The Eastern Cape health department is grounded and without an air ambulance service until September.
The health department argued before the Bhisho high court that unless its preferred air ambulance service provider, Black Eagle-Leli Investments joint venture, was allowed to operate, the government would not meet its constitutional obligation to provide emergency health services to the province’s people.
But after judge Philip Zilwa on June 1 suspended a November 2020 interdict and permitted the JV to operate the air ambulance service, health procurement officials bungled contracting the operator.
Black Eagle told officials it could only start work on September 1, leaving the province without an air ambulance service for the month of August.
The fiasco emerged as temporary replacement service provider SA Red Cross Air Mercy Services (AMS) announced its final Eastern Cape wheels-up for last Saturday.
The end of AMS’s seven-month stopgap contract saw crews and aircraft vacating the provincial Emergency Medical Services (EMS) bases in East London, Mthatha and Gqeberha, with aircraft returning to the non-profit organisation’s headquarters at Cape Town international airport.
By Sunday morning, the helicopter hangar at the East London EMS base in Vincent was deserted and AMS corporate services executive Farhaad Haffejee said: “We have now officially withdrawn from the Eastern Cape.”
Provincial health deputy director for human resources Tsokodi Ntsoane, speaking on behalf of health acting head of department Mahlubandile Qwase, said the notice period for Black Eagle to deploy was short and the department deemed it reasonable to give them further time.
After the 2020 interdict obtained against Black Eagle by fellow bidder NAC, EMS awarded an interim contract to AMS in December 2020, initially for three months, which was extended for three months and then, in line with Zilwa’s suspension of the interdict, for another month.
Ntsoane said that “due to supply chain processes, that [AMS] contract could no longer be extended”.
He said the immediate contracting of Black Eagle was delayed because procurement officials had to follow up on SA Civil Aviation Authority (CAA) certification. This had now been sorted out and the contracting could proceed.
“We are mindful of the fact the air ambulance service is critical and, while we are waiting for the full service from September, we are making arrangements for a partial deployment by Black Eagle during August... especially for the deep rural areas around Mthatha.”
Now suspended health spokesperson Sizwe Kupelo on Friday confirmed Black Eagle would only be operational by September 1, saying AMS should have been informed their temporary contract had been extended. He subsequently said it was agreed with AMS that their teams would remain on the EMS bases.
DA health spokesperson in the provincial legislature Jane Cowley slated the air ambulance mess as “an indictment on a department in serious disarray”.
“Effectively this means there is no air emergency service for the citizens of our province as we speak. Black Eagle are in violation of their contract,” Cowley said, adding it called into question Zilwa’s setting aside of the interdict which prevented the JV from operating “as they were not compliant in terms of all regulations controlling air emergency services”.
It also raised questions around how fairly the original tender process had been conducted.
Government’s latest procurement fiasco put a damper on an otherwise successful stint in Eastern Cape skies by AMS, which flew 400 hours in 300 rescue and mercy missions over the seven-month period.
“It was our privilege to provide a quality aeromedical service to strengthen our national health system to ensure that healthcare reaches all communities in the deepest rural areas of our country” CEO Dr Philip Erasmus said.
In a detailed statement put out before the debacle emerged, the 50-year-old aeromedical organisation said it had trained 100 EMS crew members to CAA-level for air ambulance operators to provide safe and efficient aeromedical services.
This is a requirement for working in this field and was done through a special AMS training unit and mobile teaching centre.
Specialised training was also provided for “external load operators”, who must work on the helicopter platform to insert rescuers to extricate patients from confined spaces, rough terrains or surf swells.
The ELO must assist the pilot to identify and avoid hazards in flight, communicate instructions and crucial information to the pilot, and monitor the safety of rescuers and the patient when on board the aircraft or connected to the rescue systems.
The training includes the operation of helicopter rescue systems, in-flight emergencies, rescue techniques and confined space landings.
Erasmus said the introductory ELO programme, if carried through, would have introduced “a full professional civilian rescue service in the province”.
The AgustaWestland helicopters deployed in the province had a dedicated specialised medical intensive care interior, with capacity for two pilots, three crew members and one stretcher patient, including mother-and-baby transport.
Helicopter pilot Franco Ponticelli, who was based at the EMS Mthatha base, described his stint on the contract as “challenging, amazing flying, while being at the service of people who need it most”.
Erasmus said: “We hope that someday we are able to return and introduce a bouquet of comprehensive aeromedical services, which includes outreach services to bring healthcare to marginalised communities.”
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