On The Ball

When the British & Irish Lions came to South Africa in 2021, they presented local rugby fans with a once-in-a-decade opportunity to see the best of the home unions take on our 2019 World Cup winners. 

The British & Irish Lions are a rugby institution. The team, with roots stretching as far back as 1888, made history in its full representative form in the 1910 tour of South Africa. It’s also immensely popular, with a television audience in the tens of millions, and enormously profitable: the tour event played a large role in the make-up of SA Rugby’s annual revenue. 

For many of South Africa’s best players, the tour represented a chance to measure themselves against the best of the best, and for the Springboks as a team, it was an opportunity to cement their legacy as one of the country’s finest. 

But it almost didn’t take place at all. 

At the end of a successful series.

Ever since the coronavirus outbreak was declared a pandemic in March 2020, businesses the world over have been thrown into chaos, with sports events particularly badly affected. Urgent and crucial lockdowns and the necessity of safe social distancing have led to huge changes in how, when and where mass-appeal sports events take place, and the global pandemic and public health crisis threatened to derail all hopes of the tour going ahead as planned. 

Yet the tour proved a triumph, despite numerous disruptions and a few dramatic overnight adjustments. The Springboks won the test series by two matches to one, conceding the first match 22–17, before coming back strongly to win 27-9 a week later and clinching the third test 19-16 in the dying minutes of the game.

How did it happen?

Much of the work that went into making the historic tour a success happened far from the public eye, says Dr Darren Green, Mediclinic’s Marketing Events Manager and the tour’s Chief Medical Officer, as he and his team worked closely with SA Rugby, SA Rugby Events Services, the British & Irish Lions medical and management teams, and a wide range of other personnel in both the private and public sectors of South Africa’s hospital and healthcare industry. 

Dr Green manages a team of doctors, nurses and paramedics who assist various mass-participation sports events organisers in hosting popular, successful, and ultimately world-class competitions. While the team is regularly on hand at matches involving the Springboks, many of the local Super Rugby teams, and the HSBC Cape Town Sevens, that list extends far beyond rugby. 

You can find Mediclinic’s fully equipped field hospital at the finish line of the Sanlam Cape Town Marathon, at all venues along the route of the multi-stage Absa Cape Epic, the Cape Town Cycle Tour, and many other running and cycling events that attract athletes from all over SA and the world. 

The pandemic has posed significant challenges to the way the team approaches these tournaments, says Dr Green, with learning curves lying around every corner. “It’s been an incredible journey,” he says. “All the factors we usually look at – volumes of people involved, the type of activity, areas and environment, weather, community disease status, local infrastructure and setup, numbers of travelling participants – are now multiplied by the risk of transmitting COVID-19.”

The Mediclinic Events team’s COVID-19 planning starts far in advance of each event, and they work together with event organisers and athlete communications to detail risks and responsibilities in fine detail. “We have to look at isolation and quarantine areas, screening procedures and requirements, access to testing facilities and financial implications, population-specific risks of amateurs and professionals – the list goes on,” Dr Green explains. 

The goal, he says, is to provide care at hospital and emergency centre standards, even when on the move or in the bush. “We carefully manage every detail – from spacing and floor plan distancing to cleaning procedures and routine infection prevention practices, a prioritised fast-tracked respiratory triage process, flow processes, access and exits.”

These sports events require layers of risk mitigation that are both creative and individually planned, he explains, and they demand a lot from the team: cohesion, optimism, hard work and determination. But the 2021 British & Irish Lions tour offered a new test of character. 

Adapt, and fast

In the months leading up to the first test kicking off, the logistics and technicalities of the tour changed regularly. 

In early 2021 it was reported that the tour could be held in Britain and Ireland instead of South Africa, or even Australia, postponed to 2022, or cancelled altogether, due to the uncertainty of the COVID-19 pandemic and the subsequent restrictions in worldwide travel. Only in March 2021, a few short months before kick-off, organisers finally confirmed it would go ahead as planned. But there were more adjustments to come.

Usually, Lions teams play seven matches while on tour, against non-national teams, in addition to three tests. From the outset the 2021 event would include only eight matches, with five coming against local rugby franchises, to be played in the home stadiums of the Lions’ opponents. 

That schedule was altered so all eight matches would be played in only four venues, in Gauteng or Cape Town, to reduce the teams’ travel requirements – a match against an SA Invitational team was replaced by one against SA’s own Lions franchise to reduce the risks associated with drawing a squad from around the country; the match against the Bulls was cancelled due to several positive COVID-19 tests in the local team’s camp; and two warm-up matches against the Georgia national team were added to the fixture list. Eventually, on 20 July, it was announced that the second and third tests would be moved from Johannesburg to Cape Town.

For the medical team, these adjustments were far more complex than the odd news headline. Each game required a match-day doctor, a concussion specialist, an orthopaedic surgeon, and a maxillofacial surgeon to be present on the side of the field, together with an emergency resuscitation team. On top of that, no match can kick off if there isn’t a trauma bed available.

“The challenges were phenomenal,” says Dr Green. “We were navigating last-minute changes almost daily. When it’s announced that the venue of a given game is changing, for example, we must move our entire stand-by intensive care unit set-up to a different stadium, overnight. We have to work with local hospitals in the area to ensure they’ll have beds available, if needed, to manage severe injuries or outbreaks – and we were doing all this at the height of a third wave in positive COVID-19 cases nationwide.”

Risk factors, contingency plans, staff, and specialists – so what was the key to a successful tour amid challenges of this magnitude? 

