pay grade, title or seniority. Neither is a leader defined by their personal attributes, such as being an extrovert. A leader is someone who has followers. There are many leadership theories and styles. In this booklet we highlight a style of leadership transformational leadership - which we feel is particularly suitable for modern leaders both within healthcare and other settings. Finding your style takes time, effort and reflection. However, as you begin your journey into leadership it is worth understanding that a more transformational style will serve you well in your humanitarian aid career. Leadership styles • Transformational leadership is a style in which the leader employs charisma and enthusiasm to transform behaviours and accrue followers through influence rather than authority. They are able to build team spirit, for example by recognizing contributions and sharing success. Transformational leaders are proactive and they are able to challenge the process. They focus on innovation by aspiring to make revolutionary changes.

• Autocratic leadership is a dictatorial style of leadership, they motivate by coercion and direct with commands. There is a downward flow of communication where decision-making concerns only the leader and does not involve others. There is a strong control maintained over the group at all times. • Laissez-faire leadership is a style in which the leader has little or no control over their followers. There is an upward-downward flow of communication that places emphasis on the group and disperses decision-making. Laissez-faire leaders provide little direction and do not criticise their followers. Leaders are innovators, they believe in change and doing the right thing. They are visionaries who imagine a better future and work to make their vision a reality. They understand the importance of honouring the past for both its strengths and flaws when innovating for the future. Leaders are highly committed to and passionate about the cause. They are resilient and use problem-solving skills to overcome barriers to their objectives. Leaders act authentically, therefore it is important they have values that align with the organisation they are working with. Leaders are inspirational, they influence and empower others to work towards a shared vision.

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They inspire curiosity and action in others, they can manage ambiguity and understand when direction is needed. They have clear communication skills and are incredibly articulate, which helps them convey their vision to their followers. Leaders are curious, they collaborate and take inspiration from others to widen their perspectives and have the flexibility to be open to new ideas. They listen to understand their followers’ goals and nurture the growth of the future generation of leaders. Leaders cultivate self-awareness, knowing their strengths and the strengths of their followers. They understand the benefits of mutual mentoring and education to improve a team’s competencies. Emotional intelligence informs their empathy and encouragement for others, enabling them to connect with their followers. Their integrity, honesty and respect for others inspires confidence in others. Maintaining their own humanity, being vulnerable and showing emotion to their followers is important to inspire a supportive team. Experiences to Acquire: • Learn your leadership style: see here • Be a role model, champion change and keep trying new things • When working in a team: encourage creativity, encourage people to make contributions and provide recognition • Observe great leaders and learn from being a follower Read: Start with Why - Simon Sinek. Dare to Lead Brené Brown.

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Learning to Lead: the journey to leading yourself, leading others and leading an organisation by Ron Williams with Karl Weber. The Power of Curiosity: How to Have Real Conversations That Create Collaboration, Innovation and Understanding - Kathy Taberner and Kirsten Taberner Siggins Youtube: Why good leaders make you feel safe | Simon Sinek: see here Great leadership starts with self-leadership | Lars Sudmann: see here

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Management: Skill names: Organisation, Supervision, Administration, Planning

how organisational operations such as supplies and finances are conducted. Experience:

• Learn management skills through self-management. Manage your time, set out goals and seek out opportunities. Self-management can be supA manager is someone responsible for orchestrat- ported by journaling. Check out the Bullet Jouring people and resources to help an organisation nal Method by Ryder Carroll. achieve its goals. What is it?

Why is it important?

• Shadow managers and reflect on what you do like and do not like.

Robert Katz found three basic types of manage- • Complete management training and ensure ment skills. your training is up to date. MSF requires staff to be mission ready, this is vital especially for re• Technical Skills: necessary to achieve goals and sponders to Major Incidents (MIDs). objectives e.g. supply management skills • Attend interdisciplinary workshops and engage • Conceptual skills: the ability to innovate ideas, in team-based activities. Working in a variety of identify issues and problem-solve teams, understanding different roles and how organisations are structured can help build man• Interpersonal skills: working and interacting efagement skills. fectively with people MSF international staff are nearly always in a management role. MSF management roles are broad, complex and include project, change, finance, risk and people management. Managers are required to demonstrate a number of competencies. Though MSF staff must undertake periodic training as warranted by their role, it is expected MSF recruits will be able to demonstrate management skills. Technical skills: Good management is key to ensure smooth running of a project or task throughout its duration. Management is concerned with planning, supervising, ensuring the project has adequate supplies, removing hurdles, distributing money and delegating to team members appropriately to enable stress-free working. These technical skills are supported by a knowledge of

• Attend a management course such as the Management Training Specialists’ Essential Management Skills Course: see here Read: How to win friends and influence people by Dale Carnegie. Managing Humanitarian Relief: an operational guide for NGOs by Eric James.

