21.10.2025
By Dr Michael Morris, lifelong RCEM member and pioneer of Emergency Medicine in South Africa
Baragwanath Academic Hospital, a sprawling conglomerate of World War II Nissan huts adjacent to Soweto, a township close to Johannesburg, was far from the well-equipped trauma centres we know today.
At the time, Casualty—affectionately known as The Snake Pit—was the primary unit for managing major trauma. The hospital was under-resourced and understaffed, with few doctors and nurses. Its design was poor, and it was located far from key resources like the X-ray department and the main hospital. Despite this, it coped under intense pressure, and we, as young doctors and trainees, learned invaluable lessons in managing both minor and major trauma.
On March 21, 1960, South Africa’s apartheid history marked a day of infamy—the Sharpeville Massacre. Our surgical unit was on ‘take’ that fateful day—a term used before the establishment of intensive care units (ICU), CT scans, or paramedic ambulances. We had neither the advanced resuscitation equipment nor the well-trained medical staff we have come to rely on today. The situation was dire, and yet, we had to find a way to cope.
Rumours quickly spread through the hospital grapevine, telling us that a police shooting of unarmed protestors had taken place in the nearby township of Sharpeville. Soon, our Casualty department was inundated with an overwhelming number of casualties—some 180, with injuries ranging from minor to life-threatening. Among them were patients with devastating gunshot wounds. Tragically, 69 people would later be reported dead. Resuscitation was rudimentary by today’s standards—intravenous saline and oxygen delivered via mask. It was a crude but effective approach given our limited resources.
Our ward quickly became overwhelmed. With no ICU and few critical care options, we had no choice but to operate on a ‘conveyor belt’ basis. As the most urgent cases were triaged, we scrambled to get patients to the operating tables. Surgeons and registrars were forced to abandon their normal operating lists, while we, the junior staff, found ourselves running from one case to the next. The usual premedication—Omnipon and Scopolamine—was administered, and the ‘goonya tube’ (an early version of a nasogastric tube) was used to empty stomach contents. Surgeons, stripped of gowns and gloves after each case, would grab a quick coffee and sandwich before rushing back to the next patient.
At the same time, relief operating teams arrived, and soon eight theatres were in full operation. Anaesthesia, primitive by today’s standards, consisted of Pentothal, Scoline, ether, and a McGill circuit, with Cape Wayne ventilators providing much-needed support. The event, chaotic and desperate, was a formative experience for me—one that would ultimately shape my career in emergency medicine and trauma care.
Now, looking back over 60 years later, I realise that it was that very event that marked the true beginning of my journey in emergency medicine. The lessons learned that day—under duress, in the heat of chaos—instilled in me the principles of rapid decision-making, teamwork, and resource management that remain central to emergency medicine today. The concept of triage, once performed by porters with surprisingly accurate judgment, became engrained in my practice. The experience taught me that, while technology and advanced techniques have transformed emergency medicine, the human element—quick thinking, leadership, and adaptability—remains just as important.
In the years since, we have seen the development of highly sophisticated trauma care systems. Today, trauma units are equipped with the latest diagnostic tools, ICU units, and advanced resuscitation techniques. However, the core skills honed that day—assessment, prioritisation, and teamwork—are still essential. The advances in technology, from CT scans to paramedic systems, have certainly improved the outcomes of trauma patients, but the ability to remain calm under pressure and make sound decisions in the face of overwhelming circumstances has not changed.
What struck me the most in reflecting on that time was the stark contrast between then and now. In 1960, we had no choice but to work with what we had: a small team, limited equipment, and a system designed to function under the most difficult of circumstances. Now, our hospitals are far better equipped, with advanced technology, and paramedics are trained to stabilise patients before they even arrive at the hospital. Yet, the fundamental principles of emergency medicine have remained unchanged. It is still about getting the right care to the right patient at the right time, and this is the heart of trauma medicine.
As I think about the development of modern emergency medicine, I am reminded of the words of the great pioneers in the field—those who worked with less and achieved more. Their ingenuity, grit, and dedication laid the groundwork for the systems we have in place today. The Sharpeville Massacre, despite the horror it caused, was one of those pivotal moments that challenged us to think differently, to act decisively, and to improve the systems of care that we take for granted today.
It is a moment I will never forget, and one that has influenced every decision I’ve made in my career. The event not only launched my career in emergency medicine but also deepened my commitment to making trauma care more effective, more compassionate, and more responsive to the needs of those who need it most.
About the author
Dr Michael Morris has been an active member of the Emergency Medicine community since the early days of the Casualty Surgeons Association (CSA) — the organisation that would later evolve into today’s Royal College of Emergency Medicine. In those formative years, UK emergency care was still delivered largely through “casualty departments” staffed by non‑consultant surgeons. The establishment of the CSA in 1967 marked a significant shift toward recognising emergency care as a distinct and developing specialty.
Across more than sixty years in the field, Dr Morris has played an important role in promoting and shaping Emergency Medicine and Trauma as recognised specialties in South Africa. Many consultants in the UK and internationally were trained directly by him, reflecting his long-standing influence on the global EM community.
Now in his nineties, Dr Morris is still an RCEM member (with a membership number in the first hundreds!) and continues to teach Trauma and Emergency Medicine via video call at two academic hospitals in Cape Town, maintaining a remarkable commitment to education, mentorship, and the worldwide advancement of the specialty. He remains an enduring champion of the discipline and a respected mentor to generations of clinicians.
Share Your Story
This blog is part of RCEM’s Share Your Story campaign, an initiative that invites the EM community to share their written or video experiences to help build inclusion, understanding, and equality across our specialty. We welcome contributions for medical awareness and diversity days throughout the year, chosen in collaboration with our EDI Committee and NHS Employers.