Life support is urgently needed for the Emergency Medical Services (EMS) in KwaZulu-Natal, according to a recent report, which found that more than half of of the ambulances had exceeded their replacement mileage, there are more than 300 vacant posts, and the communication centre lacks a computer-aided dispatch system, relying instead on manual processes.
In addition, reports IOL, infrastructure in several districts is grossly inadequate: many EMS bases still operate from deteriorating temporary park homes, with paramedics having to contend with shocking conditions.
The findings were revealed in the 2025 Health Functionality Monitoring Programme oversight report on the province’s emergency medical services, tabled last week by Health Portfolio Committee chairperson Dr Imran Keeka.
The committee had visited and assessed 32 EMS bases, headquarters, and 11 communication centres, and concluded that the entire EMS system was under significant operational pressure.
Keeka said the province has 487 ambulances, but more than half of them should have been replaced, resulting in frequent mechanical breakdowns and reduced fleet availability.
“The committee noted that the province operates significantly below the national norm of one ambulance per 10 000 population,” he added.
Only slightly more than 56% of the vehicles were operational, according to the report, with repair delays ranging between three and six months.
The hundreds of vacancies include shortages of advanced life support practitioners, operational supervisors, and shift leaders, and additionally, because of the antiquated communications centre relying on manual processes, real-time co-ordination and emergency response times – which nationally should be within 30 minutes in urban areas and 60 minutes in rural areas – were badly affected.
Keeka said the committee had made recommendations to strengthen EMS functionality, and these were part of a turnaround plan to be tabled at upcoming meetings.
“These include accelerating the replacement and expansion of the fleet, introducing a modern computer-aided dispatch system, prioritising the construction of purpose-built EMS bases, urgently filling critical vacant posts, particularly specialised emergency care, strengthening planned patient transport services to reduce pressure on emergency vehicles and ambulances, ensure adequate budget allocation to support fleet renewal, infrastructure development, and human resource capacity.”
MK Party MPL Nompumelelo Gasa said 1 189 operational ambulances were needed, but the existing fleet was way below that, and the conditions in which paramedics worked were disgraceful.
“In Phongolo, they work out of a single park home. There is no kitchen. Men and women share one toilet. There are no showers. In Msinga, the base is a prefab structure on the verge of collapse. In uMlazi, the EMS base used to be public toilets,” Gasa said.
DA MPL Shontel de Boer said that of the 3 052 approved provincial EMS posts, just 2 731 are filled, leaving 321 technical vacancies. Some abolished posts due to budget cuts are not registered as vacancies in the Persal system.
Supervisory capacity is a major concern, with 89 of 167 shift leader positions vacant, significantly hindering 24-hour operational oversight.
Operational staff shortages include 179 vacant intermediate life support posts, 132 basic life support posts, one emergency care systems post, three emergency care technician positions, and 42 emergency care practitioner posts.
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