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rates and learning objectives. Objectives should be mentee-led, a good mentor should let them lead discussions and make decisions. Mentors Skill names: must be able to listen actively, interpret non-verbal Advisor, coach, guide, trainer, educator supervisor, messages and understand the meaning, not just teacher, education facilitator the words. They must be able to offer opportunities for reflection, inspire curiosity and champiWhat is it? on their mentee’s self-awareness. They may offer Mentoring is a relationship between two people constructive feedback and provide new insights, with the goal of professional and personal devel- though remembering it is beneficial for discovery and solution-finding to be mentee-led. All converopment (Young and Wright, 2001). sations must be confidential. Additionally mentors must remain non-judgemental and refrain from Why is it important? showing negative emotions during discussions. A mentor offers support and knowledge to help achieve their mentee’s goal, such as wanting to Mentoring is flexible. It can happen in groups or in advance in a certain skill. This is important to or- individual sessions, it can focus on improving one ganisations such as MSF to facilitate professional skill or it can be broad, focusing on professional development and build capacity of their employ- development. Mentoring is important in MSF to ees by challenging them to improve. They sup- increase the levels of motivation for those involved port their mentee in their learning by empower- and provides employees with clear direction. Mening them to identify their own issues and goals. toring is an important skill, it offers the opportuniInstead of prescribing an antidote to their issues ty to refresh knowledge, competencies and learn or a resolution to their goals, mentors inspire oth- new skills. It also puts emphasis on continuous ers to seek their own solutions. Anyone can be a professional development and self-reflection. It mentor and champion others, they do not neces- improves communication across levels and inspires sarily have all the answers - mentors are a guide. interprofessional collaboration. It can resolve conflicts and professional issues through discussion They need leadership skills in order to motivate to ensure a supportive work environment. Finally and inspire, and communication skills in order to it can be key in identifying those employees with build a relationship of mutual respect and trust. additional support needs. Both parties can gain from a mentoring partnership as there are equal opportunities to learn from One well established and successful coaching new perspectives. It is important for mentors to model is GROW, first published by Sir John Whitunderstand they too are human, it can be bene- more in 1992. This technique is a useful way to ficial to share failures and personal experiences to structure reflection and support action for mentors. inspire honesty and candour in the partnership. • Goal - what is the objective? Mentors use encouragement to build their ment- • Reality - what is the current situation? ees confidence and independence. Mentors must • Options - what choices do they have? have empathy, patience and an understanding • Way forward - what will they do next? that different mentees have different progression

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Learning is a continuous process and best practice is always evolving. A workforce that concentrates on professional development and education creates a highly-skilled staff. This is why e-learning is becoming a focus of organisations education strategies, because it is a mobile, flexible, effective form of education and allows for continual assessment of staff knowledge. Experiences to Acquire: • Be your own mentor, use the GROW model to guide your reflection and goal-setting • Become a mentor, there are always opportunities no matter what stage of life you are in: • Join a volunteer group that needs a youth mentor • Become a peer mentor for your university. • Become a mentor at your organisation, by mentoring new starters and running inductions. Books: Help Them Grow or Watch Them Go: Career Conversations Organizations Need and Employees Want by Beverly Kaye and Julie Winkle Giulioni Helping People Change: Coaching with Compassion for Lifelong Learning and Growth by Richard Boyatzis, Melvin Smith, and Ellen Van Oosten Do It Scared: Finding the Courage to Face Your Fears, Overcome Adversity, and Create a Life You Love by Ruth Soukup Youtube: How to be a Great Mentor | Kenneth Ortiz | TEDxBethanyGlobalUniversity: see here Online course:

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Resilience:

Resilience has a multifaceted nature that is associated with skills, attributes and attitudes (Rose and Palattiyil, 2018). Skills such as critical thinking, probSkill names: lem-solving and planning are integral to adapting Toughness, durability, positive adaption, stress to change positively. Social skills are important to management allow resilient people to develop supportive relationships that can help process change and supWhat is it? port healing. Attributes such as a high self-esteem, Resilience is ‘a dynamic process encompassing a good sense of humour and a clear self-identity positive adaptation within the context of signifi- are also key to managing stress and continuing to work effectively. Attitudes such as optimism and cant adversity’ - Jackson et al (2007). enthusiasm can help individuals cope with challenging experiences by finding a sense of purpose Why is it important? and identifying opportunities for learning. A resilient individual is able to cope well with significant change, adversity, risk or stress. This is impor- Avoiding over-identification with work and being tant when working for organisations such as MSF, able to make reconciliation with decisions and as humanitarian aid workers often work in austere, actions taken in the workplace is essential to restressful and challenging environments. They need silience. Rose and Palattiyil (2018) found that to be able to cope with the psychological and over-empathising in situations of high emotional distress and getting overly involved can cause perphysical challenges of their working context. sonal trauma. Although empathy is undoubtedly Cardozo et al (2012) found that humanitarian aid highly necessary for humanitarian aid workers, esworkers are at increased risk of depression and tablishing empathetic boundaries is important to burnout after returning from deployment. How- allow individuals to adapt and continue to thrive ever those with a strong support network were at work. less likely to suffer burnout and had higher levels of life satisfaction. In a study of humanitarian aid Developing emotional awareness is important durworkers’ mental health, Welton-Mitchell (2013) ing a period of challenge as it helps individuals unreported that 47% of staff had difficulty sleeping derstand what they need to help adapt to change. and 57% reported feeling sadness, unhappiness Understanding, developing and maintaining indior emptiness. Other symptoms of distress after vidual self-care practices can help individuals beexperiencing stressful events included: trouble come more resilient by supporting their general concentrating, feeling guilt for past-events, feeling wellbeing. Remember: if you do not fill your own disconnected from life, fatigue and a loss of pleas- cup up first, you will have nothing to give to others. ure in normal activities. As this demonstrates, humanitarian aid workers are at higher risk of mental health challenges, building resilience is a skill that can help cope with the challenges of humanitarian work. McDonald et al (2015) found that resilience is key to helping employees flourish and improving job satisfaction.

