Emergency Medical Services (EMS) response time remained a challenge. The province was faced with a shortage of personnel and ambulances. According to the HOD, the national norm was 1: 100,000. Since the province had a population of 2.9 million, it should have 290 ambulances, but only had 120- 130 functioning ambulances according to the department. In October/November 2009 40 new ambulances were procured and in April 2010 an additional 60. However, because of the age of the existing fleet many were replaced and not added to. The department was leasing ambulances through the government garage. Each ambulance needed 8 to 10 person crew. The department planned to place certain ambulances in the districts but they needed additional ambulances and personnel. The province had opened its own EMS College to deal with the shortage of EMS staff in the province. The emergency helicopter contract was currently being reviewed and might not be renewed, given the high costs and limited service offered.