The 32^nd edition of the Africa Cup of Nations took place in Egypt in the cities of Cairo, Alexandria, Suez and Ismailia, with the new – recently expanded – format of 24 teams.

It was the first time Afcon took place during June and July, which was summer in Egypt. With daily ambient temperatures reaching into the upper 30s, precautions were taken to prevent – and if necessary – treat any heat-related illnesses.

To this end, all games were played at night. Environmental temperatures were recorded prior to every match, cooling equipment for official rest and cooling breaks within the stadia was mandated, as well as medical protocols and equipment to diagnose and urgently treat any heat-related illness, especially heat stroke, which is life-threatening.

Prof Efraim Kramer, Extraordinary Professor in the Section: Sport Medicine at the University of Pretoria – plus the tournament medical officer of the Fifa World Cup in Russia 2018 – was one of the six Confederation of African Football (CAF) venue medical officers on duty.

Prof Kramer reviewing the side-line medical team and their medical equipment at the Cairo International Stadium.  

“Besides ensuring that the wet bulb globe temperature was taken strictly 90 and 60 minutes before every single match – in order to decide whether a rest and cooling break may be required – it was also my responsibility to visit all delegated hospitals to ensure each one had a heat stroke medical protocol, that staff were appropriately trained and all the necessary emergency medical equipment was in place,” said Prof Kramer.

He was responsible for training the medical and paramedical staff in football emergency medicine protocols and procedures, as well as ensuring that all emergency medical services were in place, especially those related to heat stroke. The Cairo International Stadium was his primary stadium of responsibility, aside from being responsible for medical services planning and provision.

“It was also necessary for me to visit all delegated stadiums to also ensure everything was in place to diagnose, and if necessary, begin emergency treatment of heat stroke.

“Thankfully, no cases of heat-related illness occurred during the tournament,” he said.

The venue medical officers at Afcon 2019 included Kramer, Joseph Kabungo (Zambia), Paul Marealle (Tanzania), Cyrille Mouyopa (Gabon), Cyrille Dah (Cote d’Ivoire) and Prince Pambo (Ghana), under the direction of the Vice-President of the CAF Medical Committee, Dr Yacine Zerguini.