Awareness and First Aid
ER24 manages a 24/7 emergency helpline dedicated to rugby injuries. A player shares his experience.
ER24 manages the South African Rugby Union’s (SARU) BokSmart Spineline – a 24/7 dedicated emergency helpline for serious head, neck, and spinal injuries in rugby. One player shares how he benefitted from this initiative.
The game that changed everything
For Thembekile Mnana, 24 May 2025 started like any other rugby Saturday. “I was back on the field at Pretoria Rugby Club, representing my beloved Eersterust Rugby Club (Highlanders) after a five-year hiatus,” he says. “Since starting rugby in Grade 8 back in 2008, the sport has become my passion. It demands discipline – no more Friday night parties when you need to perform on Saturday morning.”
Mnana works in the construction industry and had taken a break from rugby because of career commitments. “But by January 2025, I was ready to return to the game,” he says. “I was fit, had been training hard, and felt prepared to contribute wherever the coach needed me – flyhalf or centre. Little did I know this comeback would lead to a life-altering moment.”
When a rugby tackle goes wrong
Twenty minutes into the match, the first team’s flyhalf was injured and Mnana was given the opportunity to show his mettle on the field. Then came the tackle that changed everything. “I can’t remember much about what happened,” he says. “All I know was that the impact was severe, I fractured my skull, and I sustained a brain injury.”
ER24’s role in the BokSmart Spineline programme
ER24 manages the BokSmart Spineline, SARU’s 24/7 emergency helpline for serious head, neck and spinal cord rugby injuries. As part of the national BokSmart Rugby Safety Programme, ER24 provides on-field medical care and urgent hospital transfers where needed, whether at school, club, or professional matches, ensuring access even when none is otherwise available.
As Heinrich Africa, ER24 Clinical Performance Operations Specialist, explains, “Our main focus is on concussions, head injuries, and spinal injuries due to their severity and because they’re potentially difficult to identify. ER24 paramedics will look for signs and symptoms such as confusion, unsteadiness, irritability, dazed appearance, or seizures for suspected concussions, or screen for traditional signs and symptoms of a potential spinal cord injury.”
To qualify for this service, the injury must be reported directly to the BokSmart Spineline on the dedicated number 0800 678 678. ER24’s emergency resource officers (EROs) at the Contact Centre will assess the injury and quickly send an ambulance with the right crew and equipment to assist – unless there is already an appropriate ambulance on standby at the rugby match – in which case the ambulance personnel on site would need to stabilise and transport the injured player.
Appropriate care pathways
Although the immediate aftermath is still a blur, Mnana knows he was rushed by ambulance to the hospital, where he had an MRI and was admitted for a week. “My family tells me I could recognise visitors and call them by name, but I don’t remember anything of the first few days,” he says.
Four weeks later, Mnana consulted Dr Andrew Mathole, a neurosurgeon and spine specialist at Mediclinic Sandton. He was frank about his patient’s situation – and his future in rugby. “You can’t take another knock,” he said. “Another significant head injury could have catastrophic consequences. You need to hang up your rugby boots.”
Finding new purpose
“My recovery brought its own challenges,” Mnana says. “Initially, I experienced double vision and had issues with my left eye appearing ‘lazy’. These symptoms gradually improved, but they served as constant reminders of how serious my injury had been. I’m so grateful that after two months off work, I’ve made a full recovery.
“I don’t have any headaches or ongoing memory loss beyond that lost week in the hospital. The healing surprised everyone, including my medical team, friends, family, and colleagues.
“While I can’t return to playing rugby, I’m exploring ways to stay involved in the sport I love through coaching. I’m also coaching our community league soccer team. I’m very grateful to the BokSmart Spineline for activating the correct care pathways for me.”