You can't talk health without health workers. Does the state have the necessary health personnel and what are you doing to keep your best hands that you have at the moment.
Ok thank you, I can tell you I just took that brief when I was talking generally about our programme. When we started all this, I can say in south-south Nigeria, the numbers of doctors we have in Delta state alone in the Hospital Management Board. When I say the Hospital Management Board I mean covering all the hospitals - that is 265 Government Hospitals excluding the health centers and the Teaching hospital. We have about 253 Doctors, nurses alone number about 1,168 and we have 54 pharmacists. Let's leave the General Hospital Management Board and let's look at the Teaching Hospital. We have 153 doctors and when you add both that is over 400 and with the 25 doctors in the primary healthcare that amounts to about 431 doctors. These are the doctors under the employment of the state government alone. Talking of nurses we have about 1,168 nurses in the Hospital Management Board. We have 153 doctors and 153 nurses in the Teaching Hospital. Very few state governments in Nigeria have these numbers of doctors, nurses, pharmacists and health workers including about 54 pharmacists, 60 pharmacy technicians, 55 medical laboratory scientists/medical laboratory technicians, 36 medical recording officers, 91 medical recording technicians. We also have 54 Hospital administrators and 98 executive officers. I can tell there are only few state governments in Nigeria that can have this experienced workers. In spite of these we still employed more. When we started this maternal healthcare we had special doctors which will call free maternal Doctors. They are not part of the one I just told you, although they are directly under the health ministry. We also have doctors that are directly under the ministry of health posted to hospitals that are not part of the hospital management board. If you now look at the totality of the doctors that we have in our system they are well over 500 from the ministry, directly from the civil service commission and from the Hospital Management Board. From the figures I have quoted from Teaching Hospital Board, and the figures quoted from the local government service commission and then from the free maternal and the free under-five doctors that were posted to areas like Warri were we have a lot of patients, Ekpan General Hospital, Sapele Central Hospital, Ugheli Central Hospital, Agbor General Hospital and also Okho where we have a lot of patients. These doctors help to assist in reducing the work load in those hospitals. I can tell you that at a point in time the total numbers of doctors in Central Hospitals in Warri alone was more the total numbers of the doctors in some Eastern States of Nigeria. That will tell you the level of our manpower employment and development. Also among the medical doctors, most of them are consulting and doing one specialty courses or the other. Today apart from the Teaching Hospital Oghara, the Central Hospital Warri has been made a specialty centre where doctors, obstetrics and gynecologists' can be trained. In addition we also have post-graduate medicine in training the students so that they can graduate as doctors.

What are you doing to keep them?
To start with I can tell you that Delta state was one of the states that implemented the present Medical Salary Structure (MSS) in Nigeria. We are not implementing 70 percent of the MSS but we are implementing it to the fullest that is 100 percent implementation. With that everybody is happy. Where else will you like to work in Nigeria, as a medical doctor, except in Delta state? Doctors who have been long in service we buy them cars. Most of our consultants today have good cars they are riding. The Chief Medical Officers here all have cars. This is to encourage and appreciate them for the good job they are doing in the state. The doctors, nurses, and health workers, the clerical officers, the store officers all are doing well; they all deserved to be complimented in terms of salary. A new graduate in the state health sector takes home at the maximum N70, 000. If you compared that to the civil servant you know about #40,000 there is a world of difference and we don't have cases of people moving out so they are confined.

How smooth is the State's Referrals System from the Primary health centers to the Specialist Hospitals? Is the Specialist Hospital prepared for anything?
The whole idea of Primary Health Care is to ensure that people have access within the region of academics so the first place of call is more important than the Secondary Healthcare and the Tertiary Healthcare if it is well implemented. The problem we are having is that the operation at that level is left at the arms of the Local Government Council chairmen and most of them are quiet oblivious of the importance of the nucleus or the central roles the Primary Healthcare is playing. They are not putting attention to that and so is falling back to the state government to build, equip and perhaps even start. We have a Primary Healthcare Development Agency, they report to me and also they intend to integrate all the activities and functions of the 450 Primary Healthcare Centers in the state. Thank God that in most of our Primary Healthcare Centers in each Local Government we have one or two doctors. So the referral system is such that when you see a case that is above your capacity to bear you refer it either to the General Hospital or to the Central Hospital. Also there are some cases referrals from the Central Hospitals and the Specialist Hospitals to the Teaching Hospitals. Referrals can be two ways and some time we also get feedback from where they were being referred to that, this is what we have done and thank you for referring the patient to us so on and so forth.

In terms of assistance in meeting the state's greater plan for adequate healthcares delivery in what area would you need international assistance?
Well, we cannot say we have gotten all because they are lot of things we still need to put in place. Don't forget that our state is a relatively new state, about 20 years old yet even in our Teaching Hospital where we have the state of the art equipment - magnetic resonance, MRI, C.T scan, fluoroscopic machine, mammograms and numerous ultra sound machines - and then good specialists from Europe and America to man them. But there are centers for instance, in cases of patients with cancer in Delta state we still don't have because we have our projections. We have what we call implementation booklet which indicates what we need to do throughout the year.

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