Backlash against a whistle-blower

Andrew Nikiforuk
The Globe and Mail
May 19/07

For years, Dr. John O'Connor has made headlines by continually asking why natives near the oil sands have so much cancer.

But that's not the only reason he's in such hot water now.

FORT CHIPEWYAN, ALTA. - When John O'Connor, a diminutive and soft-spoken Irish-born family physician, began his weekly visits to Fort Chipewyan, a picturesque community on the shores of Lake Athabasca, he never expected that eight years later he would be fighting for his professional life.

Located near Wood Buffalo National Park and once Canada's richest fur-trading post, Fort Chipewyan looks like an idyllic place. But the elders soon started to tell their new doctor stories of deformed fish and bleeding muskrats and how an unusually high number of local people had been "taken with cancer." Dr. O'Connor says he couldn't help but wonder what was happening in the settlement of 1,000 that sits near the mouth of the Athabasca River about 300 kilometres downstream from the largest capital project in the world: the northern Alberta oil sands. In 2005 alone, half the community's 14 deaths were due to various cancers.

"Is it genetics, lifestyle, the environment or just bad luck?" he recalls asking himself. "What's going on? Where could the origin be?" He had practised medicine in Fort McMurray, at the heart of the oil sands, since 1993, and had never seen such problems in the city. "I can't explain it." Since then, his concern for the health of his native patients has led to many sleepless nights as well as an open battle with the Alberta government over the lack of medical resources in the service-challenged Northern Lights Health Region, where 14 family doctors care for 80,000 people. Now, he finds himself the subject of an unusual investigation by the College of Physicians and Surgeons of Alberta that could compromise his future. A ruling could come down at any moment, and he feels that he's in such dire straits that he has decided to pack up and leave the province altogether.

The hunters, trappers, fishermen and oil-sand workers of "Fort Chip" seem flummoxed by what's happening to their doctor, who works 80 hours a week, but his colleagues feel the case is politically motivated. "This is not about shutting up John; this is about shutting him down," charges Dr. Michel Sauve, a respected Fort McMurray internist.

"There should be whistle-blowing protection for doctors." And that seems to be the root of the problem. As well as asking pointed questions about cancer causes, Dr. O'Connor, the region's chief of family medicine, has spent much of the past few years criticizing the shortage of medical resources as well as the carnage on the road to Fort McMurray, a stretch so deadly it has become known as Hell's Highway.

Yet he didn't start to speak up in earnest about his patients in Fort Chip until 2004, when he diagnosed a middle-aged patient with a very rare bile-duct cancer known as cholangiocarcinoma. He knew it well because his father had died of the same disease in Ireland. "It's vicious and fast." It's also strongly associated with chemical pollution, including arsenic and polycyclic aromatic hydrocarbons or PAHs, a group of carcinogens discharged by oil-sand mining, which now produces a million barrels of oil a day - half the nation's gasoline supply - and gives Ottawa more than $6-billion a year in taxes.

Normally, this form of cancer occurs in one in 100,000 people.

So, when Dr. O'Connor found another case the following year, as well as clusters of immune-system disorders, in a community of just 1,000 people, he called for an independent study. "Am I seeing a problem, or am I not?" he asked officials.

He wasn't the first to ask for a study. The fact that uranium mines, now abandoned, pulp mills and the oil sands have flushed chemicals into Lake Athabasca for decades prompted scientists to seek a survey of health in the region in 1999. Three years later, two Fort McMurray doctors asked again for a comprehensive health study on behalf of several first nations.

Finally, in 2004, Alberta's oil regulator, the Energy and Utility Board, recommended a study. But Alberta Health and Health Canada started working on one only after a CBC reporter asked Dr. O'Connor early last year why there were so many cases of cancer in Fort Chip.

The story made The National , and five months later the agencies released a statistical analysis, albeit one that had not undergone a peer review, which kept it from being deemed first-rate research.

