Responding to emergencies in remote towns: Insights from ER24 Kuruman

Life in outlying areas may offer peace and quiet, but sometimes when emergencies happen, access to medical care can be a challenge. 

Victor Phooko, ER24 Kuruman Branch Manager, and Shihaam Carlsen, an ER24 paramedic, share their experiences—both the rewards and the challenges—of providing emergency care in these communities.

Challenges in providing healthcare in remote areas

One of the most significant difficulties is simply locating the address of the incident. According to Victor, "In remote areas, there aren't always street names, and Google Maps often doesn't have accurate information. The roads to the address we're assigned can prove a challenge." Once they reach the scene, the nearest hospital can be over 100 km away or more than an hour's drive. Even with a swift response, the journey is long, making pre-hospital emergency care crucial. When a patient requires specialist medical care or is in critical condition, and road transport isn’t an option, helicopter transport becomes a vital alternative.

As a Kuruman resident, seeing the occasional wild animal may be a welcome treat, but in Shihaam's experience as a paramedic, it can be an occupational hazard. "We've got the additional challenges of donkeys, cows, or kudus walking onto the road as well, especially when time is of the essence."

The most common injuries or incidents in rural communities

Motor vehicle accidents are, unfortunately, the most prevalent issue in remote areas. Caused by various factors, such as bad lighting on high-speed roads like the N14 and the R31, which run through Kuruman.

The importance of community support

Working in these remote communities wouldn't be possible without the help of the residents, who play an essential part in helping paramedics reach patients in need. Shihaam shares the ways they work together with the locals.

"Community support is critical in remote areas. For example, when we often arrive at the scene, we'll see that it's the community that called the ambulance and not necessarily the patient. This is usually because the community or the neighbour had seen a change in the patient's behaviour or hadn't seen the patient for that day. In addition, the community also sometimes assists us with directions to a patient's home or provides us with the closest landmarks that help us timeously locate the scene of the collision. Many areas in Kuruman don't appear on Google Maps as easily as in a bigger city. Hence, we rely a lot on the community to explain where the patient stays, where the specific area is or where this village might be." Victor agrees with the valuable role the community plays, allowing medics to deliver essential care.

Overcoming logistical challenges

"In terms of vast distances, we respond as quickly and as safely as possible, but in some instances, I have formed relationships with our ER24 mine-based ambulance services, where they bring the patient closer to us, provide immediate care, and we take over from them and continue care and transport to the hospital. Safety is key when it comes to poor road conditions because the only way to deliver quality care is if we make it there safely. For network issues, our PTT radio always seems to have a network where our cell phones don't; for inter-branch communications, it's never such a big issue. Issues arise when we can't reach the callers, so we just always have to constantly watch on our cell phones for just that one bar of the network," Victor explains.

Despite the many challenges, working in areas like Kuruman has plenty of positives. Victor notes that one of the most rewarding parts of his job is the cooperation they experience from other emergency services and the community.

Curious about the shift from a bustling city like Cape Town to a remote town like Kuruman? Catch Shihaam Carlsen’s experience in our next article.