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Why are so many of Alberta's rural doctors from South Africa? – CBC.ca

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In January 2014, Dr. Cornelius Nortje arrived at the Edmonton International Airport, ready to start his new life in Alberta.

Nortje was met at the airport by the chief of staff at the Lac La Biche hospital. The chief of staff had two large down jackets, one for Nortje and one for his wife.

Nortje had never previously been in Canada. The day he and his wife landed, the chief of staff drove them 250 kilometres northeast to their new home town.

“We were probably just looking for a bit of an adventure,” said Nortje, who is now in the chief-of-staff role himself at the William J. Cadzow–Lac La Biche Healthcare Centre.

“Most of the South African doctors know someone that’s either been in Canada or was on their way to Canada, and the feedback we’ve always had from them once they’ve been here has been that it’s absolutely fantastic,” he said.

As the local physician in charge of recruitment, Nortje says he’s never received an application from a Canadian-trained doctor.

Lac La Biche, a hamlet with a population of about 2,300, currently has five doctors, all of them from South Africa.

Overall in Alberta, 6.5 per cent of all practising physicians graduated medical school in South Africa, according to figures provided by the College of Physicians and Surgeons of Alberta.

Outside of Edmonton and Calgary, 13 per cent of Alberta doctors trained in South Africa, the CPSA said. In the North zone of Alberta Health Services, South African-trained doctors represent one-third of all rural physicians.

Across the province, the CPSA website lists more doctors who speak Afrikaans, the Dutch-derived colonial language in South Africa, than those who speak Mandarin, Cantonese, Tagalog, Punjabi, Hindi or Ukrainian.

Amid ongoing physician shortages, the provincial government last month announced it will provide some funding to train more rural doctors.

The CPSA has also responded to the pressure. It launched a pilot to remove some barriers for international doctors from approved jurisdictions to start practising in the province. 

Since the 1970s, South African doctors have been one of the largest demographics answering the call in Western Canada’s rural communities.

Community service to community health

South African doctors’ experience at home prepares them for rural medicine in Canada, Nortje said.

The country’s medical training requires an internship at public hospitals, which are under-resourced compared to the separate private system. In addition, medical graduates complete a community service year in which they travel to townships and other communities in need before they register as physicians.

“We get thrown into the deep end,” Nortje said.

“Every physician that finishes [medical school] has to have done 10 C-sections … so everyone’s got a bit of exposure with procedural skills and maybe working a little bit more with less resources available.”

Nortje said hospital rooms designed for two patients would be overflowing with 10, with some patients on the floor and in the hallways. As a medical intern, he would have to monitor intensive-care patients and deliver babies on his own without a supervising doctor, he said.

That experience translates well to adapting in a small community hospital, he said.

When Nortje started, Lac La Biche had nine physicians, but that number has dwindled. And of the hamlet’s five physicians now, only four work in the hospital.

“We do fit in well because you have to be able to do a little bit of anything,” Nortje said of working at the Lac La Biche hospital.

“After 11 o’clock at night, it’s me and one RN in the emergency department. Anyone can walk through that door and you have to be able to deal with it.”

Barriers for International medical graduates

Some Canadian colleges of physicians give doctors with South African training and experience preferential status over their counterparts with other international medical credentials.

Since 1974, South Africa has been on a short list of countries the CPSA recognizes as approved jurisdictions.

Physicians who have trained there are able to skip some evaluation and training requirements that other international doctors need to work in Canada.

The majority of doctors who trained abroad have to complete a medical residency in Canada unless they’ve been recruited to work in Canada in their specialty. 

Doctors from Australia, Ireland, United Kingdom and the United States can transfer the skills directly in all specialties.

Physicians from South Africa — and more recently Singapore, Hong Kong and Switzerland — can transfer into some specialties in Canada.

Each province designs its list of approved jurisdictions based around guidelines from the College of Physicians and Surgeons of Canada.

“It does make it easier for South African physicians to come here and to come to Alberta when the training is recognized as similar to Canadian residency training ,” said Dr. Michael Caffaro, assistant registrar with Alberta’s college. 

While South African doctors have a more direct path to practising in Canada than most other international medical school graduates, some requirements for doctors from South Africa have become more restrictive over the years.

Physicians must complete competency exams followed by a three-month in-hospital assessment period before becoming registered as doctors here.