Positive coping strategies such as adequate sleep, yoga, exercise, dancing and reading can be a good way of redirecting energy, calming the sympathetic nervous system and tapping into the parasympathetic nervous system which focuses on rest. Reflection through writing or talking can support the processing of emotion after difficult events and it

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avoids ignoring negative emotions that can in the future threaten to sink individuals if not addressed. Self-awareness practices such as self-motivation, practicing self-affirmations and positive self-talk can also support individuals’ mental wellbeing. Cardozo et al (2012) found those that were able to maintain high levels of motivation for their work were at less risk of burnout. Maintaining a work-life balance by having hobbies outside of work is an important stress management strategy and essential to continuing to thrive at work. Environmental factors such as collegial networks in the workplace and external support from family and friends can help individuals maintain a sense of normality during challenging situations and can help put their experiences in context. Experiences to acquire: Read up about managing stress and building resilience: see here Understanding the self-care practices that work for you, try out yoga, exercise, reading, mindfulness, dancing etc. Find ways to laugh with others and create things to look forward to, such as joining a dance group or art class. Build self-awareness and self-compassion through journalling and talking about your experiences. Books to read: ‘Option B: Facing Adversity, Building Resilience, and Finding Joy,’ by Sheryl Sandberg and Adam Grant ‘Resilient: How to Grow an Unshakable Core of Calm, Strength, and Happiness,’ by Rick Hanson, PhD ‘Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence,’ by Rick Hanson, PhD

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Teamwork: Skill names: Collaboration, multidisciplinary teamwork, interprofessional collaboration, transdisciplinary working, interprofessional working What is it? Peller et al (2013) define teamwork as “an active and ongoing partnership between two or more professionals who work together to solve problems or provide services.” Why is it important?

supporting an honest and positive work culture. It allows clarity of team objectives that fosters understanding and avoids miscommunication that may lead to inefficient action. By creating open lines of communication within a respectful work environment, team members may feel more comfortable voicing issues within the team. This in turn allows problems to be tackled, resolved and work to continue. This transparency nurtures a supportive and trusting bond between the team which supports positive conflict resolution. Communication encourages development and innovation by facilitating idea sharing that supports an evolving workplace.

Factors in effective teamwork:

A positive team culture is important for fostering effective teamwork. This is supported by a non punitive environment, where team members focus on respecting others instead of finding fault with one another. Peller et al (2013) found strong interpersonal relationships are important when working in austere environments, finding a supportive culture helps decrease stress levels for workers. Defining clear roles and responsibilities within a team is important. By individuals understanding their individual role descriptions and how they fit into the team, teams are able to work effectively towards shared goals. Performance monitoring is important to assess the functioning of all team members and helps identify task overload or team lapses. To support this monitoring, it is the responsibility of all team members to assist with supportive actions, such as the redistribution of workload. Therefore individuals must be prepared to collaborate with team members and make adaptations within their role (Hogston and Marjoram, 2007).

Components of successful teamwork include: open communication, effective processing of conflict, a respectful environment and defined roles and responsibilities (O’Daniel and Rosenstein, 2008). Open communication improves team morale by

Leadership and management of performance are key to effective and successful teamwork. Clear leadership involves the organising, inspiring and motivating team members. Leaders must orientate the team by providing clear goals for team mem-

Effective teamwork is essential to facilitate the smooth running of humanitarian aid projects. This involves fluid collaboration between all MSF medical and non-medical staff, working together to meet the needs of the population they are serving and achieve the project’s targets. Effective teamwork is also one of the most important factors in increasing job satisfaction (Flin et al, 2003). The term ‘multidisciplinary team’ (MDT) refers to a diverse group of healthcare professionals collaborating to meet the needs of patients (Ndoro, 2014). Dysfunction between the MDT can lead to a breakdown in efficient and safe provision of patient care and may even cause harm. Moreover, poor collaboration between non-medical teams can result in lack of supplies, water facilities and other vital resources that could compromise a project’s functioning.

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bers to focus on collectively (Weller, Boyd and work culture where individuals have mutual respect Cumin, 2014) for each other Barriers to effective teamwork:

Experiences to Acquire:

Hurdles to good teamwork include environmental factors such as time constraints, which reduce the time for communication and puts pressure on the team as a whole, which may lead to ineffective collaboration.

Take part in MDT simulations or team training Check out the teamwork education courses / information such as TeamSTEPPS: Team Strategies & Tools to Enhance Performance and Patient Safety: see here

Sociological barriers include lack of trust or confidence between members of the team, which hinders interprofessional collaboration. Likewise clashing perceptions between individuals can lead to conflict, which if not adequately resolved can disturb a positive work environment. This can be combated by instilling a spirit of mutual respect and maintaining open attitudes. Clashing perceptions and a lack of self-awareness of the impact of an individual’s actions on the team can also negatively affect the working environment and can cause a breakdown in communication (O’Daniel and Rosenstein, 2008).

Online courses to improve teamwork competencies, suggestions include:

Interventions to improve teamwork:

University of Reading - Managing People: Teamwork and Diversity: see here University of Colorado - Teamwork Skills: Communication Effectively in Groups: see here Books: The Five Dysfunctions of a Team: A Leadership Fable by Patrick Fable.

