From 27 March to 26 August this year, the NSRI conducted 269 operations around the country. These included assisting 202 people in distress, performing 46 medical evacuations, 44 vessel tows and 27 transfers, and rescuing 20 animals in distress. A total of 348 people, animals and vessels have been assisted since the beginning of lockdown, and this number continues to rise as volunteers continue to respond to a diverse range of call-outs.
Before Level 5 lockdown, the NSRI was already on high alert. Following global warnings about the particular voracity of Covid-19, the high rate of infection and the ever-increasing fatalities worldwide, it was inevitable that South Africa would follow suit with stay-at-home orders for the general public, and the establishment of sound personal protective equipment (PPE) and personal protective behaviour (PPB) protocols for essential and medical personnel, including those working in rescue services.
Standard operating procedures
It was time to adapt, and adapt quickly. NSRI’s Lifeguard Training Coordinator and advanced life support paramedic Stewart Seini was part of the task force whose role it was to outline the PPE and PPB for crews going on call-outs. Information gathered from extensive research, international organisations, national government and their own medical knowledge, was used to formulate best practices in the form of standard operating procedures (SOPs) which included the appointment of safety officers, who concentrated on donning (putting on) and doffing (taking off) PPE procedures, and sound debriefing protocols.
‘The rescue operations that the volunteers perform are complex enough and require a significant amount of training,’ Stewart explains. ‘What the SOP does is add another major layer to the operation … so these procedures have be comprehensive enough to keep the crews safe, but at the same time created in such a way that they can be implemented easily and efficiently in an emergency situation.’ Two categories were formulated: one for crew going into high-risk situations and one for low-risk situations. Medevacs, for instance, could pose a high-risk environment. Dr Tome Mendes, a surgical registrar at Groote Schuur Hospital and Class 1 coxswain at Station 3 (Table Bay) was part of the crew that responded to a casualty suffering chest pains, who had then collapsed, on a fishing trawler some 20 miles off Llandudno, Table Bay, Cape Town, on 1 May. That was the extent of the information they were given, but the crew was well trained in Covid-19 precautions and familiar with the SOP. ‘One of the key elements was limiting crew numbers to the absolute minimum, as well as allocating clear crew roles early on,’ Tome explains. ‘In general, once the patient was on board we would split into two groups: one that would manage the patient and one that would focus solely on running the vessel without becoming exposed to the patient.’
Station 3 launched with two Metro paramedics onboard, and once they rendezvoused with the vessel, Tome noted that all the fishing vessel’s crew were wearing masks and making attempts to socially distance themselves from one another. The casualty, while stable and able to walk, presented with a fever and complained of muscle weakness. He explained he had been feeling unwell and experienced shortness of breath for a few days, but had no known exposure to anyone with Covid-19. He was made comfortable and adequately warmed on the aft deck of the rescue vessel, with Tome keeping a watchful eye on him.
He remained stable for the 1.5-hour transfer to the base and the Metro ambulance personnel on scene were alerted that the patient had failed the initial Covid-19 screening. He was transported to the a local hospital for assessment. It turned out that the casualty tested positive for Covid-19. ‘This just emphasised how prevalent the virus was becoming and how we can never let our guard down. Ironically, even though I had been working in a hospital, he was the first confirmed positive patient that I had been directly exposed to,’ Tome says.
‘I contacted each of the crew involved and informed them of the result. I debriefed with each one and we went through any potential moments where they may have felt exposed on the call-out and any immediate concerns they had. Although there was the expected anxiety, overall all of the crew felt comfortable that they had taken all appropriate precautions and, as a result, all of us were considered to be “low-risk” exposures and only needed to monitor symptoms for two weeks. Only one crew member developed symptoms, but fortunately tested negative. The remainder of the crew and Metro medics all remained asymptomatic and at the end of the two weeks everyone was immensely relieved,’ Tome explains.
A further 45 medevacs were conducted during the last five months, including a joint operation between Station 5 (Durban), Station 6 (Port Elizabeth) and the SA Air Force 15 Squadron to evacuate a casualty suffering a compound leg fracture from a vessel offshore of Algoa Bay. Station 5 was also activated to render medical assistance to a crewman of a crude oil tanker offshore of Durban Harbour. The casualty was transferred to the Alick Rennie, brought to shore from where he was transported to hospital. On the West Coast, Transnet National Ports Authority requested assistance from Station 4 (Mykonos) to evacuate an injured fisherman from a vessel near the entrance of Langebaan Lagoon.
Creatures great and small
With SOPs in place, NSRI crews quickly became used to operational best practices, remaining safe and vigilant during all rescue operations performed. Animals – big and small – were assisted: whale disentanglements took place in Agulhas and Kommetjie, a juvenile flamingo, whom the Port Alfred crew fondly called ‘Frank’, was rescued at Kleinemonde and transported to SANCCOB in Port Elizabeth; and Port Edward crew in conjunction with the KZN Marine Animal Stranding Network assisted a beached juvenile elephant seal, going as far as to guard him during the night to prevent humans or domestic or other animals from harming him. (‘Buddy’, as he was named, returned to the water the followed morning and swam away.)
More people out and about
With lockdown restrictions easing, water and nature lovers have returned to paddling, hiking and beach activities. In Herold’s Bay, a hiker trapped on a particularly slippery and treacherous rock was airlifted to safety in a joint operation between Station 23 (Wilderness) and the Western Cape Department of Health EMS/AMS rescue helicopter, and a local lifeguard saved the life of a teenager who was swept out to sea by a rip current. In this instance a group of bystanders had thrown the youngster a Pink Rescue Buoy that helped him stay afloat until the life guard was able to reach him. In Cape Town, on False Bay’s infamously fickle coastline, a paddler was swept off course while attempting the Reverse Miller’s Run. After activating SafeTRX, the NSRI was alerted to his plight and they reached him amid a swirling mass of swell in good time.
‘We never stopped working’ really sums up the last five months of NSRI operations. Crews remain rescue-ready, with protocols in place for every eventuality. Virtual platforms have been extended to facilitate more crew training, and drowning-prevention and water-safety messages continue via radio, TV, online lessons, via community leaders, as well as WhatsApp and other online learning platforms. The NSRI collective will simply say ‘It’s what we do!’
Call the NSRI’s Emergency Operation Centre on 087 094 9774 or 112 from your cellphone.
Go to https://www.nsri.org.za/wp-content/uploads/2018/10/2018-Emergency-Number-Province.jpg to download the list of NSRI bases around the country.