The first Helicopter Emergency Medical Services (HEMS) Symposium held on the African continent took place on 26 and 27 November 2025, hosted by the University of Johannesburg’s Department of Emergency Medical Care, in partnership with the Foundation of the French Academy of Medicine (FAM) and the Airbus Foundation. The event brought together around sixty South African and international doctors, nurses, emergency physicians, pilots and healthcare professionals already trained in helicopter rescue techniques for two days of knowledge sharing, interactive learning and cross-continental collaboration.
A Technically Rich and Highly Structured Programme
The programme demonstrated considerable depth across clinical, operational and strategic dimensions of HEMS, combining South African expertise with insights from FAM’s longstanding experience in helicopter rescue. Plenary presentations explored the organisation of the HEMS system in South Africa, French HEMS approaches, patient management in difficult environments, mountain and altitude operations, ECMO retrieval, neonatal care, flood response and broader system-level themes including governance, coordination and resilience.
South African speakers addressed locally specific challenges such as confined-space medical care, disaster operations and the complexities of prolonging critical care in demanding or remote settings. FAM specialists contributed technical depth through case-based discussions drawn from decades of operational experience, including alpine rescue and high-acuity prehospital care.
Case studies from recent flood responses in Mozambique and Malawi illustrated the demands placed on helicopter operations during large-scale crises. These circumstances challenge assumptions about dispatch, communication, patient preparation, safety and inter-agency coordination, offering lessons relevant to strengthening readiness within the African context.
In addition, the symposium examined the broader positioning of South Africa’s HEMS sector within the national emergency-care system. Although the value of helicopter-based medical response is recognised internationally, the local system reflects operational, structural and clinical limitations that often restrict its ability to deliver the benefits associated with more integrated HEMS networks.
A cockpit-focused session contrasted South African and French pilot perspectives, highlighting differences in aircraft types, mission requirements, regulatory environments and risk frameworks.
Globally, HEMS is structured to provide three core advantages: speed, access and enhanced clinical capability. In mature systems, these factors reduce pre-hospital timelines and improve survival in time-critical emergencies. South Africa, however, struggles to consistently realise these advantages because of how helicopters are dispatched, staffed and deployed.
As a result, national debate is shifting away from the traditional focus on aircraft performance and clinical capability towards broader questions of governance, cost, efficiency and equity. Newly emerging research and system-level analysis are challenging long-held assumptions that HEMS automatically improves outcomes or represents optimal investment in a resource-constrained health system.
A major difference is that in South Africa, the majority of HEMS services are privately owned, whereas globally this is a function of government, both in the execution of operations and the procurement of helicopters. Highlighting the need for a national policy that defines the role of HEMS within South Africa’s emergency care and health system.
Immersive Training at UJ’s New Rescue Centre
The second day of the symposium took place at the University of Johannesburg’s newly launched Rescue Centre on the Doornfontein Campus. Participants engaged in scenario-based simulations designed to strengthen decision-making, teamwork and operational readiness. The centre supports the University’s four-year Bachelor of Emergency Medical Care degree, which includes twelve rescue modules requiring practical, high-fidelity training.
The facility includes a five-metre-deep pool fitted with wave, rain and wind systems, blackout capability for low-visibility simulations, a concrete terrain platform for ground-based exercises and a three-level confined-space tube that allows for restricted-access scenarios with instructor intervention when required.
A key feature of the centre is an AS365 Dauphin helicopter donated by Airbus Helicopters. It can be repositioned throughout the space and is used for hoisting and lowering drills, trooping practice, entry and exit procedures and operations alongside the aircraft. Downdraft simulators reproduce the airflow, noise and wind conditions associated with helicopter rotor wash, contributing to realistic training while maintaining a controlled environment.
These simulations exposed participants to complex environments that extend beyond conventional helicopter settings, reinforcing the multidisciplinary nature of HEMS operations.
Airbus Helicopters
As the symposium was held in partnership with the Airbus Foundation, Airbus’s Nam-Binh Hoang, Managing Director of Airbus Southern Africa, explored the helicopters and industrial ecosystem that underpin HEMS capability worldwide. More than 2,800 helicopters are currently dedicated to emergency medical missions globally, with Airbus holding over half of this market share, largely through the H135 and H145. Both aircraft trace their origins to the BO 105, whose compact design, twin engines, and manoeuvrability helped define standard principles for emergency medical helicopters.
The H145 offers straight-in stretcher loading through rear clamshell doors, while both the H135 and H145 are optimised for rapid deployment, rooftop operations and confined-area landings. Their cabins provide unobstructed interiors, flat floors and flexible seat rails that support a range of medical configurations. Around 200 H125s also currently perform EMS roles worldwide.
Introducing the H140: A New Option Between the H135 and H145
Airbus’s newest EMS-focused model, the H140, was launched earlier this year and is positioned between the H135 and H145 in size and capability. Developed with input from HEMS operators, the H140 incorporates:
- A T-shaped fin and Fenestron tail rotor to improve ground safety and reduce noise
- A five-blade rotor system derived from the H145 D3 for increased lift and improved ride quality
- More powerful engines and optimised tail geometry providing an extra 70–80 kg of useful load
- A rapid start-up sequence designed to bring the aircraft online in under two minutes
The redesigned cockpit includes a larger windscreen for enhanced visibility and improved protection against bird strikes. Avionics are based on the Helionix suite used across the Airbus family, supported by a four-axis autopilot and full authority digital engine control.
The cabin design reflects the characteristics that have made the H135 and H145 successful in EMS operations: a high flat ceiling, a continuous flat floor, unobstructed access throughout and a wide opening for stretcher loading, with approximately 90 cm of clearance.
Airbus Helicopters Aligning Hardware, Training and System Innovation
From its base in South Africa, Airbus supports operators across the region with platforms, training programmes and technical infrastructure aligned to the evolving needs of HEMS providers. The trajectory of the global HEMS sector, and Airbus’s role within it, highlights the importance of aligning aircraft capability with the operational and clinical requirements of emergency medical care.
The 2025 symposium offered a multilayered examination of HEMS, covering clinical practice, safety, rescue capability, operational design and international approaches. For Southern Africa, it marked a significant step in advancing understanding and strengthening the future of helicopter emergency medical services in the region.
Find out more about Airbus Helicopters: https://www.airbus.com/en/products-services/helicopters
Find out more about the Fondation de l’Académie de Médecine (FAM) – HEMS : https://fam.fr/fr/hems/
Find out more about UJ’s Rescue Simulation Centre: https://pure.uj.ac.za/en/equipments/emergency-medical-care-rescue-simulation-centre/
