Several large studies from outside South Africa (in the UK and the United States) highlight a consistent trend: women experiencing out-of-hospital cardiac arrest are less likely to receive CPR from bystanders compared with men. For example:

• Researchers analysing more than 300,000 cardiac arrest cases in the U.S. found that women were about 14 % less likely than men to receive bystander CPR or defibrillation.
• Earlier research also showed women in public locations were less likely than men to receive CPR, a difference not fully explained by the setting or other factors.

These differences have real consequences: when CPR isn’t given promptly, survival rates drop sharply. That means some women who could survive with early intervention may not get that chance.

Experts suggest the reasons for this gender gap may be far less about biology and far more about perception and hesitation:

1.  Fear of causing harm or inappropriate contact

Some bystanders hesitate to place their hands on a woman’s chest, worried they might injure her or be accused of inappropriate touching. This fear, rooted in social norms about physical contact, can delay action that should be immediate.

2.  Misconceptions about symptoms and conditions

Women sometimes display different symptoms during cardiac arrest or a heart attack, making it harder for bystanders to recognise the emergency and act quickly. While this has been more studied in heart attacks, similar confusion can delay CPR recognition and response.

3.  Training biases

Traditional CPR training videos and mannequins tend to depict male torsos, which may subconsciously influence people’s confidence or comfort when performing CPR on women. This has led to initiatives like the “Womanikin,” which adapts training models to better represent female anatomy and help learners practise on all body types. 

While specific South African studies on gender disparities in CPR are limited, the global evidence is relevant here too. Sudden cardiac arrest doesn’t discriminate by gender, and South Africans are just as likely to witness a loved one collapse in a public space, in a shopping centre, at school, or at home.

What does differ is people’s confidence and willingness to act. In many communities, hesitation often comes from fear: fear of doing it wrong, fear of touching someone’s body, or fear of legal consequences. These fears can be heightened when the person in need is a woman. This means we may be inadvertently reducing survival chances for women simply because people aren’t confident in responding.

As we celebrate International Women’s Day, it’s worth reflecting on how we can support equal access to life-saving care:

Training more people in CPR for everybody

CPR training should emphasise that the technique is the same regardless of gender. A collapsed person with no pulse needs oxygenated blood circulating. Hands go on the centre of the chest, not on the breasts, and this can be done respectfully and effectively by anyone who has been trained.

Breaking down myths and fears

Part of CPR education must directly address the fears we subconsciously hold: worries about touching someone, doing it wrong, or cultural taboos. Communities that openly discuss and practise CPR are more likely to help when it matters most.

Making training widely available

Whether in schools, workplaces, community centres, or via public education campaigns, everyday people need opportunities to learn how to respond confidently to cardiac arrest. In South Africa, initiatives that bring CPR training into communities, with culturally sensitive messaging and inclusive tools, will help narrow the gap in care.

Cardiac arrest can happen to anyone, anywhere. When it does, the actions of a bystander, even before emergency services arrive, can determine life or death.

Women contribute to every aspect of community life: as mothers, leaders, workers, teachers, caregivers and more. On International Women’s Day, we honour their strength. We can also commit to ensuring that women receive equal access to life-saving care. That starts with acknowledging the gap, educating ourselves, and empowering everyone with the skills and confidence to act.

It is a statement that every life is worth saving, regardless of gender.

• Women are less likely than men to receive bystander CPR and defibrillation (Duke University study).
• Research demonstrating gender disparities in bystander CPR rates for women vs men.
• Northwell Health: Discussion on bystander CPR and women.

Multiple credible reports referencing the National Department of Health indicate a public-sector shortfall of 2,221 ambulances. In other words, the system is attempting to serve millions of people with fewer vehicles than required to meet demand.

In reporting that includes comments attributed to a Department of Health spokesperson, it is stated that only 4,007 ambulances were operating across all nine provinces, against an estimated need of more than 6,000 based on population and a recommended coverage ratio.

When ambulances are limited, callouts queue up, rural distances become even harder to cover, and response times can stretch. The painful truth is that in some emergencies, the first responder may be a parent, teacher, colleague, neighbour, or passer-by.

South Africa has articulated EMS response time standards for high-priority calls (often referred to as Priority 1). A government technical report notes targets of reaching Priority 1 patients within 15 minutes in urban areas and within 40 minutes in rural areas.

Those targets matter because they reflect what emergency care aims to achieve. But when resources are stretched, real-world experience can look very different. That gap between “what should happen” and “what does happen” is where first aid becomes critical.

Understanding EMS strain also includes the people behind it. A peer-reviewed workforce study analysing Health Professions Council of South Africa (HPCSA) registration data reported 56,894 registered emergency care personnel in 2019 and highlighted long-term concerns about whether supply can keep up with national need.

