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.
WINNIPEG – Some 250 coloured tacks pepper a large-scale world map among bookshelves at Whodunit Mystery Bookstore.
Estonia, Finland, Japan and even Fenwick, Ont., have pins representing places outside Winnipeg where someone has ordered a page-turner from the independent bookstore that specializes in mystery and crime fiction novels.
For 30 years, the store has been offering fans of Agatha Christie’s Hercule Poirot or Arthur Conan Doyle’s Sherlock Holmes a place to get lost in whodunits both old and new.
Jack and Wendy Bumsted bought the shop in the Crescentwood neighbourhood in 2007 from another pair of mystery lovers.
The married couple had been longtime customers of the store. Wendy Bumsted grew up reading Perry Mason novels while her husband was a historian with vast knowledge of the crime fiction genre.
At the time, Jack Bumsted was retiring from teaching at the University of Manitoba when he was looking for his next venture.
“The bookstore came up and we bought it, I think, within a week,” Wendy Bumsted said in an interview.
“It never didn’t seem like a good idea.”
In the years since the Bumsteds took ownership, the family has witnessed the decline in mail-order books, the introduction of online retailers, a relocation to a new space next to the original, a pandemic and the death of beloved co-owner Jack Bumsted in 2020.
But with all the changes that come with owning a small business, customers continue to trust their next mystery fix will come from one of the shelves at Whodunit.
Many still request to be called about books from specific authors, or want to be notified if a new book follows their favourite format. Some arrive at the shop like clockwork each week hoping to get suggestions from Wendy Bumsted or her son on the next big hit.
“She has really excellent instincts on what we should be getting and what we should be promoting,” Micheal Bumsted said of his mother.
Wendy Bumsted suggested the store stock “Thursday Murder Club,” the debut novel from British television host Richard Osman, before it became a bestseller. They ordered more copies than other bookstores in Canada knowing it had the potential to be a hit, said Michael Bumsted.
The store houses more than 18,000 new and used novels. That’s not including the boxes of books that sit in Wendy Bumsted’s tiny office, or the packages that take up space on some of the only available seating there, waiting to be added to the inventory.
Just as the genre has evolved, so has the Bumsteds’ willingness to welcome other subjects on their shelves — despite some pushback from loyal customers and initially the Bumsted patriarch.
For years, Jack Bumsted refused to sell anything outside the crime fiction genre, including his own published books. Instead, he would send potential buyers to another store, but would offer to sign the books if they came back with them.
Wendy Bumsted said that eventually changed in his later years.
Now, about 15 per cent of the store’s stock is of other genres, such as romance or children’s books.
The COVID-19 pandemic forced them to look at expanding their selection, as some customers turned to buying books through the store’s website, which is set up to allow purchasers to get anything from the publishers the Bumsteds have contracts with.
In 2019, the store sold fewer than 100 books online. That number jumped to more than 3,000 in 2020, as retailers had to deal with pandemic lockdowns.
After years of running a successful mail-order business, the store was able to quickly adapt when it had to temporarily shut its doors, said Michael Bumsted.
“We were not a store…that had to figure out how to get books to people when they weren’t here.”
He added being a community bookstore with a niche has helped the family stay in business when other retailers have struggled. Part of that has included building lasting relationships.
“Some people have put it in their wills that their books will come to us,” said Wendy Bumsted.
Some of those collections have included tips on traveling through Asia in the early 2000s or the history of Australian cricket.
Micheal Bumsted said they’ve had to learn to be patient with selling some of these more obscure titles, but eventually the time comes for them to find a new home.
“One of the great things about physical books is that they can be there for you when you are ready for them.”
This report by The Canadian Press was first published on Sept. 15, 2024.
MONTREAL – Canada’s labour minister is praising both Air Canada and the union representing about 5,200 of its pilots for averting a work stoppage that would have disrupted travel for hundreds of thousands of passengers.
Steven MacKinnon’s comments came in a statement shared to social media shortly after Canada’s largest air carrier announced it had reached a tentative labour deal with the Air Line Pilots Association.
MacKinnon thanked both sides and federal mediators, saying the airline and its pilots approached negotiations with “seriousness and a resolve to get a deal.”
The tentative agreement averts a strike or lockout that could have begun as early as Wednesday for Air Canada and Air Canada Rouge, with flight cancellations expected before then.
The airline now says flights will continue as normal while union members vote on the tentative four-year contract.
Air Canada had called on the federal government to intervene in the dispute, but Prime Minister Justin Trudeau said Friday that would only happen if it became clear no negotiated agreement was possible.
This report from The Canadian Press was first published Sept. 15, 2024.
When it comes to plant-based alternatives, Canadians have never had so many options — and nowhere is that choice more abundantly clear than in the milk section of the dairy aisle.