The 15 Commitments of Conscious Leadership: By Jim Dethmer, Diana Chapman and Katie Warner • Training that instills teamwork competencies e.g. Klemp TeamSTEPPS Also gain experience in a variety of teams to gain • Activity-specific team training using simulation an understanding of different team working environments e.g. by joining a group of volunteers in e.g. daily rounds or resuscitation procedure an area of your interest • Training teams together e.g. group training across disciplines or between the MDT • Teaching effective communication strategies Supporting teamwork with protocols, policies and procedures e.g. checklists, a conflict resolution policy • Fostering a democratic, supportive and positive

Introduction to essential knowledge

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The 4 founding principles of humanitarianism Humanitarian and medical aid has a great history, one that is important for potential applicants to be aware of. It is important that MSF employees understand humanitarian principles and issues, global health and ethics, to inform their understanding of MSF’s founding principles. In addition to this, it is paramount that applicants have an understanding of the politics behind the issues MSF face and the history of the countries where they might provide aid . Though this is not something we have touched on, staying up to date with political material and world issues through books, articles and the media will assist you in your knowledge.

How to navigate this section? Pick an area of knowledge that you feel you need to improve your understanding in. First gain an insight of what it is, before looking at our ‘learn more’ section where we signpost useful resources to help you further develop your knowledge Essential Knowledge Humanitarian principles

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Challenges in humanitarian aid

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What is global health?

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Humanitarian principles

ples of impartiality and neutrality were supported by the introduction of humanitarian law, as part of Think about challenges that come with working the Geneva conventions of 1949. with these core principles in society: These concepts were eventually formalised by the The principles of independence and impartiali- United Nations (UN) General Assembly: initially the ty are challenged by the increased interference principles of humanity, neutrality and impartiality in of governments in the humanitarian field - it be- 1991, the principle of independence being added comes difficult to draw a line between the political in 2004. (Rysaback-Smith, 2015) and humanitarian grounds for intervention. The difficulty in staying financially independent is that it is much easier to access resources via donations from countries, than from direct donors in large-scale emergencies. This may contradict impartiality as the provision of assistance can become based on the availability of governmental funds rather than evaluation of people’s needs. MSF strives to refrain from becoming resource-driven in order to remain accessible to the most threatened populations, by strengthening their connection to societies in their countries of origin and countries of intervention.

Relevant case studies

The principle of ‘humanity’ is comparable to the medical ethical imperative to ‘do no harm’. In practice, however, this commitment is not always upheld. In arguably the most high-profile example in the last 20 years, in 2018 it was revealed that Oxfam staff in Haiti had paid young women for sex during the international aid response to the 2010 earthquake. Unfortunately, this was not a singular event; a recent UK government report chronicled around half a dozen such examples of sexual exploitation in the humanitarian aid sphere over just the past 20 years. These practices threaten the Establishing the principles of humanitarian aid very institution of humanitarian aid. It is thus vital to publicise and adhere to the humanitarian prinHumanitarian aid has been a part of human nature ciples, to ensure that the practice remains viable. throughout our history, necessitated by countless (International Development Committee, 2018). disasters, natural and man-made. The humanitarian principles have their roots in millenia-old cul- Why are the four humanitarian principles tural practices - from zakat, one of the pillars of important? Islam, to the concept of Christian charity, to ethical wartime conduct, which is inherited from the Clearly, the humanitarian principles need to be Greek, Roman and Chinese empires. However, the upheld in the field, at all times, and by everyone. series of international conflicts that unfolded dur- However, the complex political landscapes that ofing the 20th century sparked a formalisation of the ten surround spaces of humanitarian need mean process. The Treaty of Versailles, ratified following that sticking to the principles is not always straightWorld War I, formalised the existing networks of forward. At all stages, there can be conflicts of ininternational aid and with it, provided the rationale terest and political forces which make the provision for ensuring impartiality, independence and neu- of neutral and impartial aid difficult. For those who trality in humanitarian aid. The horrors of World wish to engage in the provision of humanitarian War II provided further incentive, and the princi- aid it is therefore vital to have an understanding of

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these principles: not only to shape personal practice, but to inform choices when deciding where to work and for whom (The New Humanitarian, 2013). Learn more: Course: Universite de Geneve online course: see here Articles: Challenges to ethical obligations and humanitarian principles in conflict settings: a systematic review: see here How is Oxfam being held accountable over the Haiti scandal?’ see here

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Challenges in humanitarian aid

and being liable (Tan and Von Schreeb, 2015).

As the old adage goes, hindsight is 20/20. This can be applied to any scenario, humanitarian aid included. When dealing with questions of human life and livelihoods, decisions should be made with as much prior knowledge as possible, striving to build on practical experience and avoid repeated mistakes. Recently, this imperative for evidence-based decision making was brought to the fore by the Covid-19 pandemic as radical lockdown policies, informed by an evolving situation, were implemented in the UK and abroad (Cairney P, 2021).

In order to empower aid recipients, the focus should be shifted from arguably neo-colonial models of providing short-term help, to the collaborative reinforcement of existing systems (World Humanitarian Summit, 2016) (Rejali, 2020). For example, following the 2010 earthquake in Haiti, aid organisations set up new health facilities in tandem to the country’s existing system. In providing this level of short-term aid, a new parallel system was created. This was favoured by residents (Heymann, 2015) but achieved by siphoning of local health workers. This is diametrically opposite to advice of the World Humanitarian Summit (2016) who state there is a core responsibility to reinforce but not replace existing national systems. In addition, working in collaboration with aid recipients would also ensure that humanitarian programmes fulfil expectations, another key part of accountability (Tan and Von Schreeb, 2015).

