Exploring lived experiences of Gauteng based military pre-hospital emergency care providers during external deployment

Abstract

Introduction The South African Military Health Service (SAMHS) provides multi-disciplinary health care, including emergency medical care (EMC), to the South African National Defence Force (SANDF). Post 1994, the SAMHS pre-hospital emergency care providers (PECPs), in support of SANDF, have been deployed in various external operations and have gained a wealth of combat EMC experience. The challenges experienced during deployment are reported using formal military reports which often do not address the in-depth experiences of individual PECPs during service delivery.

Aim of the study This study aimed to explore and describe the lived experiences of Gauteng based military PECPs when providing EMC during external deployment.

Objectives The study’s objective was to describe the experiences of PECPs working at SAMHS in Gauteng during external deployment.

Methodology The study was conducted using a qualitative, exploratory and descriptive research design guided by a phenomenological approach. Eighteen (18) participants, who had been deployed, were recruited from a study population consisting of 276 military PECPs based at four SAMHS units in Gauteng using a purposive random sampling method. Semi-structured, in-depth individual interviews were conducted and subsequently analysed using thematic analysis.

Results Five themes emerged from the study, namely, the organisational culture of the SAMHS; political situation during external deployment; resources; human resources and safety. The sub-themes that emerged included the challenges reported in formal military reports, tactical decisions that may affect healthcare, harsh environments, political will of the host country, civilian hostility, gaps in what the mandate authorises, prolonged casualty evacuation times, limited resources, unique casualty transportation,

mental stress, lack of trauma care experience, task overload, training expectations and inadequate guarantee of safety.

Conclusion The findings of this study indicated that the Gauteng based military PECPs interact well and receive a high degree of group support from their co-workers. This decreases the morbidity and mortality of their patients during external deployment. However, they also reported feelings of anger and frustration because of unresolved challenges arising from previous deployments, inappropriate casualty transportation and inadequate leadership. They further reported that the limited transportation and the political situation in the host country during deployment contributed to both stress and feeling unsafe. The findings also indicated a low rate of service delivery by military PECPs which negatively affects the maintenance of human resources and which may, thereafter, adversely affect the success rates of external missions conducted by the SAMHS and the SANDF