Work together, and well

“This was a pinnacle event,” says Tristan Manning, Event Risk and Disaster Manager: Mediclinic Southern Africa, who’s been an integral part of the Mediclinic Events team for the past three years. “If you look at the Springboks alone, you have a high‑profile event, and when you consider that they pick the very best of the best from across the UK to represent the British & Irish Lions, then suddenly you’re looking at a very different kind of tournament.”

“The planning is on a different level,” Manning explains. “We have to look at every intricacy that could affect a player and have systems in place to manage them. We must think of every eventuality and have a plan for all of them. This is a big enough challenge every 12 years and when you add COVID-19 to the mix, yes, you could say there was a fair amount of stress.”

Positivity helps. “We took a proactive approach to finding, recruiting, and working with local industry experts. Every time we had to brainstorm around a new scenario, we brought everybody together and thrashed out everything we could think of to ensure the solution put on the table was the absolute best at the highest standard.”

Mediclinic worked with several teams at other hospitals to manage and mitigate against a wide variety of risks. These included Professor Zeyn Mahomed and his specialist emergency medical services team at ​​Chris Hani Baragwanath Academic Hospital, the biggest and busiest trauma hospital in the country; Professor Jon Patricios, founder and Director of Sports Concussion South Africa and a sports concussion consultant to SA Rugby; the emergency medicine team at Groote Schuur Hospital; physicians at Netcare Milpark Hospital’s world-renowned Level 1 Trauma Centre; as well as those at Life Groenkloof Hospital, previously known as Little Company of Mary, in Pretoria.

Among those was also Mediclinic Morningside, which provided professional and frequent support to all teams and staff, says Dr Green. 

Covid swabbing: Rigorous testing protocols during the peak of the third wave, Tristan Manning.

Experience is another crucial factor. Mediclinic’s events team is the preferred medical assistance provider at the HSBC Cape Town Sevens, where they provide a crucial and appreciated support service. A recent report compiled by World Rugby compared all 10 of the tournaments on the HSBC World Rugby Sevens Series 2018/19 calendar, and Cape Town was ranked far ahead of its overseas counterparts. 

The ER24 pitch side emergency response team – geared and ready.

Cape Town’s 92.1% overall score was the highest recorded for any tournament – and the tournament scored an outstanding 94.5% in the medical support category. This recognition is due at least in part to Mediclinic’s approach of putting the players first, says Manning. 

Logistics man on the move – Charles Lawton.

“For the players who we’re looking after, rugby is their career. If something happens to them, we need to make sure we minimise the damage and work on improving their chances for recovery so they can get back to work.” 

Stay positive, keep learning

To be part of the Mediclinic Corporate Events team, nurses must have a mix of experience and clinical competency – but most of all, an adventurous spirit, says PN Caroline Murray, Clinical Logistics Coordinator: Mediclinic Southern Africa. 

The 2021 British & Irish Lions tour only cemented that ethos. “None of us can do this alone,” she says. “We were working with people we’d never met before – doctors and staff at stadiums we’d never seen before. And we just knew, all the time, to stay open to learning – this is a huge production. We each have our role to play.”

Usually, a tour like this would attract staff candidates from all over the country simply because it can be a lot of fun, she explains. This time, it meant enduring COVID-19 nasal swab tests three or four times a week, often late at night; it meant constant 4am wake-up calls and hours in a hotel room, alone. 

“The team spent a lot of time on the road, away from their families, far outside of their comfort zones, doing a lot of back-breaking labour. They loved it. I was having meetings where I’d have to say, “Forget what I said yesterday, or this morning, this is what I’m saying now. It was such a positive, easy-going team environment that every time we changed direction, everyone was on board immediately.”

Despite the stress of last-minute changes to the schedule and sudden, overnight outbreaks of COVID-19 cases within team hotels, Murray’s abiding memory of the tour is the encouraging, uplifting team spirit between a group of people coming together with a common vision. 

Murray has been with the Mediclinic Corporate Events department on a permanent basis since 2011. As leaders in the field of eventing medicine in South Africa, Mediclinic Corporate Events services up to 20 events a year – each with its own specific needs and challenges.

The specialist support teams with Prof Jon Patricios. 

Still, the Lions tour is an achievement like no other. “We all knew that if we get it right, we can be part of something special, something that will stay with us forever,” she says. “Ego has no role in that. I think that’s what makes us a team: we believe in the end goal, we understand the value we bring to the environment, and we trust in the team leader to make the right guiding decisions.”

Core values

All these curveballs have made the Mediclinic Events team stronger and more capable. With COVID-19 mitigation protocols easing up as more people choose to vaccinate against the coronavirus, sports events are inviting participants and fans back to stadiums. Mediclinic is ready for new and interesting challenges. 

Since the 2021 British & Irish Lions tour the team has had its hands full, helping to manage the Cape Town Marathon, the Absa Cape Epic, the Cape Town Cycle Tour, and Wines2Whales. 

The Team going for 10/10 professionalism in player safety.

“It was a huge step up,” agrees Murray. “Communication, honesty, openness: these are core values that are really instilled in us. I think this tour is proof that if you work together, with an open mind and a positive spirit, anything can happen.”

“We’re more prepared now, after a tour like that, than we’ve ever been,” says Manning. “The relationships we built, the expertise we gained, the way we grew so much and managed the challenges so successfully, it really was a positive experience that bodes well for the future.”

One of many pre-event emergency drills for safe player extrication.
Siya Kolisi flanked by Mediclinic specialist team.

“It’s been an incredibly rewarding journey for all of us,” says Dr Green. “We had to strategise and optimise our approach every step of the way. The fact that we were able to adapt so quickly and competently, and that this tour was such a success made it all worthwhile. We’re very proud to have been a part of it.”

Image credit: Supplied

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