However, despite its millennia-long history (see ‘Humanitarian Principles’ section *can you hyperlink this to the page), humanitarian aid lags behind other spheres of policy in that it is comparatively poorly informed by research. Thus, there is a growing call for humanitarian aid to be more evidence-based (Kohrt et al, 2019). In doing so, humanitarian practice can evolve to become more accountable, thus working towards the core responsibilities generated by aid donors and recipients in the 2016 United Nations World Humanitarian Summit ( Department for International Development, 2012) (World Humanitarian Summit, 2016). Fostering accountability in the humanitarian sector is therefore a high-profile and worthwhile endeavour. We will explore this theme, using case studies to illustrate its relevance to humanitarian aid in practice. Accountability: what does it mean? Accountability in global health contexts can be a vague term and a definition is still contested (Frenk et al, 2013) (Tan and Von Schreeb, 2015). However, for humanitarian aid organisations, some authors argue that it encompasses empowering aid recipients, optimising the organisation in order to provide the greatest benefit, fulfilling expectations

Liability is also important for building accountability. Being liable for one’s actions requires a system of enforcement so that agreed codes, such as the Humanitarian Principles, are followed. In legal theory, liability states that a company can be taken to court for causing harm to an individual (Keating, 2001). However, in humanitarian aid, there is no single authority to whom organisations are held accountable. Following the legal theory of liability, it seems that the service provider should be held accountable to the service user, and this can logically be applied to the aid donor-recipient paradigm as well (Tan and Von Schreeb, 2015). However, in practice this is not always upheld: during the 2010 Haiti earthquake response the International Committee of the Red Cross found that more than 70% of those surveyed didn’t know how to complain or make suggestions to the aid providers (Rejali, 2020), thus limiting the capacity for recipient-focused accountability.

Essential knowledge

Finally a component of accountability is optimisation of the organisation to provide the greatest good (Tan and Von Schreeb, 2015). This can arguably be achieved by adhering to the Humanitarian Principles: humanity, neutrality, impartiality and independence. Accountability in practice In the absence of a single regulatory body for the sector, holding organisations to account for their actions may be done pragmatically, on an individual case basis. After the Oxfam scandal, a mix of methods was used. Some aid organisations claim to regulate themselves in their practice - as Oxfam did with an internal investigation into the claims of sexual misconduct, although this system is arguably inherently predisposed to conflicts of interest (Tan and Von Schreeb, 2015) (Oxfam, 2001). Nonetheless, forces outside the organisation also played a part: the Haitian government withdrew permission for Oxfam to operate in the country, and the organisation reportedly lost 7,000 regular donors in the aftermath of the scandal (Gayle, 2018). These practical sanctions, while not brought by a single regulatory authority, suggest that Oxfam was indeed held accountable for their misconduct. Accountability in the humanitarian aid sector is clearly a complex issue, subject to a lack of clear definition and enforcement. However, an appreciation of these problems is key to practicing ethically in humanitarian aid and upholding the Humanitarian Principles. Learn more: Online course: What humanitarian accountability? [Internet]: available here

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Blog: Effective Aid: Ensuring Accountability in Humanitarian Assistance [Internet]. Harvard International Review. 2019: available here

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What is global health?

Why is it important?

The definition of global health is not universally agreed upon however the Lancet’s definition is the most cited: “the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide” (Koplan et al, 2009). Generally it is agreed that global health involves research, practical intervention and policy shaping - all focusing on improving health outcomes globally.

Global health is integral to achieving equity universally but why is that important? To put it simply because lives are on the line. For many this is an aim driven by morals and compassion. Morality: when it comes down to it, what is the difference between yourself and the people who benefit the most from global health interventions? One was lucky enough to be born in a country with universal healthcare and a fairly developed health system, the other was unlucky enough to be born into war, instability, poverty etc. You are human and so are they. They hold the same entitlement to medical attention and of course human rights.

The main aim of the field is to achieve healthcare equity by eliminating health disparities. Naturally, this requires international collaboration and strengthening of local healthcare systems and public health policy. Terms like public and international health are often thrown around when talking Disease Management: moreover from the ethabout global health and it is easy to get confused ical aspect, global health is important because the borders between countries continue to shrink in this new era of an increasingly interconnected and global economy. Investment in health equity Public health: The health of a population of a is productive beyond improving pandemic manparticular community or nation. This is often tai- agement. In an international community, commulored to the health profile of the specified pop- nicable diseases will continue to resurge despite ulation: e.g. disease burden and social determi- generational mass-vaccinations of high-income nants of health. countries. Antimicrobial resistance will continue to develop if antimicrobial stewardship is not endemInternational health: this is an ill-defined term, ic universally. but the most common uses refer to the followEconomic Rewards: beyond disease, we depend ing definitions: on the health of the rest of the world for goods, 1. This term was used in the initial expansion of especially from more impoverished countries as global health as a field and is used as a synonym they tend to have cheaper exports. In the UK, we import more resources than we export. If workers for global health on farms, plantations and in factories are compro2. The disease burden and health issues in mised, so are our resources. As dehumanising as it is, these individuals are by extension, resources to low-income countries be preserved and invested in. 3. The involvement of international aid agencies such as the World Health Organisation (WHO)

Political Security - Global health also acts in the favour of global diplomacy, it encourages the pros-

Essential knowledge

perity of international collaboration whether that be in the context of humanitarian aid or political assets. It also ensures political stability as lack of basic healthcare and aid pushes desperate citizens towards unrest and at the same time allows controlling figures to weaponize healthcare.

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ing vaccines and medicine worldwide.

