News and Business
ER24’s Site Based Medical Solutions provides medical support to more than 23 industrial sites, mines, and remote projects that don’t have full emergency medical services or basic healthcare facilities.
Peter van der Merwe, the manager of ER24’s Site Based Medical Solutions , which employs over 220 medics and paramedics nationwide, explains what’s involved in providing emergency medical services at mines and other remote locations where it can be challenging and even hazardous for rescue teams to work.
With a background as a paramedic firefighter, Van der Merwe has worked in emergency medicine for over 30 years, including more than 10 years in the Middle East. In 2013, he returned to South Africa and joined ER24 as a road paramedic, later becoming branch manager at the Johannesburg North branch.
“In mid-2015, I moved to the site-based team as the Site-Based Manager,” he says. “I’ve been here ever since, overseeing the day-to-day operations of all our projects.” His role includes handling administration, travelling often, interacting with clients, delivering contracts, and helping the business grow, making sure everything runs smoothly. “It’s a high-demand job, often requiring 12- to 16-hour days,” he says.
To keep things running efficiently, Van der Merwe has eight managers reporting to him. “Each site has its own manager, and where there are smaller sites, we adjust accordingly.”
Custom solutions at diverse sites
Among the sites the team serves are multiple mines, including Mponeng, the deepest mine in the world. They also work on solar farms, at airports, and in corporate settings like the Johannesburg Stock Exchange. One of the more remote places they work at is the Square Kilometre Array (SKA), an international radio telescope project located in a remote area near Carnarvon in the Northern Cape.
“Wherever a client has a site where they require their own medical infrastructure, medics, paramedics, vehicles, equipment, first aid rooms and associated services, we come in,” Van der Merwe explains. The Site Based Medical Solutions team assesses what clients need and creates a customised solution for them.
“We work closely with the occupational health and safety teams on site,” Van der Merwe continues. Clients and teams working on mines must follow the key performance indicators (KPIs) set by the Department of Minerals and Energy, which are regulated by the Mine Health and Safety Act. Regular businesses follow the rules under the Occupational Health and Safety Act.
Although teams may manage health and safety efforts, the places they work usually need paramedics and medics on site for emergency situations, especially in case of injuries. “Since they’re often so remote, to get someone to what we call ‘definitive care’, like a hospital, might take hours,” Van der Merwe says.
This sometimes requires evacuation via helicopter or aeroplane. “When we see the patient, they’re at the absolute worst they’ll ever be,” he adds. “You’re the first point of contact for that patient, and you’ve got to start the treatment right then and there.”
Skills for extreme conditions
Working in harsh, remote areas with limited resources means Site Based Medical teams need to be physically fit, mentally strong, and resilient. Since they might be hours away from a hospital, they often stay in contact with the patient much longer than a typical paramedic would and provide expert care, usually with little support.
“We don't micromanage,” says Van der Merwe. “We need people who are competent, comfortable in their own skin, can work independently and who can reach the patient and start the initial treatment.”
Clients want the patient to get the best treatment possible onsite, at the hospital and throughout the rehabilitation process so they are fit to return to work as soon as possible. “We want to limit the time that the person is offsite as much as possible because the client can’t afford to have a depleted workforce,” Van der Merwe explains.
Depending on where they’re based, paramedics and medics might need extra skills beyond their usual medical training to deal with tough conditions. For example, some sites may involve working at great heights, requiring rope rescue or fire training. In other cases, teams are trained to handle rescues in trenches or tight spaces.
Some mine-based paramedics or medics work underground most of the time where they can treat and extract patients, says Van der Merwe. However, there is usually a specialised proto rescue team, called the underground mine emergency rescue team, who reach the patient and transfer them to a safe area for treatment.
“In a road operations scenario, paramedics work in a more controlled environment with all resources available. However, on a mine, it could take you an hour- and-a-half just to get access to the patient, and then another hour- and-a-half just to get the patient out. If it’s a serious case in a remote location, you may have to call a helicopter or an airplane to evacuate the patient.”
For reasons like these, working in Site Based Medical Solutions is a tough job that requires passion and dedication, Van der Merwe says.