To be honest i don't know why these guys can't get their act together and "control" their borders just like other countries do...the requirement is physical presence only...so its not mandatory for citizenship purposes to "drive" or "go to a doctor" or "go to work"!!
How about stamping the passports of all PR's on the way in and way out at all borders (including land borders)...just like 3rd world countries do.. rather than to rely on a health card or driver's license to try and guess if someone was in the country or not...