To meet growing demand, companies are investing in new products and technology to keep up with consumer tastes and differentiate themselves from all the other players on the shelf.
“The product mix has just expanded so fast,” said Liza Amlani, co-founder of the Retail Strategy Group.
She said younger generations in particular are driving growth in the plant-based market as they are consuming less dairy and meat.
Commercial sales of dairy milk have been weakening for years, according to research firm Mintel, likely in part because of the rise of plant-based alternatives — even though many Canadians still drink dairy.
The No. 1 reason people opt for plant-based milk is because they see it as healthier than dairy, said Joel Gregoire, Mintel’s associate director for food and drink.
“Plant-based milk, the one thing about it — it’s not new. It’s been around for quite some time. It’s pretty established,” said Gregoire.
Because of that, it serves as an “entry point” for many consumers interested in plant-based alternatives to animal products, he said.
Plant-based milk consumption is expected to continue growing in the coming years, according to Mintel research, with more options available than ever and more consumers opting for a diet that includes both dairy and non-dairy milk.
A 2023 report by Ernst & Young for Protein Industries Canada projected that the plant-based dairy market will reach US$51.3 billion in 2035, at a compound annual growth rate of 9.5 per cent.
Because of this growth opportunity, even well-established dairy or plant-based companies are stepping up their game.
It’s been more than three decades since Saint-Hyacinthe, Que.-based Natura first launched a line of soy beverages. Over the years, the company has rolled out new products to meet rising demand, and earlier this year launched a line of oat beverages that it says are the only ones with a stamp of approval from Celiac Canada.
Competition is tough, said owner and founder Nick Feldman — especially from large American brands, which have the money to ensure their products hit shelves across the country.
Natura has kept growing, though, with a focus on using organic ingredients and localized production from raw materials.
“We’re maybe not appealing to the mass market, but we’re appealing to the natural consumer, to the organic consumer,” Feldman said.
Amlani said brands are increasingly advertising the simplicity of their ingredient lists. She’s also noticing more companies offering different kinds of products, such as coffee creamers.
Companies are also looking to stand out through eye-catching packaging and marketing, added Amlani, and by competing on price.
Besides all the companies competing for shelf space, there are many different kinds of plant-based milk consumers can choose from, such as almond, soy, oat, rice, hazelnut, macadamia, pea, coconut and hemp.
However, one alternative in particular has enjoyed a recent, rapid ascendance in popularity.
“I would say oat is the big up-and-coming product,” said Feldman.
Mintel’s report found the share of Canadians who say they buy oat milk has quadrupled between 2019 and 2023 (though almond is still the most popular).
“There seems to be a very nice marriage of coffee and oat milk,” said Feldman. “The flavour combination is excellent, better than any other non-dairy alternative.”
The beverage’s surge in popularity in cafés is a big part of why it’s ascending so quickly, said Gregoire — its texture and ability to froth makes it a good alternative for lattes and cappuccinos.
It’s also a good example of companies making a strong “use case” for yet another new entrant in a competitive market, he said.
Amid the long-standing brands and new entrants, there’s another — perhaps unexpected — group of players that has been increasingly investing in plant-based milk alternatives: dairy companies.
For example, Danone has owned the Silk and So Delicious brands since an acquisition in 2014, and long-standing U.S. dairy company HP Hood LLC launched Planet Oat in 2018.
Lactalis Canada also recently converted its facility in Sudbury, Ont., to manufacture its new plant-based Enjoy! brand, with beverages made from oats, almonds and hazelnuts.
“As an organization, we obviously follow consumer trends, and have seen the amount of interest in plant-based products, particularly fluid beverages,” said Mark Taylor, president and CEO of Lactalis Canada, whose parent company Lactalis is the largest dairy products company in the world.
The facility was a milk processing plant for six decades, until Lactalis Canada began renovating it in 2022. It now manufactures not only the new brand, but also the company’s existing Sensational Soy brand, and is the company’s first dedicated plant-based facility.
“We’re predominantly a dairy company, and we’ll always predominantly be a dairy company, but we see these products as complementary,” said Taylor.
It makes sense that major dairy companies want to get in on plant-based milk, said Gregoire. The dairy business is large — a “cash cow,” if you will — but not really growing, while plant-based products are seeing a boom.
“If I’m looking for avenues of growth, I don’t want to be left behind,” he said.
Gregoire said there’s a potential for consumers to get confused with so many options, which is why it’s so important for brands to find a way to differentiate themselves, whether it’s with taste, health, or how well the drink froths for a latte.
Competition in a more crowded market is challenging, but Taylor believes it results in better products for consumers.
“It keeps you sharp, and it forces you to be really good at what you’re doing. It drives innovation,” he said.
This report by The Canadian Press was first published Sept. 15, 2024.