• Yemen: the situation in Yemen has been dubbed the biggest humanitarian crisis of this decade, despite the lack of attention this crisis has seen. Close to 3 million people have been displaced by war, famine and poor living conditions. This number shows no signs of decreasing and continues to Key Principles: grow. MSF has a presence on the ground supporting local infrastructure, providing medical aid and Global health comprises a variety of specialisms continues to campaign for donations. and each situation requires different management • Maternity services: childbirth can be a physicaland intervention. Examples of the most prominent ly and mentally traumatic experience. There are sub-specialities of global health includes: many complications and often medical attention

is required but women have no access to it. For example, over 2 million women worldwide suffer from obstetric fistulas – a hole between the vaClimate change gina and bladder or rectum which urine or stool Conflict and displacement leaks. They occur with complicated childbirth but are more common in Africa. It’s a mostly hidden Emergency preparedness problem affecting young women who give birth at Health systems and delivery home in poor, remote areas with very limited or no Non-communicable disease access to maternal healthcare. If a woman survives a complicated birth and suffers a fistula as a result, Access to medicines she may be shunned by her family and communiTrade and investment ty. Because of this social exclusion, it is even less likely the sufferer will receive care. MSF healthcare Global health diplomacy teams work with pregnant women to prevent the occurrence of obstetric fistulas, while at the same Current Issues: time, treating those with the condition and proThere are numerous on-going hot topics in global viding psychological support to fistula sufferers to health, some new, some unfortunately persistent. help them rebuild their lives. Examples of prominent issues in global health: Learn more: • Vaccine access campaign: in many low-income countries, vaccines and medicines are vastly unaf- Global health is an extensive and complex field. If fordable and sold at prices that simply cannot be you’d like to learn more, we have collated useful afforded by governments or NGOs. Pharmaceuti- links below to find more information: cal manufacturers compete for the most profit by patenting a drug so they can charge high prices as 10 global health issues to track in 2021: see here they are the only company producing the vaccine or medicine. This consequently leaves the medi- Global Health at NIH: see here cines inaccessible for those who need it. Médecins Sans Frontières campaigns for the mitigation of The Global Health Network: see here the harmful effects of patents and for stakeholders to promote price-lowering competition for lifesav- The Irish Global Health Network: see here Food and water security

Working Overseas: Interview with Cara Brooks

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Working overseas

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MSF is an organisation of staff. The Chantilly principles require an altruistic and “individual commitment to people in precarious situations” from all volunteers. It is the spirit of volunteerism that avoids neo-colonialism and saviourism, whilst ensuring that bringing assistance to people in crisis remains the focus of the organisation. You might consider volunteering with another humanitarian organisation, a charity that provides medical aid or one that runs advocacy campaigns - there are copious opportunities. Volunteering ideas: Missing Maps are an organisation that aims to put vulnerable people on the map. Their mission requires the help of volunteers to map vulnerable places in the developing world with the access of a phone or computer. NGOs such as MSF and the Red Cross, use these maps to plan and orientate their humanitarian projects. Find out more here There are limited volunteer and intern positions available at operational and support offices across the movement, though are most likely possible for those looking to a future in finance, communications, programmes etc. However, for security reasons and lack of supervision capacity internships are not offered in the field. Many MSF roles ask for experience volunteering, travelling or working abroad. These opportunities can be hard to source, leaving students and young professionals asking – what really are the benefits of working abroad? In this interview FoMSF Manchester talks to Cara, who has worked on 10 projects in 3 different roles for MSF. We discuss her experiences working abroad, how working overseas has enriched her career and her advice to students looking at an overseas elective.

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Interview with Cara Brooks

FoMSF: So Cara, what did you do prior to your work for MSF? Cara: I had worked in the UK for 4 years after graduating, in the aviation industry, but I knew I wanted to work in the humanitarian field. Without a very specific profession (whether it be accounting, engineering, or a profession within the medical field) it was hard to find a route into the field of humanitarian work. So that’s my first piece of advice – you should be a qualified professional. MSF isn’t a training ground for your career. You will face elements of your profession, and challenges, that you’ve never faced before, so you need to know the foundations of what you do very well first. That said, the experience I had in management, training and teamwork in high stress working environments meant I was qualified for a role in HR management within MSF. Thanks to my management role within the airline I had experience in HR areas such as recruitment, scheduling and professional development of employees. What I lacked was the experience working in a setting different to that of the UK. FoMSF: So how did you go about gaining work experience abroad? I decided to go and actively search for that experience. I moved to Kampala, Uganda and joined an organisation called ‘Heroes’ as a volunteer. This organisation needed an operations manager, someone with management experience to manage a team of Ugandan social workers working with street children and their families. The program was part of a government initiative to change the established practice of institutionalising children in homes, and focus on family reunification. I stayed at Heroes for 2 years. Alongside this work I continued to share knowledge with and volunteer for

Interview with Cara Brooks

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other organisations who were wishing to implement this ’alternative care model’. FoMSF: There is certainly a romanticism of volunteering and working abroad in popular culture, what are some common misconceptions, realities, difficulties and dilemmas of volunteering abroad? Cara: I have to say, I am conflicted about this part of my experience. Why? Because, constantly we have to ask ourselves a number of questions…. For example, could a local person do this job? And the answer in my case was yes, a Ugandan with management experience, and likely a far superior knowledge of the social system and legal system in relation to street children, could have not only done the job, but done it better than I. This is one of the elements of volunteerism that we need to be careful of. FoMSF: so what is your advice to prospective volunteers? Cara: So when looking at volunteer opportunities, I’ve mentioned already - the importance of being a professional in your field. You need experience before joining MSF, for most roles it is 2 years of professional experience as a minimum. I would say the same goes for any volunteering role you may want to undertake. If you are hoping to add value to an organisation, you have to be able to contribute from your field and that takes professional experience. A 2 week trip will not suffice, only experience of 3 months or more can really help you begin to understand the communities and context in which you may be working with. It is impossible to be a useful volunteer unless you understand the needs of the community. However much you want to help, first look at the situation objectively. What skills do you have to

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Interview with Cara Brooks

bring to the table? Why would they need you specifically? Do your qualifications fit the role? Is the project creating sustainable solutions? Does it involve capacity building of local staff? Does it put the community at the centre of the discussions and programs?

to do what they can with study. The organisation continues to support their parents with school fees today.

