The Hampton Health District has been without a full-time director since June, when Dr. William "Bill" Berg retired after 17 years at the helm. Since then, Dr. Nzinga Teule-Hekima, director of the Peninsula Health District, has been doing double duty, serving as acting director for the neighboring health department.

She's not fazed by the additional work. "I enjoy the pseudo-regional atmosphere. We can do some brain-storming as a collective," said Teule-Hekima, whose Peninsula district serves three cities and two counties. "Adding one more city is no big deal. It doesn't seem that much of an effort to divide my time; it's just another locality."

Her predecessor, Berg, who did double duty with Portsmouth, the Peninsula and Three Rivers at different times during his tenure in Hampton, had a different take. "It works out much better if a director doesn't have to cover two districts. It's difficult to do big-picture, innovative stuff when much of your time is taken up with the day-to-day," he said.

Hampton is not the only district without a permanent director. In all, there are five health districts statewide out of 35 that are seeking full-time leadership, according to Bob Hicks, deputy commissioner for community health services for the Department of Health. Together, those comprise 119 local health departments. He assured that in the absence of a director — Teule-Hekima is only in the Hampton office on Tuesdays — a physician or nurse-practitioner is always on site to answer questions.

The lag time for filling district director positions is typically a few months, though it can extend longer depending on the location. When the Virginia Beach director retired in February, Hicks noted, the position was filled within a couple of months. Three Rivers, which encompasses 10 localities, has had an opening at the top for just under a year, and the Eastern Shore district, which has seen some turnover, has been leaderless for eight months. West Piedmont near Martinsville has been open the same length of time as Hampton's.

To date, no interviews have been held for the position, which will remain open until filled, according to the agency's web site.

The job requires a Virginia physician's license, and the Hampton description says that a Master's in Public Health is preferred. The office comes with a $5.1 million budget, oversight of 51 employees, and a charge to oversee the public health of a population of 137,400 at two locations. Health districts manage disease control and prevention, family planning, maternal and child health, and other public health issues. Berg targeted teen pregnancy and sexually transmitted diseases as his priorities. "Choosing will be the new director's prerogative," he said.

The positions are listed on the state web site, http://jobs.virginia.gov that Hicks describes as the state's recruit system. "We periodically check and see if we've got applications in. When we have good ones, we'll work with the city to set up interview panels," he said.