Emergency medical services in South Africa are a public/private system aimed at the provision of emergency ambulance service, including emergency care and transportation to hospital.
Organization
Land Ambulance
Emergency ambulance service is provided by each South African province. The government-operated ambulance system, also known in the Western Cape as METRO (Medical Emergency Transportation and Rescue Operations) provides emergency medical care as well as various rescue options (land, air and sea) to the public. In addition to the paid responders, the government system is supplemented in many areas by volunteers. In cases where volunteers are used, the standards for operation are set by the provincial Health Department, which also provides vehicles, equipment, and operating expenses. Operations are normally administered at the local level through the Emergency Management Service, which oversees police and fire protection as well. The co-location of ambulances with fire apparatus is common in South Africa, although they are two independent services. The national emergency number for ambulances in South Africa is 10 177.
These publicly operated services are supplemented by multiple private-for-profit ambulance companies, NetCare 911 and ER24, of which operate locally and nationally. The statutory services and private companies are further supplemented by voluntary ambulance services, including the South African Red Cross, and St. John Ambulance. All are required to meet the same standards as the public services with respect to staff qualifications. These services are self-dispatching and do not participate in the national emergency number scheme.
Air Ambulance
Public and Private air ambulance service is provided by the multiple private aircraft charter companies throughout the country.
The system operates both helicopters and fixed wing turboprop aircraft.
These contracts(Tenders) is provided by each Province on a yearly basis to all respective service providers.
Rescue
Technical Rescue services is for the most part provided by the local Fire Service of each municipality. However, due to the reduction in service, much of this has been taken over by volunteer organisations. Who work alongside the South African Air Force since the high altitude dictates the use of military specification helicopters. Carrying out the technical rescue needs in each province in conjunction with the South African Police Service Search and Rescue Division.
Standards
Training
In South Africa there are currently 3 different levels of proficiency in Short course training:
BAA or Basic Ambulance Assistant – This is a Basic Life Support (BLS) certification, and approximately the equivalent of the US EMT. This is the minimum qualification to be a crew member of an ambulance in South Africa. Training includes a 160-hour course consisting of lectures and practical simulations. The lectures cover basic anatomy and physiology, basic life support (including both CPR and first aid), emergency care, the use of ambulance equipment, including Automated External Defibrillators (AED), and various medico-legal issues. This qualification is no longer offered in the country since 2017. Existing Practitioners are allowed to continue their supervised practise.
This qualification has now been changed to:
ECA or Emergency Care Assistant – a One year Full-Time study at college or University This is currently a Basic Life Support (BLS) certification containing the scope of the Ambulance Emergency Assistant qualification with a few additions. Excluding the ability to Practise Emergency Medicine Independently. This qualification is Registered as Supervised practise and Graduates register under the ECA register with the HPCSA.