It’s important to be clear: registration figures are not the same as “available ambulances on the road today,” and not everyone registered is necessarily working in public EMS. But it is still a valuable, verifiable indicator of the broader emergency care workforce pipeline and pressures within it.

The National Department of Health also describes EMS oversight and system strengthening as a formal function within its Primary Health Care Services programme, reflecting that EMS governance is recognised at the national level. 

When someone is injured or suddenly ill, you don’t need to “do everything.” You need to do the right things early, calmly and safely.

First aid can:

• Keep an airway open and support breathing.
• Control severe bleeding.
• Reduce the risk of shock.
• Support someone having a seizure.
• Help in choking emergencies.
• Begin CPR early when the heart has stopped.

These actions do not replace EMS. They bridge time, and time is exactly what feels scarce when the system is stretched.

Here are common situations where first aid can make a measurable difference:

1)  Chest pain or collapse

If someone collapses and is unresponsive, early CPR can sustain circulation until advanced help arrives. Many people freeze because they’re terrified of doing it wrong. Training replaces fear with simple steps.

2)  Road accidents and heavy bleeding

In serious trauma, uncontrolled bleeding can become fatal quickly. Knowing how to apply direct pressure, use a dressing correctly, and keep someone warm and still can protect them from rapid deterioration.

3)  Allergic reactions

Anaphylaxis can escalate quickly. Knowing the signs, calling for help early, in order to save a life.

4)  Children and sports injuries

From head knocks to fractures, first aid helps you respond without worsening the injury, while keeping a child calm and supported.

Most people only think about first aid after a frightening incident. But training before something happens changes everything. It gives you:

• Confidence to act rather than panic.
• Skills that apply at home, work, school, and in public.
• A calmer mindset during emergencies.
• The ability to help someone you love, or even a stranger.

In an environment where EMS resources are stretched and response times may vary, first aid becomes part of community resilience.

If you want to feel more confident about what to do while waiting for professional medical help, first aid training is one of the most practical forms of self-reliance and care.

Explore training and resources through the South African First Aid League at www.firstaidleague.co.za. Even a few hours of learning can change how you respond for the rest of your life.

Emergency responders often refer to the "Golden Hour" as the first 60 minutes after a traumatic injury, the critical window to save a life. In remote areas, the chance of emergency services arriving within that window is slim.

This makes it even more important for road professionals to be trained in:

• - Cardiopulmonary Resuscitation (CPR)
• - Wound dressing and bleeding control
• - Managing fractures and sprains
• - Treating shock or heatstroke
• - Responding to choking or breathing difficulties

Even a few minutes of stabilising care can dramatically improve the outcome before help arrives.

Having first aid training not only saves lives, it boosts confidence on the road. Trained professionals are more likely to stay calm in emergencies, assist injured co-workers or passengers, and take leadership roles during crises. This is especially valuable in high-pressure environments like logistics, mining transport, or fuel delivery.

Many industries that involve road-based work already require first aid certification as part of Occupational Health and Safety (OHS) compliance. Companies that encourage or mandate training for their mobile workforce can reduce insurance costs, improve response times, and show a strong commitment to employee wellbeing.

Let’s look at a few common situations that make first aid knowledge vital:

1. A Truck Driver on the N1 Experiences Chest Pain

    Knowing the signs of a heart attack and how to safely stop, alert emergency services, and begin basic care can prevent tragedy.

2. A Commuter Witnesses a Collision in a Rural Area

    Being the first responder with even Level 1 First Aid can mean the difference between life and death for accident victims.

3. A Delivery Bike Rider Is Injured in a Minor Crash

    Understanding how to clean wounds, immobilise an arm, or assist until help arrives can minimise complications.

4. A Tour Operator Deals with Heatstroke on a Remote Safari Road

    Quick action to cool the affected person and rehydrate them properly can prevent escalation into a life-threatening condition.

Founded on a legacy of service and safety, the South African First Aid League (SAFAL) has been a leader in first aid training for 90 years. SAFAL doesn’t just teach the basics, they empower individuals and companies to build a culture of preparedness.

With accessible basic, intermediate and advanced First Aid courses, SAFAL ensures that even road-based professionals working in remote or high-risk areas are not left behind. Their instructors use local knowledge and real-world scenarios to ensure relevance and impact.

First aid knowledge should not be viewed as optional for road-based roles. It should be seen as essential professional development. Whether you're a self-employed courier or part of a major logistics fleet, having life-saving skills gives you more than a personal edge. It makes you a responsible community member, a prepared professional, and a vital link in the chain of care.

So, the next time you hit the open road, ask yourself this: If something goes wrong out there… would you know what to do? Let us help you answer that with confidence.