SOUTH Africa has a critical shortage of qualified paramedics. It is a scarce skill, with a total of just under 2 300 qualified Advanced Life Support paramedics.
To grow the number of professional paramedics in this country, Nelson Mandela University has been offering its Bachelor in Emergency Medical Care (BEMC) programme since 2014 – and on 24 April, celebrates its very first 15 graduates.
The university is one of just four tertiary institutions offering the qualification in South Africa.
“The need for paramedics is massive,” said Nico Louw, who heads up the university’s BEMC programme. “There is one paramedic for every 22 000 of the population. In the Eastern Cape, that ratio is even worse: one paramedic to 120 000 people.” Fourteen of the 15 graduates have chosen to work in the Eastern Cape.
Louw is quick to point out that paramedics are different from ambulance staff, who only need to complete a four-week course in Basic Life Support to qualify for an entry-level job. They can go on to complete a three-month Intermediate Life Support course after working 1 000 hours. However, Louw says there are over 100 000 people with the basic qualification and just 16 000 with the intermediate qualification.
“There is an over-supply of staff with the basic qualification, and not enough of those with a higher qualification … This is one of the concerns of our profession.”
Should someone with an intermediate qualification go on to complete a further 10-month Advanced Life Support course, after completing 1 000 working hours, they would then qualify as paramedics – however, these days, this three-tiered short course system is being phased out in favour of a three-tiered tertiary qualification structure, namely one and two-year higher certificate and diploma programmes and the four-year degree course. This is part of a drive by the Department of Health to elevate the level of education of all Emergency Care personnel in South Africa.
Louw said while a paramedic’s skills were essential, they were not easy – and the university tries to prepare the students for any situation through a series of endurance events during their studies.
“Our working environment is unique. It’s outside, in the sticks, in the gutter, in the valley, on the beach, in the surf, in hotels, in flats, in shacks – that’s where we go to treat patients. Our students have to step outside of their comfort zones, physically, mentally, emotionally and psychologically. You often get right up into a patient’s personal space, so much so that the smell of your breath matters and your sweat could drop onto a patient.”
The endurance events students must complete include “Vasbyt” (loosely translated as “keep on going”), a 36-hour endurance event, where first-year students are dropped off and have to hike, swim or paddle from point A to point B, some 60 to 70km away.
Second-year students must complete “Masiphakameni”, which Louw calls “the 48-hour shift from hell”.
“Never will they ever experience a worse shift than this. It starts at 7am, on campus. We give them many realistic yet challenging simulated calls. For example, they’re being dispatched to the 14th floor of the university’s main building, but the lift is not working so they need to take the stairs. They have to resuscitate the patient, package him for the journey down the stairs, load him into an ambulance and hand him to the campus clinic staff, acting as the receiving hospital.
“As they complete the task, they receive the next call. A guy has fallen off his mountain bike in the university’s nature reserve and is immobile. They have to go and search for him on foot, package him and carry him out, as the terrain does not allow for a vehicle to drive in. Then the next call comes. Patients are trapped on the first floor of a burning building. There are no stairs. They have to use a ladder to move the patients from the first floor, and it goes on and on.
“Like any realistic shift, the last call always comes in when least wanted: 30 minutes before the shift is over, just when they think it’s all over.”
In third year, the students embark on a “Wilderness search and rescue hike”, where they spend five days in the mountains in a simulated search for lost hikers, working in partnership with the Air Force, the Mountain Club of South Africa and the SAPS dog unit.
“In fourth year, we simulate an international rescue mission scenario,” said Louw, who himself has assisted in international emergencies, including rescue efforts in Nepal in 2015, following a devastating earthquake.
“It is dangerous to be a paramedic – and there have been many instances where paramedics have been targeted by criminals, while on the job.
“Even if South Africa were a first world country with no crime, the stuff we do is dangerous,” he said.
Despite this, he is passionate about the profession and about training tomorrow’s practitioners. “I was an industrial engineer before … I only made the change at 27. The moment I started studying EMC, I knew this was what I was supposed to be doing.”
“I love what I do and am thrilled to be celebrating our first BEMC graduates at Nelson Mandela University.”