Also bear in mind that creditable programs that engage professionals should also ask for your qualifications and licensing (for medics), there should be criminal record checks for any role that works with vulnerable members of a community (like children).

Cara: I would say, it isn’t easy getting into MSF, it’s not a directly out of school option, but it is well worth it once you do join. It is something that motivated me throughout all those other years and can really be a driving force whilst in your studies and early career.

FoMSF: what is your final piece of advice to students and young professionals!

FoMSF: alongside gaining experience in settings My advice is, take an interest in the world whilst similar to those MSF work in, what other skills you are embarking on this journey towards MSF are key for an MSF employee? humanitarian work. So many of the humanitarian crises that we work in are not on the mainstream Cara: I’ve been exceptionally lucky to have made news, but these are complex crises, often with some incredibly close friends during my 2 years outside international involvement for various in Uganda. I’m currently in Uganda and one has agendas. It is fascinating (and shocking) to begin just asked me to be her bridesmaid! My close to understand why these humanitarian crises are group of 5 friends were all student social workers occurring, and it isn’t as simple as flood, famine, at Makerere University, Kampala, or working for disease or earthquake. You have to ask questions. the organisation in administrative roles. I come Why is that particular group of people at risk of back to Uganda in almost all of my breaks be- famine or disease? Why did they not have the intween contracts with MSF to see them, and as the frastructure and technology to cope? And is there weather is a bit better than Manchester! a political agenda is behind it? I’ve also been exceptionally lucky to see 2 particular young boys turn into incredible young men. I’ve known them since they were 12 and seen them through the Heroes street children’s program in Kampala. They have reached the final year of high school now (equivalent to our final year of sixth form) and have plans to go to university once they are finished with school. COVID may delay that with schools being shut for extended periods in Uganda, but they are incredibly motivated and use their time wisely at home

Whilst you travel, volunteer or work abroad in other situations, immerse yourself in local culture, get off the tourist track, talk to the locals, live with the locals and understand more deeply. Get out of your comfort zone, because once in MSF, you’ll really know the meaning of outside your comfort zone!

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So, where do I go from here?

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Self-reflection

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Starting is the hardest part! This booklet contains a vast amount of information, and you may be left questioning: where do I start? This section was built to help students and young professionals, like you, to engage in your professional development through self-reflection and goal-setting. This doesn’t have to necessarily be MSF focused – this can help you plan a career in anything! Get stuck in and do not be afraid to be detailed. Practice envisioning your future to help make it a reality. After these exercises there are some useful resources, have a look at some current job specifications, sign up to some newsletters and find some books you might be interested in reading! “The associative character of MSF permits… a capacity for questioning ourselves” - Chantilly Principles (1995, pp.4) Pick and answer 3 questions relevant to you: What are the top 3 skills that I could work on to build my portfolio? What does my dream career look like in 10 years? What is stopping me? What am I afraid of? What are my motivations for wanting to apply to MSF? Why would I be an asset to MSF? What I am proud of achieving in my studies/career so far? A moment in my studies/work that has not gone well, why was that the outcome? Where will I be in 5 years if I carry on, on this path? What would my career look like if money and social obligations were not a consideration? When was the last time I stepped out of my comfort zone? eg. My motivations for applying...

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Goal setting

Goal setting Finish this activity by finalising your 1 year goals, 5 year goals, 10 year goals – make them SMART goals: specific, measurable, attainable, relevant and time bound. Setting your intended actions are really important in order to keep you focused and accountable. Keep checking back in with your goals quarterly: what progress have you made, have any goals been left neglected, were they attainable or are there any you want to change?

1 year...

2 years...

Goal setting

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Getting involved Start by getting involved! Follow MSF on Instagram, Facebook and twitter. Sign up to its newsletters. Join your university’s Friends of MSF, or if it does not yet have one, then set it up! If you’re at school there are still ample ways to get involved. Get vocal by supporting campaigns and appeals online, such as the MSF Access to Medicines campaigns. You can make a real difference by sharing social media posts, joining global twitter storms and writing articles for student/local newspapers. Check out the resources section for more information on where to start.

5 years...

10 years...

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Where do I go from here?

