PLEASE REMOVE THE NUMBER PLATE AND OBSCURE THE PATIENT'S FACE. Claudine says she does not want to talk to us or be identified in any way (not even where she lives) Claudine Senekal/The Ladysmith Herald A severely dehydrated patient is placed on the "bin" of the emergency response vehicle after medical personnel were called out to her Northern KZN home. She had to wait more than four hours before an ambulance was made available.

Durban - A shortage of working ambulances has forced state paramedics in parts of KwaZulu-Natal to take patients to hospital in their rapid response bakkies.

The “emergency bakkies” are double-cab vehicles fitted with canopies.

Medical equipment is kept in the back of the bakkies while patients are having to be transported on the back seats.

State paramedics in Estcourt and Ladysmith said the makeshift ambulances had been used for the past two months after many of the ambulances had broken down.

The KwaZulu-Natal Department of Health has admitted that a recent change in the government fleet service provider had resulted in “some challenges”, including the time taken for repairs and maintenance to vehicles.

However, it preferred to describe the bakkies as “rapid response vehicles”, saying they had “full medical equipment and personnel trained to intermediate life support levels”, said the department’s spokesman, Sam Mkhwanazi.

They did not confirm or deny the allegations and said that they needed more information on the alleged incidents where the injured were transported to hospital using these vehicles before they could comment.

12 broken

Paramedics said they were used to stabilise patients at the scene of an accident, and then normally an ambulance would be used to transport patients to hospital.

“There are… 12 (or) 13 broken-down ambulances in Estcourt, leaving only one for us to use,” said one of the area’s paramedics, who cannot be named because he is not authorised to speak to the media.

Some had problems with their shocks, brakes or tyres, while others were accident-damaged, he said.

The Emergency Medical Rescue Services (EMS) response vehicles, from the town’s four bases, took patients to the Estcourt Provincial Hospital, he said.

He claimed the bases were also not adequately resourced.

Ladysmith had three working ambulances, “but they also serve a large area and need more vehicles”, the source said.

He said seven ambulances were being repaired and in the meantime, EMS teams were forced to use their emergency response bakkies to transport patients to hospital.

The paramedic said transporting patients to hospital on the back seats of double-cab bakkie was not, strictly speaking, against safety protocols.

“We only do this with patients who are suffering minor injuries, because the bakkie is too small and cramped for seriously injured patients. It’s very inconvenient.”

He said that their equipment was kept in the back of the bakkies.

“We have been making enquiries (with the KZN Department of Health) since the beginning of April but we never get any straight answers.

“They always give us the run-around.”

He added: “This is obviously affecting the staff’s morale and their ability to do their jobs.”

When asked what would happen if there were several accidents in the same vicinity at the same time, he sighed and said:

“Well, what can we do? We’ll have to assess the situation, prioritise the condition of the patients, and queue them up accordingly.”

The paramedic said he and the team had been managing so far but worried about bigger accidents, especially those involving minibus taxis.

“If there are over six or seven injured, that could be a disaster for us,” he said.

Mkhwanazi said a new service provider had taken over responsibility for the government’s fleet of vehicles from April 1.

“This includes the servicing, repair and maintenance of these vehicles.

“The service provider is also responsible for the authorisation mechanism (call centre) for the provision of these services.”

The Daily News asked the department for details of the service provider to find out if the service provider had perhaps been subcontracting to other companies and why the process had been delayed, and was referred to the national Treasury. By the time of publication the Treasury could not provide the necessary details.

Mkhwanazi said one of the challenges of the new system was the turnaround time on the servicing and maintenance of vehicles.

“For example, uThukela District, which includes the areas referred to in your enquiry, operates 19 ambulances, but currently 13 ambulances are available,” he told the Daily News.

“The province of KwaZulu-Natal is currently in discussions with the top management of the new service provider to improve their systems, so as to ensure that service delivery is not compromised.”

Mkhwanazi said while the affected towns had not had major or multiple accidents at the same time, paramedics were taught how to handle such situations, including prioritising casualties and taking those with life-threatening injuries to hospital first.

“Ambulances may return to the scene to ferry the remainder of casualties until the scene is cleared,” he said, describing this as normal practice.

“Furthermore, aeromedical services will be summoned to assist in such an incident.”

Asked about the use of emergency bakkies, Mkhwanazi said that the department needed more information – such as details of patients involved, the location and time they were used, as well as particulars of the vehicle – before it could comment.

The Daily News reported in February that state medics were being forced to work without essential supplies such as surgical gloves, gauze and bandages.

The department at the time denied knowledge of it. A paramedic had said that they had been faced with the problem since November.

Last year the department came under fire after a glitch over the supply of oxygen to ambulances in the province.

Daily News