Dr. Peter Bouch, who practises in Red Deer, emigrated from South Africa in 1993 after a patient told him about an open position in Canada.

He wanted to travel and Canada was one country that made it easier to transfer his credentials. Thirty years ago he faced far fewer barriers to entry than doctors do now, he said.

“Back in the good old days of faxes I sent a fax off and they said sure,” he said. 

Without an interview, a local health board invited him to be the new physician in Whitemouth, Man. He was able to take his competency exams in Canada after he started his practice.

I sent a fax off and they said sure.– Dr. Peter Bouch

Caffaro said he didn’t know if fewer South African doctors are practising in Alberta than before, but the trend over the years has been that more internationally trained doctors from other countries are practising in the province. 

In January, the CPSA announced a pilot that will waive certain requirements, such as clinical review exams, and the first three-month assessment for international medical graduates. The program is designed to encourage more doctors from approved jurisdictions to apply to work in Canada. 

Caffaro said the pilot could also provide a step toward adding more countries to the list of approved jurisdictions in the future.

“There’s no other jurisdictions yet,” he said. However, in concert with the experts in postgraduate education, the expectation would be that there would be an interest in actually looking at how we can expand the list.” 

Medical exodus

For years, the South African government has expressed concerns about the steady outflow of trained physicians to other countries, primarily in the commonwealth. 

Many doctors who came from South Africa to Canada described the safety of their family as part of the impetus to move.

South Africa has one of the highest homicide rates in the world, according to a United Nations report. Initially, the murder rate continuously declined post-apartheid, but statistics suggest there has been a rise since 2011. 

“Safety is definitely, I think for me one of the biggest things,” said Nortje. “You’ve got alarm systems and response units that people privately hire to monitor their houses.” 

Nortje was working at a hospital in Cape Town one night when a physician from Nigeria went to a gas station to get something to eat. But his colleague never returned. Nortje said he found out two days later the man was killed. 

Dr. Tracy Lee Lindenberg, another doctor in Lac La Biche who trained in South Africa, said she was held up at knifepoint in her car while stopped at a stop sign in the middle of the day.

She remembered seeing hundreds of people around and a police officer across the street. For years after that, even in Canada, she said she would have heart palpitations while stopped at a traffic light if it looked like someone was approaching.

“It just made it such an easier decision to move,” she said. 

Five years ago, Lindenberg moved to Canada with her husband and six-month-old daughter.

She said many medical challenges are similar to her experiences in South Africa and her family has embraced their new lifestyle in Lac La Biche, ice fishing and going on snowmobile trips.

“I really fell in love with the rural aspect,” she said. ” People here were just so inviting and it just made me feel so much like home.”

Doctors wanted

On Jan. 26, the province announced it would provide $1 million to fund four Alberta post-secondary institutions to look for ways to train doctors in Grande Prairie and Lethbridge. It’s part of an effort to train more Alberta doctors who want to practice rural medicine.

Medical resident Topher Mostert, who is currently working in Lac La Biche, is part of a Red Deer-based University of Alberta training program that includes a rural rotation.

Topher Mostert, a medical resident in Lac La Biche, and Dr. Nortje walk outside the William J. Cadzow hospital.
Topher Mostert, a medical resident in Lac La Biche, and Dr. Nortje walk outside the William J. Cadzow hospital. (Trevor Wilson/CBC)

Mostert, who grew up in Fort Nelson, B.C., wants to be in rural medicine and said the residency has affirmed his decision.

“I can tell you that I will not be going back to a city. I much prefer small-town medicine,” he said.

“Every day is different. And it’s nice seeing the same patients and having that continuity of care.” 

Nortje is hopeful Mostert might join the team in Lac La Biche. 

In the meantime, the Lac La Biche medical clinic is looking to address its current shortfall of doctors, with one of its five doctors set to retire this spring.

The community has hired two internationally-trained doctors who are already living in Alberta. One studied in South Africa and the other trained in India.

Both are waiting to complete assessments before they can join the team in Lac La Biche.

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‘Our story is incomplete:’ Famed dino hunter reflects on the history of paleontology

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EDMONTON – Canada’s famed dinosaur hunter and one of the inspirations for the “Jurassic Park” phenomenon turned 75 earlier this year and has no plans to drop his chisel and rock hammer.