Useful sources

ReliefWeb World Bank Here are some resources to help you dig deeper ODI OECD into applying and working for MSF: World service enquiry Welcome to MSF Why MSF What to expect Advice for future MSFers Staff blogs Patient blogs Founding principles: The Chantilly Principles: The La Mancha Agreement MSF’s clinical guidelines Well reviewed course providers:

Check out some organisations like MSF: Medical workers: International Committee of the Red Cross Medecins Du Monde British Red Cross Raleigh International Handicap International International Medical Corps Marie Stopes International Pharmaciens Sans Frontières International Health Exchange Medical and non-medical workers:

RedR UK BOND Mediar

Save the Children Oxfam GOAL Look for jobs and volunteering opportunities in Voluntary Service Overseas (VSO) CARE International the charity sector: Action Aid Islamic Relief Charity Job Chritisan Aid Eldis Action Against Hunger UN volunteer Amnesty International UK Global Health Jobs Human Rights Watch Sign up for relevant newsletters with world news A deeper insight: and humanitarian response updates: The New Humanitarian UN News MSF newsletter The Eldis blog

An article shows the difficult decisions field workers need to make: see here Field administration worker talking about the re-

Where do I go from here?

cruitment process: see here

An imperfect Offering – James Orbinski

An article about witnessing suffering: see here

Hope in Hell – Dan Bortolotti

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What a logistician packs in their mission kit: see War doctor - David Nott here Half the Sky: Turning Oppression into OpportuniEffect field work can have on MSF field workers ty for Women Worldwide By Nicholas D. Kristof & mental health: see here Sheryl WuDunn Saving lives at sea: see here In the Eyes of Others: How People in Crises PerUnconventional transport in remote areas: see ceive Humanitarian Aid By Caroline Abu-Sada here Enough: Why the World’s Poorest Starve in an The reality of danger in the field: see here Age of Plenty By Roger Thurow & Scott Kilman An interview with the former international presi- Chasing Misery: An Anthology of Essays by Womdent of MSF, Joanne Liu: see here en in Humanitarian Responses (2014) Wider Resources Videos and films:

City of Thorns: Nine Lives in the World’s Largest Refugee Camp (2017)

Chasing Chaos: My Decade In and Out of HuA Walk To Beautiful (EMMY AWARD WINNING manitarian Aid (2013) DOCUMENTARY) | Real Stories: see here Emergency Sex (And Other Desperate Measures): Midnight traveller by Hassan Fazili - a refugees True Stories from a War Zone by Kenneth Cain story filmed solely on phone cameras Band-Aid for a Broken Leg (Paperback) by DamRequest one of the inspiring films that MSF rec- ien Brown ommend here: see here “Double take: a single woman’s journey to mothAfghanistan: Medics Under Fire; documentary on erhood” by Kathryn Cole Youtube (2016) : see here Podcasts: MSF UK’s YouTube page: see here Everyday Emergency - Doctors without borders Books: David Nott - Desert Island Discs - BBC Radio 4

FAQs

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Frequently asked questions: If I only meet some of the criteria, should I still apply? MSF receives a large number of applications, so it’s unlikely you’ll be accepted if you don’t meet the essential requirements for a role. There are an average of 28 applications a month, with just 5 interviews a month. If I am unsuccessful, will I get feedback? MSF provides feedback to unsuccessful applications that reach the interview stage. Unfortunately, if you do not reach the interview stage you will not get feedback as standard due to the volume of applications. If I am unsuccessful, can I apply for future roles? Yes, you can make multiple applications. Though you might consider how good your fit was to the role required and if you apply again – what has changed? MSF encourages you to apply when you believe you have the skills and experience the role requires . Do you have to be based in the UK to apply to work with MSF? You must have the right to work in the UK and be domiciled there to be able to apply in the UK; otherwise you must find the nearest MSF office to your place of residence to apply. Are there age restrictions to work internationally for MSF? There is no minimum or maximum age for participation in MSF projects, though there are other criteria such as good health, adequate experience and professional maturity. If English is not my first language, can I still apply? MSF does not require a formal English test, however a good level of verbal and written English is required. Do I need to speak another language for MSF? French and English are the official MSF languages – it is desirable to be fluent in one and have basic skills in the other. Fluency in any other languages will put you at an advantage in your application. Depending on the needs of the current projects, MSF may only accept applications for those with additional language skills e.g. fluency in English and minimum B2 level French (CEFR).

FAQs

Is there any health screening prior to going into the field? The challenges of working for MSF require you to be in good general health, as living conditions in the field can be in extreme climates, have only basic facilities and be physically challenging. Therefore, there is usually a health check-up required prior to leaving for your mission, to ensure you have medical clearance. Can I apply for more than one role? You may apply for more than one, but each role has specific responsibility, and each application must have its own cover letter. I have a disability and have certain requirements to enable me to attend an interview. Would I still be considered? MSF is openly an equal opportunity organisation and is committed to principles of inclusion and respect of diversity. Let them know any special requirements and they will work to accommodate your needs as much as possible. How much experience do I need before applying? For non-medical applicants, generally a minimum of 2 years’ experience. For medical applicants, a minimum of 2 to 3 years post-qualification. Experience is essential as staff require a high level of autonomy in the field. Is it possible for medical students to carry out placements within MSF during studying? No, due to extensive workloads and entailed risks, field staff are unable to oversee unqualified staff. Do I need experience of working abroad? Most roles require at least 3 months travelling or working in the developing world as a bare minimum. Can I apply to work in a specific country? It is rare MSF advertises job openings for specific countries or projects. MSF recruits applicants into professional register or “pool”. Placements are determined by operational needs. What is provided for you whilst on post? Daily expenses such as food, hygiene products and local transport costs are covered. Accommodation is provided whilst in the field, though expect to share facilities such as bathrooms, kitchens and sometimes rooms themselves (depending on the context).

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This book has been created by Friends of MSF Manchester, a student society that supports the work of MSF UK through awareness raising and fundraising. This is not an official MSF publication and it has not been endorsed by MSF.

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Friends of MSF Manchester's Roadmap to a Career in Humanitarianism