EMERGENCY AND AMBULANCE SERVICES IN SOUTH AFRICA

AT-A-GLANCE

TO CALL AN AMBULANCE IN SOUTH AFRICA DIAL 10177, or 112 (from mobile phones)

  • In past 15 years, South African EMS has moved from isolated fire departments to sophisticated systems of ground and air response
  • Coverage, resources and training vary from highest to lowest standards to none at all
  • EMS personnel in South Africa experience a remarkable spectrum of clinical exposure
  • Recently established specialty in emergency medicine should lead to greater political support and higher quality

Dial 10177 or 112 to Call an Ambulance in South Africa
South Africa EMS Coverage Map

Return to Global EMS Database home page

CAN I CALL AN AMBULANCE IN SOUTH AFRICA?

HOW DO I CALL FOR HELP?

The toll-free number for emergency services in South Africa is 10177.
You can also call 112 from any cellphone.

You will then reach a call centre and they will route you to the closest emergency service. It’s also a good idea to familiarise yourself with the number of the ambulance service (either public or private) in your area and make sure you keep it handy – close to the phone or programmed into your cellphone.

CAN I CALL FOR HELP ANYWHERE?

No. It’s good to know the numbers of private ambulances as well.

South African response has high levels of disparity in coverage.

WHAT OTHER EMERGENCY NUMBERS CAN I CALL?

PRIVATE GROUND AMBULANCE SERVICES IN SOUTH AFRICA

EASTERN CAPE

 

FREE STATE

 

GUATENG

 

LIMPOPO

 

MPUMALANGA

 

NORTHERN CAPE

 

KWAZULU NATAL

 

NORTH WEST

  • Carletonville
  • Klerksdorp
    • DKJ Ambulance Service: +27 72 826 4499
    • Quickcare 24/7: +27 86 123 1233
    • Intensive Medical Response (IMR) Paramedical Services: +27 18 468 5561
  • Lichtenburg
    • Golden Eye Medical Rescue: +27 18 632 4637
  • Potchefstroom
  • Rustenburg
  • Vryburg
    • Gerijo Private Ambulance Service: +27 83 292 9111
  • Wolmaranstad
  • Zeerust
    • Platinum Emergency Care Ambulance: +27 84 954 0818

 

WESTERN CAPE

AIR AMBULANCE SERVICES IN SOUTH AFRICA

WHAT ABOUT IN DISASTERS?
ARE THE RESPONDERS TRAINED?

Training varies according population and socio-economic levels:

  • Public Sector – Insufficient personnel and poorly maintained vehicles and equipment due to financial restraints
  • Private Sector – Growing competence to provide sophisticated pre-hospital care and exceptional clinical expertise

 

TRAINING LEVELS

Basic Ambulance Assistant (BAA):

  • Min 1mo trainingCPR/AED
  • First Aid
  • Basic Vehicle Extrication
  • Packaging Techniques
  • Simple Trauma Mgmt
  • O2, Entonox, Oral Glucose and Activated Charcoal
    • Recommended industry standards: minimum BAA personnel on every EMS vehicle

Ambulance Emergency Assistant (AEA):

  • Experience + 3-4mos. Training
  • Neb Rx for Asthma
  • IV and Fluids
  • IV glucose
  • Aspirin
  • Man. Defib

Critical Care Assistant (CAA):

  • Similar to US Paramedic
  • Experience + 9-12mos. full-time training
  • Extensive emergency medical protocols designed along lines of:
    • PALS
    • ACLS
    • ATLS
  • Advanced Airway Mgmt
  • Synchronized Cardioversion
  • 27 different meds
    • Benzodiazepines
    • IV analgesics
    • Emergency Cardiac meds

National Diploma in Emergency Medical Care:

  • Post-Graduate study
  • Top level of prehospital Emergency care practitioner
  • Dedicated 3yr full-time training programs at specificpost-graduate technical colleges
    • In-depth Anatomy/Physiology
    • Wide range of related disciplines
      • Rescue
      • Communications
  • “They may, in fact, be amongst the best trained paramedics in the world” (Macfarlane, 147)
    • Thoroughness and Extent of Training
    • Significant on-road experience
    • High quality of advanced medical instruction
    • May extend academic training by completing 4thyr and graduating with a Bachelor of Technology degree
HOW WILL I GET TRANSPORTED?

