First on scene Life as a paramedic in South Africa by Daniel Cuthbert and his Leica M8

Over 35000 Road Traffic Accidents (RTA’s) a year in South Africa. 5000 losing their lives annually to bad driving. Along with road accidents, South Africa continues to struggle with high crime levels. As a result of such sobering figures, the work that paramedics do in South Africa is invaluable and often goes unrewarded. It is their job to ensure all South Africans, no matter what ethnic background, status or income, received the best possible medical attention. There exists a stark divide between poor and rich when it comes to healthcare in South Africa. Here is the story of those who arrive first on scene.


In 2011, I traveled with ER24 paramedic teams in Durban and Johannesburg, for six months, capturing the extraordinary dedication and care the teams have for their work. Initially I wanted to understand what role they played, but also understand the challenges they faced on a daily basis. After negotiations with ER24 and how the project would work, I was thrown into the deep end right at the start with us attending a mass brawl in the Durban docks, where a group of friends had decided to violently attack each other with bottles and knives. Watching the Paramedics being abused as they are trying to help save someone’s life, saw this project quickly change focus.

Spending time between Durban, on the coast and Johannesburg, I was embedded with the teams on long shifts. This is not a nine to five role; often we would work above and beyond the allocated shifts. Each paramedic I spent time with all had the same outlook — they wanted to save lives and help people. I was drawn to Paul Knoesen, an advanced life-support paramedic and base manager for Pietermaritzburg ER24, due to his dedication to the role. On his days off, he’d scan the radios to see if he could offer help and always had his gear ready to act when needed.

The hardest part of shooting a documentary involving people at their most vulnerable point, is keeping a balance between what you want to shoot, not getting in the way of the Paramedics and also being compassionate towards the situation. I recall one horrible scene, a suicide, where when entering the home, which was a converted garage, we saw a heavily traumatized kid, no more than 10 years old, standing whilst his father was casually reading the newspaper whilst his wife was bleeding out next to him. In those situations, you can’t bring it upon yourself to lift the camera and produce a shot. Inevitably, after a few months, I started helping out where possible and when guided by the Paramedics and on most days, I didn’t shoot a single frame, just leaving the Leica swinging over my shoulder.

In the six-month period spent with the men and women of ER24, I saw a dedication and passion like I’ve never experience before. A truly amazing group of people who just want to help someone in need, ignoring their background.

This project was shot using a Leica M8 with a 50mm Summicron V4.

To know more about Daniel Cuthbert’s work, please visit his official website and follow him on Twitter.

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