Philip Currie says he’ll keep digging until he’s one with the fossils he has spent his life unearthing.

“I decided when I was about 40 or 50 that I was going to continue until, suddenly one day in the (Alberta) Badlands, I would go poof and I’d be gone,” Currie said in an interview ahead of the museum that’s named after him celebrating its 10th anniversary.

And he says before he does go, he hopes to find an intact specimen in Alberta of his favourite dinosaur — Troodon formosus.

It’s a brainy, big-eyed dinosaur that resembles the nasty, two-legged, big-tailed and sharp-toothed velociraptor made famous in the “Jurassic Park” movie series.

“(It) was probably the most intelligent dinosaur we know,” said Currie.

“It’s got the biggest brain. It has eyes that face forward in a way that gave it binocular vision. And now we know they were feathered.”

In other parts of the world, teeth of a similar dinosaur have been found with serrations as big as those of a T. Rex’s tooth.

“We still haven’t got a complete specimen (of the Troodon formosus) anywhere in the Western North America. It’s crazy,” he said.

“I would love to see them just to learn from it and see what we got right and what we got wrong.”

The Troodon can be seen in a death pose in the logo of a museum named after Currie in Wembley in northern Alberta.

The Philip J. Currie Dinosaur Museum is marking its 10-year anniversary next year by exhibiting its recent and largest discovery in northern Alberta so far — the skull of a pachyrhinosaurous. The skull alone is the size of a baby elephant.

The Wembley centre is among several museums Currie has helped build in Canada and around the world, including China and Japan, as dinosaur research boomed over the course of his career.

It began when he was a 12-year-old growing up in Ontario, reading the Roy Chapman Andrews book “All About Dinosaurs” and dashing through the Royal Ontario Museum, looking at all the dinosaur displays, confident he would one day hunt some of his own.

Most of the fossils were from Alberta, so he moved there to work.

He says the province is home to the Dinosaur Provincial Park, east of Calgary, where 50 species of dinosaurs and 150 species of turtles, crocodiles, lizards, snakes, flying reptiles, mammals and fish lived together.

“That makes it one of the best sandboxes or playgrounds for somebody like me,” he said with a laugh.

On his first day out in the field, around 1976, he uncovered his first fossil: a spine. I was holding in my hands dinosaur bones — this evidence of ancient life.”

He worked at the Royal Tyrrell Museum of Palaeontology in Drumheller, but his expertise has taken him to dinosaur bonebeds all over the world, including regularly to Mongolia and China, along with the University of Alberta in Edmonton, where he teaches.

While his subjects were long gone millions of years ago, the science of digging them up has ebbed and flowed for about a century.

In the 1920s, some of the world’s first paleontologists, including Andrews, had already completed expeditions to China’s Gobi Desert, despite the warlords that ruled the area, and unearthed some of the largest dinosaur fossils seen at the time.

But until the 1970s, Currie said, the Great Depression and world wars halted further discoveries. It was further hampered by the erroneous belief there were few dinosaurs left to be found.

From the 1960s through the ’80s, paleontology grew a bit, aided by advances in technology, but remained in the shadows of popular science.

In 1993, Hollywood changed that.

Director Steven Spielberg released “Jurassic Park.” Based on the book by Michael Crichton, it told a story of paleontologists pursuing — and being pursued by — dinosaurs brought back to life.

While developing his lead character, Alan Grant, Crichton was inspired by the few paleontologists working at the time, including Currie. Crichton has acknowledged it was Currie’s research method that piqued his interest.

Currie said the book and movies have shown the world paleontology is “multidisciplinary” and that bones tell stories of not only what lived but how it lived.

Paleontologists, in turn, were viewed less as diggers and more like detectives.

“You’re, first of all, digging (evidence) up. Then you’re trying to figure out what is it or who is the victim, why did they die, why are they being found in this particular way, and what can we learn from this,” he said.

“Every time you answer one question, you end up with two more questions.”

He said the hours he has spent digging and brushing dirt off fossils in Alberta and all around the world have humbled and matured him.

“When you’re looking at dinosaurs, you look for evidence for why they became extinct,” he said.

“If dinosaurs hadn’t become extinct, what would we look like now? Even though I’m not religious, I think about these things on a bigger scale.

