Alan MacMahon: Cape doctor who revolutionised emergency services
1943-2014
DR Alan MacMahon, who has died in Cape Town at the age of 70, was the father of emergency medical rescue services in South Africa.
MacMahon revolutionised ambulance care and introduced paramedical training and advance life support systems. He pioneered the idea of providing instant medical care, resuscitation and stabilisation of patients at the scene of an accident rather than waiting for them to get to hospital. This was a revolutionary model when he introduced it 40 years ago and it was adopted across the country.
MacMahon led from the front. For at least 20 years as the principal doctor on call in the Cape’s Metro Rescue Service, which he established in 1979, he was on duty 24 hours a day, seven days a week, 52 weeks a year, dashing from one emergency to another in his Range Rover. He wrote several of them off, but said it was not his problem.
All he wanted was to get to the scene of a disaster before anyone else so that he could manage the situation. This he did with minimum fuss and quiet efficiency.
He expected the same high standards he applied to himself from those working with him. Ambulance crews knew they would be in trouble if they arrived at an accident scene after MacMahon.
At the same time, they were wary of arriving before him because he did not like being beaten to an accident scene. If they saw his flashing light behind them, they would diplomatically allow him to pass and then stick to him like glue.
Blunt, pragmatic and practical, he allowed nothing and no one to interfere with what he thought was necessary to save the patient. His philosophy was never to ask for permission — only, sometimes, forgiveness.
“His attitude was let’s solve the rescue problem and worry about the red tape later,” said a mountain rescue leader who worked closely with him.
He supervised the redesign, manufacture and equipping of ambulances and kept hammering away until he got what he wanted.
A Cape Town ambulance chief told him there was no need for oxygen on ambulances and chased MacMahon out of his office when he persisted. But MacMahon won and oxygen on ambulances became standard.
He designed his own rescue vehicles, knew exactly where each item of equipment should be and heaven help anyone who moved it or did something that was not on his plan.
In 1975, tired of struggling for hours with a hacksaw to free patients trapped in motor vehicle accidents, he was party to importing the first Jaws of Life to South Africa, which reduced rescue time from between one and two hours to between 10 minutes and half an hour.
In 1983, he persuaded the executive of the Cape Province, which then incorporated the East-
His attitude was let’s solve the rescue problem and worry about the red tape later
ern Province, Western Province and Northern Cape, to buy a Cessna Citation jet for R3-million for the Red Cross Air Mercy Service.
He pounced like lightning on unused funds to bolster his beloved emergency services. When an ill-conceived marketing campaign run by the provincial government came unstuck, MacMahon bullied the authorities into dumping it and using the money, R3-million, to buy a new rescue crane instead.
He deployed cranes and other heavy equipment in rescue situations in ways that had never been done before. Often nobody else knew what he was doing, but he always had a well-thoughtthrough plan in mind and it invariably came together.
Under his leadership, Metro Rescue Services incorporated the Mountain Club of South Africa, the National Sea Rescue Institute, traffic, fire and police departments and hospitals.
He devised a radio communication and transport network so that they could work together seamlessly when necessary, and many lives were saved because of this.
Although he hated heights (he was so averse to flying that national emergency service meetings had to be held in Cape Town), he was often involved in mountain rescues. Medics teased him about not getting close to the edge or abseiling down a rock face.
He was not fond of water either, but this did not stop him seeing the need for, and creating, a rescue diving unit.
Many years before it became government policy in 1994, MacMahon drove the shift of resources and staff from hospitals to primary-care clinics so that communities far from hospitals could have immediate access to healthcare.
A man who could be brusque and had no time for undue displays of emotion, he hid his compassion well, but it was compassion that drove him.
MacMahon was born on November 28 1943 and qualified as a doctor at Stellenbosch University. While working as a medical registrar at Tygerberg Hospital in 1973, he organised a system of emergency response cars linked to the Tygerberg and Groote Schuur hospitals, which led to his appointment as head of ambulance services in the Cape province.
He visited Seattle in the US to study its emergency services system and brought what he learnt there back to South Africa.
He is survived by his wife, Jean, and two daughters. — Chris Barron