Facing the threat of violence daily , paramedics are now arming themselves so that they can get on with the business of saving people's lives.
This emerged yesterday during a judgment in the case of two men accused of raping two paramedics in Roodepoort, on the West Rand, in 2010.
Private paramedics who spoke to The Times claimed that up to 60% of emergency workers at certain emergency services companies carried weapons to protect themselves against attack while on duty.
According to the SA Private Ambulance and Emergency Services Association, of the country's nearly 100000 paramedics, 3% carry guns on duty.
The association's CEO, Oliver Wright, said these numbers were a "grave concern".
"This shows how bad the situation is. Although we don't condone this, we understand it," he said. "This creates a serious ethical situation, which could escalate attacks, with [paramedics] being targeted for weapons."
Delivering her judgment in the case of Tshifhiwa Luruli, 29, and Michael Khorombi, 30, Johannesburg High Court Judge Sharise Weiner was scathing in her comments about South African society, which she said had allowed rape to get out of control.
"The rape statistics are horrific - one of the worst in the world," said Weiner. "Statistics from a Medical Research Council study in 2011 are a strong reminder of the gravity of rape in South Africa.
"The study shows that reported rape figures are 55000, while unreported figures are estimated to be 500000 annually. This means there is one rape a minute," she said.
"No one is safe on the streets of South Africa because of people like these perpetrators."
Refusing to look Judge Weiner in the eye, Luruli and Khorombi - who are both facing charges of rape, sexual assault, assault with the intent to do grievous bodily harm, robbery with aggravating circumstances, and possession of an unlicensed firearm and ammunition - sat with their heads bowed, while their victims sat silently, weeping in the public gallery as their ordeal was being recounted.
The paramedics - referred to as "Miss R" and "Miss T" as both had requested that their names be withheld - were raped after responding to a call in March 2010 in Durban Deep in Roodepoort.
Luruli and Khorombi were arrested the same month.
Both paramedics are back on duty and appeared in court in uniform yesterday.
Miss R was too emotional to speak about the incident.
Though not as scared as she used to be, Miss T said she still sometimes go t worried when attending to a scene.
"We have been sent on self-defence training and have the police to escort us, which makes us feel safer," she said.
"The fact that the case is coming to an end is helping my life get back to normal."
Both claimed in court papers they had suffered immense emotional trauma, with Miss T getting divorced afterwards.
Weiner, whose judgment continues today, lashed out at the accused, and said rape was used as a "weapon of power, of control".
"Rape is regarded by some as a 'night out on the town' in the way in which weak drunk young men entertain themselves by humiliating the women they prey on," she said.
"The facts of this case are an example of the depths that certain sectors of communities have sunk to," she said.
SA Emergency Personnel Union president Mpho Mpogeng said safety standards for paramedics were appalling.
"Emergency personnel are extremely vulnerable, especially to violent crimes. On average, 10 paramedics are attacked a month while on duty.
"We are worried. Nothing is being done with the situation getting worse."
Wright said South Africa unfortunately followed the same international model that saw police accompanying paramedics to dangerous situations.
"We simply do not have enough of these resources for this to happen."
He said the scale of attacks was unknown as they were seldom reported, even though they were often violent.
"Paramedics are so used to the situation that unless it is life-threatening [incidents] are not reported."
Johannesburg Emergency Services spokesman Synock Matobako said though safety systems were in place, he could not discuss them.
"These systems ensure paramedics communicate in an emergency."
He said after the 2010 attack, the city trained most of its staff in self-defence.
"What is critical is that these are preventative measures. As an emergency service, our personnel do not anticipate being attacked, hence we treat security differently," he said.
Werner Vermaak, ER24 spokesman, said most of their staff did not report their attacks, writing them off as "part of the job" instead.
"We know a lot are threatened on scenes especially in informal settlements."
He said the company had safety mechanisms in place, including tracking systems in ambulances. Vehicles were fitted with panic buttons.
Vermaak said paramedics carrying guns on dutyhad to comply with the Firearms Control Act.
Netcare 911 spokesman Jeffrey Wicks said there had been sporadic incidents in which paramedics had been assaulted or hijacked.
"We try never to pair women paramedics on an ambulance. Our vehicles are fitted with tracking devices and panic buttons and we have a policy that, if a situation is too dangerous, they must wait for police. Our policy on weapons is that staff cannot carry them," he said.