Our knowledge of EMS management around the world never stops. For our “EMS in the World” section, this time we focused on Africa and the activity which emergency services provide in the country. In particular, the following article is going to explain the activity of the National Department of Health of South Africa throughout the nation. The Head of Emergency Services for the government, Raveen Naidoo explains what they do every day to save lives.
- How is EMS service structured in South Africa?
“EMS service is regulated by National Health Act and health service structure in South Africa is managed and implemented at provincial level. Our service is mainly provided by the government, but of course there are also private organizations which provide emergency services, especially in urban settings.”
“In terms of clinical provision we have various registration categories of personnel within the country: basic ambulance assistance, ambulance emergency assistance, paramedics, emergency care technicians and emergency care practitioners. EMS education and trainings in the country start with a short course system, then it develops into a formal system, in order to prepare students to education in university and public sector colleges. EMS education and training policy was recently approved and that makes provision for 1 year high certificate, 2 year diploma and a 4 year bachelor degree in emergency medical care. We also have a master degree and a PHT degree. The labels of provision is determined in consultation with the profession looking at what is the best evidence to support the clinical practice and that is done and is regulated under the Health Profession Council of South Africa. More specifically we have a professional board for Emergency Care, which provides regulations for the practice of emergency care provided. In particular it guides the ethical conduct of individuals and emergency service practices according to the cathegory of professionals.”
- How does the ambulance dispatch work?
“On an ambulance you should have somebody that is at least intermediate life support qualified, but we don’t have enough professionals like them, so if it is not a we are in the process of moving a basic ambulance life support which is dispatched to the patient by now. Currently, what happens if a person call the govern number 10177, which in future will be integrated to the 112 national emergency number? It will access the local emergency medical dispatch communication center. The center receives the call and the dispatchers check which is the nearest available ambulance and will dispatch the unit. If it is a major scenario like multiple casualties, like many car accidents, they will also dispatch an advanced life support unit and they look after extra resources that may be needed.
- How many ambulances or vehicles you dispose of?
“The complete fleet counts around 5.000 vehicles in the whole South Africa. About the remote areas, we also cover mountain zones and zones with poor routes thanks to 4×4 vehicles. In case emergency is particularly serious, there is the Air Ambulance Service which may be dispatched. In case the response times are going to be longer, and if the issue is to minimize the time of response, patients that can be carried and helped are transported by local people to specific pick-up points. If we have an incident for instance in the mountains, once activated all the emergency services, the challenge is being able to assist the patient, also because of all agencies involved. In case of multiple casualties in remote areas, we will be also combined to multiple emergency services in South Africa to be able to provide that level of care.”
- You said you also cooperate with an Air Ambulance Service. How is this partnership organized?
“We have not a government service, but a contract service with a private air medical service in the country; each province will engage a contract in air medical service within that geographic area and they provide emergency response service, or better, flying doctor service. In particular we have contract with an air ambulance service in each province. Generally this service provides care in rural areas where there is a lack of EMTs or in case, we may provide a rescue service in the air medical services. And it can be provided by helicopter service and it can be a day service or combined day-night service that we are able to offer 360 day per year, basically.”
“In south africa the EMS is provided by Health Government. Fire services and Civil defence are provided by local government organizations localized in different areas. In some cases happens that ambulance service is combined with fire service and civil defence for the efficience but mainly these services are not combined. Even if they all are services under government supervision, they are not combined among each other.”
- Do you have some project to improve emergency support throughout the country in the future?
“We are very optimistic about that, because we are going to publish very defined emergency medical services regulations which will regulate all the provision of ambulance services. We are now going to be working on promotion of regulations which all regulate the emergency medical services providers so they will be standards for equipments, for vehicle designs, for provisions, they behave the organization etc. So this is an exciting development and it will include private services as well so every one will operate the same standards.”