The gut-wrenching realities of medical evacuations

In recent years, the NSRI has seen a rise in the need to perform medical evacuations (medevacs) for injured or ill crew members aboard large vessels like container ships and tankers.

Positioned along key global shipping routes, South Africa's ports – including Richard’s Bay, Durban, East London, Gqeberha, Mossel Bay, Cape Town and Saldanha – are frequently called upon for urgent rescue medevac operations. The growing complexity of these missions has driven the creation of specialised maritime extrication (MEX) training, empowering crews to execute rescues with safety and precision.

The complexity of medevacs

Medevacs conducted by the NSRI are multi-faceted operations requiring precise coordination, physical endurance, and technical expertise. Large ships, often 200 to 300 metres long and towering several storeys above the water, create significant challenges for rescue crews. The smaller NSRI vessels must come alongside these moving giants while dealing with rolling seas. Crews must then climb rope ladders to board the ships – a feat requiring substantial fitness and skill.

The process becomes even more complicated when dealing with casualties who cannot be easily transported. Injured casualties may need to be stabilised in confined spaces before being carefully extracted using high-angle rope systems and techniques. These intricate operations involve setting up raising and lowering systems, establishing secure anchor points, and safely transferring the patient to the waiting rescue vessel. Given the inherent dangers, rigorous training is essential to ensure the safety of both rescuers and patients.

Specialised MEX training

The NSRI has developed a structured MEX training programme to prepare for these high-risk rescues. Training is conducted at multiple levels:
- Basic Rope Work and On-Station Training: Volunteers receive foundational training in rope handling, knot tying, and basic rescue techniques. This training ensures that all personnel have a baseline understanding of essential safety measures.
- Level 1 Training: Volunteers who complete Level 1 training are qualified to assist in medevac operations. They help with rigging systems, securing safety lines, and providing logistical support during rescues.
- Level 2 Training (Train-the-Trainer): More experienced rescuers advance to Level 2 training, where they learn to manage complex operations, oversee anchor placements, and ensure all safety protocols are followed. These individuals also train new recruits, expanding the NSRI’s capability across different stations.

Training is ongoing, with multiple courses held annually. Additionally, station-specific training is provided for unique rescue scenarios, such as cliff rescues in the Plettenberg Bay/Wilderness Search and Rescue areas.

Medevacs in action

The importance of this specialised training is evident in recent medevac missions.

Gqeberha: A high-angle extraction from an oil tanker

On 22 March, NSRI Gqeberha evacuated a 32-year-old crewman from an oil tanker 10 nautical miles offshore. The crewman had sustained serious injuries from a fall. Two NSRI MEX technicians and a paramedic were transferred onboard. The patient was stabilised and secured into a Stokes basket stretcher before being lowered using the ship’s crane and a high-angle rope system. Once safely aboard the NSRI vessel, the patient was transported to the hospital.

Durban: Cruise liner evacuation

On 13 March, NSRI Durban was alerted to a medical emergency aboard a cruise liner involving a 71-year-old woman suffering from a medical condition. The next day, a rescue team and Red Line Ambulance Services paramedic rendezvoused with the vessel offshore. The patient was assessed on board, and as her condition was stable, the ship was permitted to dock in Durban, where paramedics took over her care.

Mossel Bay: Fishing hook incident

On 5 March, NSRI Mossel Bay assisted a 20-year-old fisherman who had suffered a hand injury when a fishing hook lodged deep into his left hand. The vessel, 80 nautical miles offshore, made its way toward Mossel Bay while NSRI launched a rescue craft. Meeting the vessel 16 nautical miles offshore, NSRI medics transferred the patient and transported him safely to the hospital for further treatment.

Preparedness and precision

Medical evacuations conducted by the NSRI are some of the most complex and high-risk operations rescue crews undertake. From navigating treacherous seas to executing high-angle extractions, these missions demand precision, skill, and resilience. Thanks to specialised MEX training, NSRI teams are well-equipped to handle these challenges, ensuring injured seafarers receive the critical care they need as swiftly and safely as possible. With training programmes evolving, the NSRI remains dedicated to safeguarding lives along South Africa’s vast coastline.