“It’s not just an asteroid hitting the world 65 million years ago. There is something else going on.

“Our story is incomplete.”

This report by The Canadian Press was first published Oct. 13, 2024.



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Three people dead, two injured after head-on collision involving truck and bus: OPP

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WELLAND, Ont. – Three people are dead and two others are injured after a collision involving a pickup truck and a bus in Welland, Ont.

Police say first responders rushed to the scene of a crash at a Highway 58 address at around 10:20 p.m. Saturday.

Ontario Provincial Police say the truck had rolled over and was engulfed in flames after the head-on collision with the transit bus.

It says the truck driver and their two passengers were pronounced dead at the scene, and the bus driver was airlifted to hospital with life-threatening injuries.

Police say two passengers were on the bus at the time — one was seriously injured and sent to hospital and the other was released at the scene.

They say a portion of highway between Kleiner Street and Forks Road East will remain closed as the investigation continues.

This report by The Canadian Press was first published Oct. 13, 2024.

The Canadian Press. All rights reserved.



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In an engineering feat, mechanical SpaceX arms catch Starship rocket booster back at the launch pad

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SpaceX pulled off the boldest test flight yet of its enormous Starship rocket on Sunday, catching the returning booster back at the launch pad with mechanical arms.

A jubilant Elon Musk called it “science fiction without the fiction part.”

Towering almost 400 feet (121 meters), the empty Starship blasted off at sunrise from the southern tip of Texas near the Mexican border. It arced over the Gulf of Mexico like the four Starships before it that ended up being destroyed, either soon after liftoff or while ditching into the sea. The previous one in June had been the most successful until Sunday’s demo, completing its flight without exploding.

This time, Musk, SpaceX’s CEO and founder, upped the challenge for the rocket that he plans to use to send people back to the moon and on to Mars.

At the flight director’s command, the first-stage booster flew back to the launch pad where it had blasted off seven minutes earlier. The launch tower’s monstrous metal arms, dubbed chopsticks, caught the descending 232-foot (71-meter) stainless steel booster and gripped it tightly, dangling it well above the ground.

“The tower has caught the rocket!!” Musk announced via X. “Big step towards making life multiplanetary was made today.”

Company employees screamed in joy, jumping and pumping their fists into the air. NASA joined in the celebration, with Administrator Bill Nelson sending congratulations.

Continued testing of Starship will prepare the nation for landing astronauts at the moon’s south pole, Nelson noted. NASA’s new Artemis program is the follow-up to Apollo, which put 12 men on the moon more than a half-century ago.

“Folks, this is a day for the engineering history books,” SpaceX engineering manager Kate Tice said from SpaceX headquarters in Hawthorne, California.

“Even in this day and age, what we just saw is magic,” added company spokesman Dan Huot from near the launch and landing site. “I am shaking right now.”

It was up to the flight director to decide, in real time with a manual control, whether to attempt the landing. SpaceX said both the booster and launch tower had to be in good, stable condition. Otherwise, it was going to end up in the gulf like the previous ones. Everything was judged to be ready for the catch.

The retro-looking spacecraft launched by the booster continued around the world, soaring more than 130 miles (212 kilometers) high. An hour after liftoff, it made a controlled landing in the Indian Ocean, adding to the day’s achievement. Cameras on a nearby buoy showed flames shooting up from the water as the spacecraft impacted precisely at the targeted spot and sank, as planned.

“What a day,” Huot said. “Let’s get ready for the next one.”

The June flight came up short at the end after pieces came off. SpaceX upgraded the software and reworked the heat shield, improving the thermal tiles.

SpaceX has been recovering the first-stage boosters of its smaller Falcon 9 rockets for nine years, after delivering satellites and crews to orbit from Florida or California. But they land on floating ocean platforms or on concrete slabs several miles from their launch pads — not on them.

Recycling Falcon boosters has sped up the launch rate and saved SpaceX millions. Musk intends to do the same for Starship, the biggest and most powerful rocket ever built with 33 methane-fuel engines on the booster alone.

Musk said the captured Starship booster looked to be in good shape, with just a little warping of some of the outer engines from all the heat and aerodynamic forces. That can be fixed easily, he noted.

NASA has ordered two Starships to land astronauts on the moon later this decade. SpaceX intends to use Starship to send people and supplies to the moon and, eventually Mars.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.



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