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.
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. (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.
TORONTO – Will Taylor Swift bring chaos or do we all need to calm down?
It’s a question many Torontonians are asking this week as the city braces for the arrival of Swifties, the massive fan base of one of the world’s biggest pop stars.
Hundreds of thousands are expected to descend on the downtown core for the singer’s six concerts which kick off Thursday at the Rogers Centre and run until Nov. 23.
And while their arrival will be a boon to tourism dollars — the city estimates more than $282 million in economic impact — some worry it could worsen Toronto’s gridlock by clogging streets that already come to a standstill during rush hour.
Swift’s shows are set to collide with sports events at the nearby Scotiabank Arena, including a Raptors game on Friday and a Leafs game on Saturday.
Some residents and local businesses have already adjusted their plans to avoid the area and its planned road closures.
Aahil Dayani says he and some friends intended to throw a birthday bash for one of their pals until they realized it would overlap with the concerts.
“Something as simple as getting together and having dinner is now thrown out the window,” he said.
Dayani says the group rescheduled the gathering for after Swift leaves town. In the meantime, he plans to hunker down at his Toronto residence.
“Her coming into town has kind of changed up my social life,” he added.
“We’re pretty much just not doing anything.”
Max Sinclair, chief executive and founder of A.I. technology firm Ecomtent, suggested his employees avoid the company’s downtown offices on concert days, saying he doesn’t see the point in forcing people to endure potential traffic jams.
“It’s going to be less productive for us, and it’s going to be just a pain for everyone, so it’s easier to avoid it,” Sinclair said.
“We’re a hybrid company, so we can be flexible. It just makes sense.”
Swift’s concerts are the latest pop culture moment to draw attention to Toronto’s notoriously disastrous daily commute.
In June, One Direction singer Niall Horan uploaded a social media video of himself walking through traffic to reach the venue for his concert.
“Traffic’s too bad in Toronto, so we’re walking to the venue,” he wrote in the post.
Toronto Transit Commission spokesperson Stuart Green says the public agency has been working for more than a year on plans to ease the pressure of so many Swifties in one confined area.
“We are preparing for something that would be akin to maybe the Beatles coming in the ‘60s,” he said.
Dozens of buses and streetcars have been added to transit routes around the stadium, and the TTC has consulted the city on potential emergency scenarios.
Green will be part of a command centre operated by the City of Toronto and staffed by Toronto police leaders, emergency services and others who have handled massive gatherings including the Raptors’ NBA championship parade in 2019.
“There may be some who will say we’re over-preparing, and that’s fair,” Green said.
“But we know based on what’s happened in other places, better to be over-prepared than under-prepared.”
Metrolinx, the agency for Ontario’s GO Transit system, has also added extra trips and extended hours in some regions to accommodate fans looking to travel home.
A day before Swift’s first performance, the city began clearing out tents belonging to homeless people near the venue. The city said two people were offered space in a shelter.
“As the area around Rogers Centre is expected to receive a high volume of foot traffic in the coming days, this area has been prioritized for outreach work to ensure the safety of individuals in encampments, other residents, businesses and visitors — as is standard for large-scale events,” city spokesperson Russell Baker said in a statement.
Homeless advocate Diana Chan McNally questioned whether money and optics were behind the measure.
“People (in the area) are already in close proximity to concerts, sports games, and other events that generate massive amounts of traffic — that’s nothing new,” she said in a statement.
“If people were offered and willingly accepted a shelter space, free of coercion, I support that fully — that’s how it should happen.”
This report by The Canadian Press was first published Nov. 13, 2024.
TORONTO – Hundreds of Taylor Swift fans lined up outside the gates of Toronto’s Rogers Centre Wednesday, with hopes of snagging some of the pop star’s merchandise on the eve of the first of her six sold-out shows in the city.
Swift is slated to perform at the venue from Thursday to Saturday, and the following week from Nov. 21 to Nov. 23, with concert merchandise available for sale on some non-show days.
Swifties were all smiles as they left the merch shop, their arms full of sweaters and posters bearing pictures of the star and her Eras Tour logo.
Among them was Zoe Haronitis, 22, who said she waited in line for about two hours to get $300 worth of merchandise, including some apparel for her friends.
Haronitis endured the autumn cold and the hefty price tag even though she hasn’t secured a concert ticket. She said she’s hunting down a resale ticket and plans to spend up to $600.
“I haven’t really budgeted anything,” Haronitis said. “I don’t care how much money I spent. That was kind of my mindset.”
The megastar’s merchandise costs up to $115 for a sweater, and $30 for tote bags and other accessories.
Rachel Renwick, 28, also waited a couple of hours in line for merchandise, but only spent about $70 after learning that a coveted blue sweater and a crewneck had been snatched up by other eager fans before she got to the shop. She had been prepared to spend much more, she said.
“The two prized items sold out. I think a lot more damage would have been done,” Renwick said, adding she’s still determined to buy a sweater at a later date.
Renwick estimated she’s spent about $500 in total on “all-things Eras Tour,” including her concert outfit and merchandise.
The long queue for Swift merch is just a snapshot of what the city will see in the coming days. It’s estimated that up to 500,000 visitors from outside Toronto will be in town during the concert period.
Tens of thousands more are also expected to attend Taylgate’24, an unofficial Swiftie fan event scheduled to be held at the nearby Metro Toronto Convention Centre.
Meanwhile, Destination Toronto has said it anticipates the economic impact of the Eras Tour could grow to $282 million as the money continues to circulate.
But for fans like Haronitis, the experience in Toronto comes down to the Swiftie community. Knowing that Swift is going to be in the city for six shows and seeing hundreds gather just for merchandise is “awesome,” she said.
Even though Haronitis hasn’t officially bought her ticket yet, she said she’s excited to see the megastar.
“It’s literally incredible.”
This report by The Canadian Press was first published Nov. 13, 2024.
OTTAWA – Via Rail is asking for a judicial review on the reasons why Canadian National Railway Co. has imposed speed restrictions on its new passenger trains.
The Crown corporation says it is seeking the review from the Federal Court after many attempts at dialogue with the company did not yield valid reasoning for the change.
It says the restrictions imposed last month are causing daily delays on Via Rail’s Québec City-Windsor corridor, affecting thousands of passengers and damaging Via Rail’s reputation with travellers.
CN says in a statement that it imposed the restrictions at rail crossings given the industry’s experience and known risks associated with similar trains.
The company says Via has asked the courts to weigh in even though Via has agreed to buy the equipment needed to permanently fix the issues.
Via said in October that no incidents at level crossings have been reported in the two years since it put 16 Siemens Venture trains into operation.
This report by The Canadian Press was first published Nov. 13, 2024.