The report found that, from 1995 to 2005, the community's cancer rates "were comparable to the provincial average," although officials agreed the incidence of bile-duct cancers -- by this point, five cases in the North Lights alone -- was "provocative." Dr. O'Connor challenged the thoroughness of the analysis while people in Fort Chipewyan expressed deep skepticism. In response, Alberta Health accused him of having withheld cancer reports. "Either there is no evidence, or he has decided to ignore the law," charged provincial spokesman Howard May.

Expressing disbelief at the charge, Dr. O'Connor said: "I haven't received any requests for information. I don't know what they are talking about." In an independent analysis, well-known Alberta ecologist and statistician Kevin Timoney also found the provincial study to be deeply flawed.

"It's difficult to find a significant result in a small sample size," he explained. Because missing just one case would skew the results, "statistics offer a blunt tool for detection of elevated cancer rates" in such a small community.

Mr. Timoney also found widespread evidence of chemical contamination in the Athabasca River. According to data collected by a government and industry group known as the Regional Aquatics Monitoring Program (RAMP), the levels of PAHs in the river's sediment now resemble those found at highly contaminated sites in the United States.

A RAMP report last year also found that 7.4 per cent of fish from the river had growth abnormalities. "That's high," says Mr. Timoney, who is now conducting an extensive water-quality study for the community's local health board.

Frustrated by government unwillingness to conduct a proper health study, Dr. O'Connor announced in December that he plans to leave Fort McMurray this summer and move to Nova Scotia. Then he caused an even bigger sensation by writing in an emotional letter to Halifax's Chronicle Herald newspaper that life in Fort McMurray is "intolerable." He also warned Atlantic Canada workers not to expect to come west and find a family doctor or affordable housing when they get here.

"The quality of life," he said, "is extremely low." Because of the letter, Dr. O'Connor admits, "a lot of people in administration thought I was the worst thing that had happened to the town." After all, the provincial government was in the middle of a campaign to recruit more health-care workers to a region that it says has "the most severe" gaps in care.

Within weeks, three employees of Health Canada, one from Alberta Health and another from Environment Canada had filed a complaint against Dr. O'Connor with the College of Physicians and Surgeons.

According to one source, the bureaucrats have accused him of "irresponsible actions" and "raising undue alarm among the public." His concerns about contamination, they said, have left the people of Fort Chipewyan "fearful of the places they live in and their traditional foods." Asked why government employees would take such a drastic step, a Health Canada spokesperson stated via an e-mail simply that health professionals of all sorts are obliged to report on "professional practice issues." However, the timing of the complaint has led Dr. Sauve and other local doctors and nurses to conclude that the federal and provincial governments wanted to silence an outspoken critic of the area's industrial growth. The college normally reviews complaints made by patients, Dr. Sauve explains, and shouldn't be used as "a state tool for censoring doctors." The "fearful" people of Fort Chipewyan, meanwhile, contend that they have voiced concerns about cancer rates and water pollution for years. When the wind is right, they can smell the oil-sands plants, and now carry filtered water into the bush when hunting.

Margaret Simpson, a 60-year-old Dene and Catholic lay priest, says that in 2005 she often buried two people a week. "What is happening here? It drove me nuts," she says, describing Dr. O'Connor as her friend as well as her physician.

"It's not fair what's happening to him. Maybe they are trying to keep him quiet about something they don't want known." Raymond Ladouceur, a 65-year-old commercial fisherman who says he routinely pulls deformed fish from the lake, echoes her sentiment.

"These guys who accuse him of agitating the community should apologize.

Let O'Connor do his job. He is concerned about life and we support him. The whole community does." Five years ago, Mr. Ladouceur says, he sent 200 pounds of pickerel riddled with tumours, bulging eyes, crooked tails and pushed-in faces to Fort McMurray for testing he hoped would determine what has been going wrong.

But provincial officials didn't pick up the fish, he says, and they were left to rot in a truck.

Andrew Nikiforuk is an award-winning Calgary journalist. Next month, he will be among the speakers at an Alberta Environmental Network conference on water in the Athabasca Basin, as will Dr. John O'Connor.