By Hannah Zhihan Jiang

Dozens of Mamelodi community members waited outside the local fire station on Wednesday for the unveiling of 255 new Emergency Medical Services (EMS) vehicles for Gauteng. The community knows the pain of ambulances arriving late or not at all due to chronic shortages in the province.

Scepticism rolled off Dimakatso Modebi, a 29-year-old mother from extension 5 of Mamelodi, Tshwane, as she stood with arms crossed watching as Gauteng Premier Panyaza Lesufi and Health MEC Nomanttu Nkomo-Ralehoko arrived to present the vehicles.

Modebi has been directly affected by the ambulance shortage. Two years ago, she was forced to make her own way to a clinic to deliver her daughter as the ambulance never arrived.

Modebi told Health-e News her frustration made her attend the briefing.“Most of the time, if you call an ambulance, maybe around 7pm, it will arrive at four in the morning,” she says.

When she had contractions and needed to deliver her daughter two years ago, she says the ambulance did not come soon enough so she had to make her own way to a nearby clinic.

“We had to go from our homes to the streets to look for transport. We had to pay 150 rands.”

Small dent to ambulance shortage

During the briefing, the Gauteng Department of Health (GDoH) unveiled 255 new EMS response vehicles ahead of the Easter long weekend when traffic is expected to increase.

The newly acquired vehicles will be allocated to all five districts of Gauteng Province, according to GDoH. The vehicles will include Intermediate Life Support, Gauteng Scheduled Emergency Transport, ICU, Primary Response Cars and Violent Incident vehicles.

The Gauteng Province as well as the entire country has been suffering from a shortage of EMS vehicles, says Gauteng EMS Operational Director Reuben Ruiters.

The government aims to have one ambulance per 10 000 people, which would require more than 1 600 ambulances in Gauteng. Ruiters says the province currently has just over 900. With the 255 new vehicles, the number will add up to about 1 100.

Govt needs to double its EMS fleet nationally

In December 2022, Health Minister Joe Phaahla told the parliamentary portfolio committee South Africa has 3 342 ambulances. But 967 of these were out of service due to accidents or maintenance. For the government to fulfil its ambition of one ambulance per 10 000, it needs to almost double the fleet.

The average response times for an ambulance in Gauteng last year ranged between 30 to 60 minutes. Eight minutes is regarded as the international standard response time for ambulances.

The addition of vehicles to the EMS fleet comes as South Africa heads into the Easter long weekend. The 2023 Easter will be the first in three years to be held with no COVID-19 restrictions, which were repealed by the South African government in June 2022.

The National Transport Department recorded 162 national fatalities with 24 in Gauteng during the 2022’s Easter period and 235 national fatalities with 36 in Gauteng in 2021. These were decreases from the 2018 Easter period before the COVID-19 pandemic, which witnessed 510 national deaths, 89 of which were in Gauteng.

Communities urged to keep EMS workers safe

Both MEC Nomantu Nkomo-Ralehoko and Premier Panyaza Lesufi in their addresses urged the community to protect the first responders operating the emergency vehicles.

At least 24 incidents of violent attacks on emergency workers in Gauteng were recorded in the past two years, which included robbery and hijackings.

“Don’t hijack these cars when they are meant to assist you. We have so many cases where our workers are scared to go to certain areas because they feel they are not safe. All these cars are here for one thing and one thing only: to save lives,” says Lesufi.

For a sceptical Modebi, it remains to be seen whether the addition of new EMS vehicles will make a difference to her and her community. “We should not put our hopes that high. Maybe sometimes it’s for show, sometimes it’s for us.”

New EMS systems and technology 

JP Von Benecke, deputy director of special operations of the EMS, demonstrated to Health-e News the new operating systems and technology of the unveiled EMS vehicles.

1) Gauteng Scheduled Emergency Transport

“For lower acute patients, like walking wounded, who don’t need to get to hospitals right away, they can go to a hub, and they know that at 10 o’clock the vehicle will come across and they can use the vehicle to access the hospital,” says Benecke.

Since 75% of the total call volume are not urgent incidents, says Benecke, sending emergency vehicles to every call takes up medical resources. The new scheduled transport system will run like a train or bus service for patients who do not need urgent medical care.

2) Newly equipped ICU ambulances that support premature childbirth

New ambulances are equipped with mobile ICUs with medications that allow the vehicles to transfer patients needing critical medical care from one hospital to another if necessary.

One significant improvement, Benecke says, is the advanced newborn incubators installed in the ambulances. The old incubators were only safe for healthy babies. For newborns who are low weight or premature, Benecke says they have a greater need for ventilation. Previously, the paramedics would “play around with” pressure, which Benecke says is risky.

“There’s more space in the new ambulances. The practical layout of the incubators is more workable.”

3) Riot Transport

The Riot Transport vehicles are prepared for violent attacks during service delivery protests or for areas difficult to access such as muddy terrain and barricaded roads. Some vehicles were covered with shields to protect them from throwing rocks, while others were designed to be bulletproof.

Benecke said his vehicle was attacked a week ago with a window broken through. No one was hurt in the incident.

“Riot Transport” – New EMS vehicles prevent violent attacks against paramedics (Photo : Hannah Zhihan Jiang)

Protestors disturb presser, demand permanent healthcare jobs

Protesters demand permanent jobs for temp health workers hired during the COVID-19 pandemic (Photo: Lilita Gcwabe)

Lesufi and Nkomo-Ralehoko came face to face with disgruntled health workers affiliated with the Health & Allied Workers Indaba Trade Union. Several protestors encircled the Premier and the MEC as they entered the tent.

The protestors stood up and chanted in the middle of MEC Nkomo-Ralehoko’s speech, accusing the Health Department of ignoring their demands. They called on the GDoH to permanently hire healthcare workers who were temporarily employed during the COVID-19 pandemic.

The MEC addressed the workers during her speech, reiterating the department did not have the budget to extend the temporary contracts. One protestor close to the podium shouted, “If you have no money, where do you get these cars? You must hire the health workers.”Lesufi told protestors he was ready to meet with them. No date has been set for this meeting. – Health-e News