The vehicles used by EMS in South Africa can vary greatly across a broad range. They may be large or small, new or quite old, often driven by local economics. There is no specific current standard for ambulance design in South Africa. Some vehicles comply with either the European standard CEN 1789 or the US standard, KKK-1822, but many meet neither standard. There are even examples of motorcycles with stretcher-carrying sidecars.[17] There is currently a major initiative underway by the government of South Africa to replace much of the aging fleet with new high standard emergency ambulances. Plans call for the replacement of approximately 450 ambulances by 2010.[18]

Source: WIKIPEDIA

Helicopter EMS and other specialized rescue services are also available:

  • Single national coordinating service
  • Run under auspices of Air Mercy Service of the Red Cross
  • 5 dedicated helicopters in the major metropolitan areasJohannesburg 24h twin-engine service was once busiest in world
  • Private-operated fixed-wing air evacuation, both nationally and into sub-saharan AfricaHospitals frequently receive poly-trauma/complicated medical cases from entire Southern African region
WHERE WILL I BE TRANSPORTED TO?
HOW WILL I PAY?

“The amount will depend on how much you earn and on how many dependants you have, according to the hospital rating scale.

At the low end of the scale – that is, if you are unemployed – you will be expected to pay R39 as an outpatient. This will cover your consultation, medication and possible blood or other tests. A pensioner will pay only R13 for the same service. If you are unemployed and need to be admitted, you will pay R194 for up to 30 days.

The maximum a state hospital will charge, if you’re at the top end of the income scale, is R55 for a consultation. However, you will be charged additional amounts for medication and tests. For a stay in hospital, a top-end patient (including those on medical aid) will pay R484.90 per day, excluding medicine and theatre costs.

The government is trying to guide patients away from hospitals to its public clinics and community health care centres – where free primary health care services are available. However, patients on medical aids will be charged.

Specialized treatment and care is available at state hospitals, but waiting lists are often very long, depending on the problem or medical procedure needed. If you have medical aid cover it may be easier to go to a private hospital.”

Source: BrandSouthAfrica.com

 

“A service that has been designed specifically with international visitors in mind is the provision of travel assistance packages, costed at a daily rate, which include emergency assistance. These services include dedicated hotline numbers that can be called in case of an emergency and liaison with visitors’ travel insurers under such circumstances. 

While they are not emergency service providers themselves, they use a network of such providers to respond to clients’ emergency needs.”

Source: country.southafrica.net

ADDITIONAL INFO

GOVERNMENT OVERSIGHT

Lead Agency

Emergency ambulance service is provided by each South African province. The system of government-operated ambulances is generally referred to as ‘Metro’

Source: WIKIPEDIA

Government Oversight

  • March 2004 – Emergency Medicine officially established/recognized as separate medical specialty
  • Gov’t Hospitals
    • Modelled on former UK “Casualty Departments”
    • Significant Patient overload
    • Large number of ambulatory, non-emergent Patients
    • Many are primary health care Patients that have bypassed local clinics
    • Patients s can be impatient, aggressive and can resent more serious cases being attended before them
  • Private Hospitals
    • Well-developed and extensive private sector, many of which have EDs
      • Many EDs are essentially general practices
      • Non-regular presentation of “true emergencies”

Funding

  • Services funded by individual provinces from funds allocated by national gov’t; EMS Care free of charge to all earning below certain threshold

