Fig. 3

Trauma facilities in the nine provinces of South Africa. Six provinces have one or several trauma centers. With limited numbers of trauma centers, most patients do not go directly to a major facility and require subsequent transfer delaying definitive care. The government “primary health care” approaches are somewhat restrictive. Private services will often take the patient to a more appropriate facility due to cost-drivers. The country is well covered by helicopter Emergency Medical Service: four private companies (Netcare, ER24, HALO-aviation, LenMed) and one non-profit company, the Red-Cross AMS which operates in Cape Town, Oudtshoorn and Kwazulu-Natal. All are equipped for advanced life support and difficult access (mountain or sea rescue and high-rise rescue). Staffing is either doctor-paramedic or dual paramedic emergency care practitioner level