Comrades Medical Protocol

Petros Sosibo Passed

The following information indicates what medical facilities will be provided by the CMA, and what runners can do to help us, and to prevent themselves from ending up in a situation where they are in need of medical attention. It is important to remember that medical attention is retro-active, i.e. we only respond when a runner is in trouble. It is still the responsibility of the runner to take care of his or her own health. 

The CMA will provide the following medical facilities for runners during the 2018 Comrades Marathon.

  1. ROUTE:

On the route:

Netcare 911 will provide the following:

  • 14 ambulances equipped with satellite tracking to enable us to accurately position the vehicles and ensure optimal response times to attend to runners in difficulty.
  • 6 rapid response vehicles with advanced life support paramedics and full emergency equipment
  • 6 motor bikes with paramedics.
  • 1 helicopter dedicated to Comrades.

These will be controlled from the Medical Joint Operations Control Centre (JOC), based at the finish, where there will be 8 computers, a full complement of staff to operate them and record all details; and to despatch vehicles as and where necessary.

CALL 082 911

All calls for medical assistance for runners should be made to the Netcare 911 medical emergency number 082 911.  These calls will then be routed directly to the Medical JOC. 

Medical Stations (1s t Aid Stations):

There are 8 Netcare medical stations on route manned by qualified Professional Nurses and Paramedical staff. These stations also incorporate diabetic facilities where blood sugar levels can be tested. The medical stations will treat minor medical problems and will be used to treat or stabilise runners till arrival of ambulance.

Physio Stations

There are 8 physio stations on route manned by qualified Physios and 3rd year Physio students who will treat minor problems like cramping and strapping injuries. The Physio and 1st Aid Stations will be situated together.


Medical Tent

The medical facility at the finish venue will include critical care facilities, manned by approximately 65 Doctors and 20 Nurses. The facility will also have a mini laboratory provided by Ampath.

There will also be a three bed, fully equipped, ICU type resuscitation area. This area will have a dedicated specialist emergency team to provide appropriate emergency care if needed.

Please note. The medical facility is for runners only. Due to the large number of runners being treated and staff working in the tent, particularly during the last two hours of the race, we cannot allow relatives or friends into the tent. We just do not have enough space! They should go to the Information tent, from where they will be directed to the Medical Waiting tent to wait for their runner, have some tea or coffee and receive updates as to the runner’s condition and expected time of discharge.

Finish Line

There will be a small medical facility on the finish line. This will be staffed by an emergency care doctor and a paramedic. Its purpose is to be used as a primary emergency resuscitation area if a runner is in severe trouble at the finish, and needs care immediately, prior to transferring them to the medical tent.

Last Mile and entrance to stadium

There will be an advanced life support paramedic stationed along, or at the end of the Mile. Their purpose will be to respond to calls to runners in that area who are in trouble before or as they enter the stadium.

St. John’s Ambulance Tent

The St. John’s tent will be located adjacent to the Medical tent at the finish venue. The staff will treat minor medical problems, do rub downs, strapping and massages.

Physio Tent at Finish

There is a fully staffed Physio tent with 40 beds at the finish venue. This will be situated within the stadium adjacent to the south stand.

Public 1st Aid:

Public 1st Aid will be provided by Netcare at the finish venue. It will be found in the vicinity of the Information Tent.



St. Annes Hospital in Pietermaritzburg and St. Augustines Hospital in Durban will be our primary referral hospitals as in the past.

Runners with Medical Aid will be charged at Medical Aid rates.

Runners without Medical Aid will be treated free of charge for a maximum of 24 hours. This ONLY applies to runners transported from the route or referred from the Medical facility at the finish. It does not apply to runners who make their own way there after finishing the race.

If a runner has a serious medical problem that will need more than 24 hours hospital care and does not have Medical Aid, that runner may be transferred to a Provincial hospital after 24 hours, at the discretion of the relevant hospital management.

We assure runners that the standard of medical care which has been provided by the Comrades Marathon over the years will not be compromised.


Prevention is better than cure

The CMA has embarked on a preventative education campaign to runners. This campaign has been carried through to the roadshows, on the website, newsletters and at the registration points.

The first thing that runners can do is to make sure that they are adequately prepared for the race. This means that they should have done enough training. They should also do their best to ensure that they have no underlying medical problems, of which they may or may not be aware. The following is a list of questions that runners should ask themselves. If you have answered “yes” to any of these questions, it is recommended that you see your doctor or a Cardiologist for a full check-up at some stage before the race.

  • Has your doctor ever warned you that you have “heart issues” or that you should only be physically active or do sports under medical supervision?
  • Are you overweight or underweight?
  • Are you over 35 and have not been physically active for a long period of time?
  • During blood pressure monitoring, have you ever recorded high blood pressure?
  • Have you ever been diagnosed with high cholesterol?
  • Do you smoke or have you smoked extensively in the past?
  • Has anyone in your direct family ever suffered from high blood pressure,

calcification of the coronary blood vessels/ heart attack, blood sugar disease, or


  • Do you have diabetes?
  • In the past few months, have you had the sensation of a ‘racing heart’, problems breathing, or chest pains; whether while at rest or during athletic activity?
  • Are you taking any medication for high blood pressure, heart or breathing conditions?
  • Do you ever feel dizzy or pass out, whether at rest or during physical activity?
  • Do you have any problems with your musculoskeletal system, which worsens during physical activity?

Remember, any of these symptoms could be indicative of a serious underlying medical problem.

Awareness on Race Day

We urge runners to be aware of any unusual symptoms that may develop during the race, eg: chest pain, dizziness, severe nausea, unusual shortness of breath, change in your running style, confusion and disorientation. If this happens, stop running and seek medical attention. It has become apparent over many years that people feel it is more important to finish the race than be concerned about their health.

Assisting Other Runners

As introduced in 2008, a medically orientated enforcement of the rules will be applied. As the name and the origins and ethos of the Comrades implies, it is a personal battle to finish, and the support and encouragement of one’s fellow runners is an intimate part of the race. However this could, and has, led to runners being helped and carried when they should have stopped running and sought medical help. Again we will enforce the rule that any runner who is unable to move forward under their own power, (ie. is being carried by other runners) will be prevented from continuing and medical attention will be called for, and that runner’s race will be over!

Race Plan

The CMA would like to appeal to runners that they demonstrate a great degree of self-responsibility. They must make sure that they are adequately prepared to run Comrades. The following is a list of the basic principles every runner should adhere to.

  • Do drink enough.
  • Do eat if necessary.
  • Do listen to your body.
  • DON’T run if you are not fit enough or not properly prepared.
  • DON’T run if you have been sick or on antibiotics in the three weeks prior to the race.
  • DON’T take ANY medication during the race.
  • DON’T be afraid to bale.

Remember, the aim is to enjoy the race and finish in a reasonably healthy state.