Dispatch

  • Call centers have varied capabilities with more sophisticated using software programs for triage and appropriate vehicle dispatch
  • No formal EMD training courses yet implemented for most call center personnel
  • Response Time Goals
    • Urban – 15mins
    • Rural – 40 mins
      • Greater Johannesburg only reported district to achieve these goals “semi-regularly”
HISTORY
  • 1910 – Act of Union: “The provision of ambulance services was designated to third tier government and thus fell under the local authority. Town clerks (in the interest of their ratepayers) combined firefighting and ambulance services into one service, thus presenting us with the Fire and Ambulance Service. With notable exceptions, and because of a lack of medical control and input the ambulance component of these services tended to lack support and thus problems were experienced with equipment, training and standards” (Dalbock, 1996)
  • Late 1960s – Western Cape Ambulance Services are regionalized and a medical director assumes control of the services
  • 1977 – A national law is passed making provision of ambulance services responsibility of the then four provincial administrations
    • Basic ambulance services begin serving communities within local government boundaries, though services in many parts of country are still unavailable
  • 1980s – Provinces work to develop comprehensive systems, including:
    • Training academies (up to intermediate life support)
    • Strategically located ambulance units
    • Upgrades to communications systems
  • Late 1980s – Services in four major urban centers have advanced care providers and are meeting established international standards, but “these islands of pre-hospital excellence, however, existed in a sea of mediocrity and large areas of the country had rudimentary if any, ambulance services with standards varying tremendously – depending on which service one inspected.” (Dolback, 119)
    • This leads to fragmented services of varying norms and standards, and frustrates reciprocity among prehospital providers between provinces
  • 1992 – Leads to the establishment of the Professional Board for Emergency Care Personnel who ultimately grant national recognition to ambulance practitioners by South African Medical and Dental Council.
  • 1994 – New regulations are passed making it compulsory for all practitioners to register
    • National curricula for emergency care established
  • Great disparity of services available between provinces
    • All have problems with use of services for mild injuries and illnesses
      • Resulting drain on resources
      • Public education, better public transport and availability of more basic patient transport vehicles required
REFERENCES
  • Dalbock C: “A history of ambulance practitioners and services in South Africa.” SA Family Practice 1996;17:118-121
  • Govender K, Grainger L, Naidoo R. “Developing retention and return strategies for South African advanced life support paramedics: A qualitative study.” Afr J Emerg Med. 2013 Feb 21;:1–8.
  • Govender K, Grainger L, Naidoo R, MacDonald R. “The pending loss of advanced life support paramedics in South Africa.” Afr J Emerg Med. 2012 Jun 1;2(2):59–66.
  • Hackland S, Stein C. “Factors influencing the departure of South African advanced life support paramedics from pre-hospital operational practice.” Afr J Emerg Med. 2011 Jun 1;1(2):62–8.
  • MacFarlane C, van Loggerenberg C, Kloeck W: “International EMS Systems: South Africa – Past, Present and Future.” Resuscitation 2005;65:145-8.
  • Newton PR, Naidoo R, Brysiewicz P. “The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa.” S Afr Med J. 2015 Sep 29;105(10):844–4.
  • Stein C, Wallis L, Adetunji O. “Meeting national response time targets for priority 1 incidents in an urban emergency medical services system in South Africa: More ambulances won’t help.” S Afr Med J. 2015 Sep 29;105(10):840–5.
LINKS

SCOREBOARD

% of Seriously Injured Patients Transported by Ambulance in South Africa, 2013

50-74%

[Source: 2013 Global Status Report on Road Safety, WHO]

Road Traffic Injury Deaths
(per 100,000 population)

  • South Africa
  • Russia
  • United States

[Source: 2015 Global Status Report on Road Safety, WHO]

Reported Homicides
(per 100,000 population)

  • South Africa
  • Russia
  • United States

[Source: 2014 Global Status Report on Violence Prevention, WHO-UNDP]

Assaults against paramedics and drivers – 2016

Reported in Western Cape province last year.

[Secondary source: TheNation.ae]

OFFICIAL TWITTER FEEDS

Leave a Comment