Riding with Alpha-20 — on the road in Joburg with a team of paramedics

“I’m so sorry,” says the tearful patient at the back of the ambulance. She has a contusion on her head, and two paramedics are attending to her.

“It’s fine, ma’am,” says one of them, a 24-year-old speaking to someone twice his age while her parents look on. “It’s what we signed up for.”

It’s early on a warm evening in Norwood, Johannesburg, and the walls and trees lining the streets are lit up by red and blue flashing lights. In the back of an ambulance, paramedics Pamela Jwala and Kian van der Walt are treating a woman whose husband, possibly under the influence of drugs, assaulted her.

Private security was first on the scene; the local SAPS took about 40 minutes to arrive. The ambulance — or “bus” as it’s colloquially known — took just eight minutes.

This is Alpha-20’s first call of the evening, and there are about 11 hours left of the shift. These are people who work in a profession we experience only in fragments, at the most desperate times, when our lives — or those of the people we love — are on the line.

“For the patient or the loved ones, it is often the most devastating moment they will face. To stand in that gap and bring care is profoundly meaningful,” says Saul Behrmann, a former paramedic and the CEO of Medi Response, the company whose crew I’m riding along with.

“I always wanted to be a firefighter,” says Jwala, as she sits down for a formal interview. The first call of the night has been completed, and we are trying to squeeze in the formalities before the radio squawks again.

At 33, she’s the oldest of the crew that night. She’s single, and her daughter is home alone while she works the shift. She has held several jobs, but firefighting was her dream.  She volunteered at a fire station — back when fire and paramedic services were combined — but the opportunities dried up, and she followed the paramedic track instead.

“It affects me sometimes when I’m at a scene … but once we sit together and then talk about it … you continue with life,” she says.

Van der Walt (24) is the youngest of the team that evening. Initially reserved, his confidence eventually shines through. He is finishing his law degree, working as a medic part-time. At one point, he ponders whether a life spent exposed to trauma can ever be sustainable: “Maybe it’s not the path to living a happy one of my own.”

Outside, at the tail end of a night at a popular bar, a couple laughs over drinks while TK Netshidzivhani and another medic tend to a patient who collapsed and cracked his head on a table after downing booze and smoking a joint.

Many calls are like this: banal, sometimes absurd. Not everything is a gunshot wound, stabbing, or any of the other violent ills South Africa is plagued with. With no concussion and his vital signs checked, the patient, keen to go home, signs a refusal-for-transport form and is released at no cost.

Expertise

Yet the banality hides expertise. Netshidzivhani is an Extended Care Paramedic — the highest level of pre-hospital qualification, the only cadre permitted to perform rapid sequence intubation, among other advanced procedures. He is 27.

Much of the job is to hurry up and wait. Relief and restlessness intermingle in the break room, its walls pinned with medic memes. “Skeem Saam” flickers on the TV. Four paramedics wear slippers, their boots lined up neatly beside the water cooler. Some of the crew are sprawled on a couch, others are doing paperwork. Netshidzivhani is at “prayer” — napping. They wake easily: the radio cuts through sleep.

The chatter runs the gamut that one would expect from a group of people comfortable with one another and spanning the race and class diversity of Johannesburg: dream cities to live in (none abroad), gossip about colleagues laced with kindness, debates about food. The best bunny chow in the country (Britannia Hotel in Durban). The price of kota and avocados. Netshidzivhani often returns from Limpopo with bags of avocados for the team. Another medic, also from Limpopo, catches grief for never bringing any. The comparison becomes comic: R20 a bag back home, R60 in Bryanston.

If you think South Africans can’t get along despite their differences, the prescribed treatment would be to spend a few nights with a group of paramedics. Race, class, age and training levels all dissolve because of their common cause.

Belonging grows out of necessity, out of trust, out of food shared. What binds them is the work itself and how it strips away the fascia of pretence.

It’s 2.43am and the radio crackles again: a suspected stroke. A young patient, barely into their thirties, can’t type, has facial droop, disorientation and aphasia. It is a high-priority call, yet the crew walks to the “bus” — paramedics never run.

“You don’t rush anything. Rushing leads to mistakes. The time saved just isn’t worth it,” says Van der Walt.

The drive takes 18 minutes, and on this call, the ambulance is as silent as the city. The crew have had maybe an hour of real rest all night. By the time they arrive, another service is already on scene, and the patient is being treated. Gloves go on regardless — readiness is muscle memory, and if they can help, they will.

Gender-based violence, guns, crashes, stabbings — everything spills into the ambulance eventually, and sometimes it takes a toll. “We are also human beings … we get tired, we get exhausted, and sometimes we do need a break,” says Jwala.

She wishes that people understood that paramedics are merely human beings. “They believe we can perform miracles … we would like them to believe that once we get there, the situation will change.”

The shift winds down. The city outside begins to stir. Inside the ambulance there is silence again, and fatigue.

“We are scared sometimes,” says Jwala, “but somebody has to do it. If not you, somebody has to do it.” DM