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Alex Alvarez, shown in this undated handout photo, is moving from Anchorage, Alaska, to Nanaimo, B.C., to work as a nurse. The Ministry of Health says around 174 American health care workers accepted an offer to work in the province between last May and September after B.C. ramped up its American recruitment efforts. THE CANADIAN PRESS/Handout — Alex Alvarez (Mandatory Credit)