Your medical insurance may exclude scuba diving as a hazardous recreational activity and/or may not provide coverage when you are traveling out of the country. If it does provide coverage, it may pay only a minimal amount for chamber treatments. There are also often large out-of-pocket payments for deductibles and co-pays. These alone can total thousands of Rands. DAN's Dive Cover Plans are recognised worldwide and can be confirmed 24 hours a day through the DAN Emergency Hotline (+27 828 10 60 10). DAN's Dive Cover Plans provide secondary cover of up to R800 000 and pay 100% of eligible expenses

Most divers realise that diving is an adventure sport that may result in injuries as such they want the peace of mind that, in case of a diving emergency, there is a 24-hour hotline to call with membership benefits for the medical services they will need.

DAN membership is not expensive by most standards. Diving medical advice is offered free of charge and is available 24/7/365. Membership benefits are secondary to any primary medical insurance and include diving medical and travel related cover that are also extremely affordable and very competitive. DAN members also have access to discounts on safety and educational materials.

Many divers like being part of an organisation that is so obviously committed towards their safety. Apart from being available as a diving emergency and diving-medical-information line, DAN is always actively campaigning for safety, initiating and supporting safety initiatives, and finding practical ways to make diving safer and more enjoyable.

DAN is a very personal organisation. Callers quickly learn that DAN is not an “institution”; it is a living and vibrant organisation. In many ways, DAN members feel that they are becoming part of a “family” who look out for one another “divers helping divers” as we always like to say.

So, many divers just seem to like the idea of being part of something worthwhile and they are willing to give up some of their discretionary income to be a part of it.

That being said, it is also common knowledge that DAN offers top-rated services and has an exceptional network of experienced diving medical professionals. One call to the DAN hotline and divers find themselves talking to a professional diving doctor who “speaks their language”. This is truly something special. With access to so many likeminded people, DAN is able to arrange evacuation by land, sea or sky if required and help injured divers gain access to specialised medical treatment facilities such as recompression chambers.

In a nutshell! DAN members help support a 24-hour hotline. This hotline offers access to specialists trained in diving medicine and is freely available to members with a diving-related query. The DAN hotline can be called 24/7/365 by a member worldwide in the event of a dive emergency. DAN membership subscription contributes towards the 24-hour emergency and information line. The emergency and diving-medical-information line is freely available to DAN members. So members can call for medical advice on any topic to do with diving or ask to be referred to a health professional knowledgeable in diving medicine.

When you support DAN, you support the organisation’s ongoing efforts to reduce dive injuries and improve first response and medical treatment. One hundred percent of DAN’s profits are reinvested in research, medical services and programs that make diving safer for all divers. As a diver, you need DAN and DAN needs you.

DAN offers comprehensive plans that provide protection and peace-of-mind in the event of a dive accident for far less than the cost of an unplanned event.

DAN’s dive accident cover plans are recognised worldwide providing secondary coverage of up to R800,000 and paying 100% of eligible expenses.

It is true that some medical insurance include cover for diving injuries. However, divers who have tried to go this route soon discover that it is not easy to work with a medical insurance when trying to organise an emergency evacuation for a diving injury. That is simply not the time to discover that your medical insurance is not able to assist you in getting the most appropriate treatment or advice. Their convenient 0800 toll-free number doesn’t work in Zanzibar and even in South Africa, working your way through a multi-prompt menu from a cell phone is not what you need in a crisis. Also, getting documented authorisations takes time and nearly all private emergency service providers now insist on a written Guarantee of Payment (GOP) before responding. That is not surprising given that most aeromedical evacuations in Africa come in at R200 000 or more and even evacuations by ambulance approach R20 000 plus when advanced life support services are involved. Evacuations are costly. Recompression, on the other hand, is not that expensive in Africa. In the rest of the World, it may set you back about R100 000, but in South Africa the cost is usually under R20 000 unless multiple treatments are needed. However, if evacuation and hospitalisation are called for, the costs can be very high.

As a DAN member, all these concerns disappear. One number and you have all the help and cover you need for a diving emergency. The travel and medical benefits are an added bonus, but don’t tear up your medical insurance card just yet. So, should a diver have a medical insurance or be a DAN member? A diver should be both!

I found a number for DAN Southern Africa and even though I wasn’t a member I thought I’d risk calling in case they would give me advice. Within seconds I was talking to a doctor trained in diving medicine and I got advice, support and a lifeline! DAN was the first to take me seriously. Dr Jack Meintjes, Medical Director of DAN Southern Africa, took on the case and concluded my symptoms pointed towards DCS. He advocated immediate evacuation to a recompression chamber. When I called my insurance company in Johannesburg they wondered if it was contagious, asked how I could climb a tower with ‘this sickness’ and was planning to get a doctor to come and visit me. In this area there’s only one boat a week to/from the island. They didn’t know what DCS is and that time is a vital factor. DAN fully understood the urgency and stepped in to help me in every way they could. DAN logged all my correspondence and calls, mapped out on GPS my island’s exact position and activated an emergency evacuation plan. DAN Southern Africa's Medical Director Dr Meintjes also wrote a letter to the airlines explaining that I had DCS and suggested Oxygen should be administered on board, should symptoms become acute. At 17,000 feet on the short flight from West Papua to Manado, my tingling sensations worsened. On the longer three hour flight at 38,000 feet from Manado to Singapore my left fingers went numb, my left wrist and arm began to ache and the tingling in my left foot, toes and left hand now extended to my right side as well. A few hours after landing I made my way to the recompression chamber at the superb Tan Tock Seng hospital in Singapore, a chamber facility vetted by DAN. I had 13 hours of recompression treatment. It goes without saying that I wouldn’t do another diving trip without DAN!

DCS doesn’t always present as a ‘typical’ profile. You don’t always have joint pain or rashes! Don’t go on a dive trip with ‘ROAMON’ SMS only. This means you cannot make outgoing calls or receive any, and you can’t deactivate it from abroad! When my friend in Cape Town called Vodacom and explained we had a medical emergency, they nevertheless refused to deactivate it without speaking to the owner, which they naturally couldn’t do, since I was on SMS only! Take your symptoms seriously, even if others don’t. Then get professional advice with trained diving doctors, even long-distance. DAN will offer us this at any time of day or night. Do not expect your GP to have knowledge of symptoms occurring as a result of diving. A travel insurance company may not understand the urgency of our symptoms, may not understand what our call is about and may not have fast access to anyone who is qualified in diving medicine. A travel insurance company may have foreign offices, who act on their behalf, eg in Indonesia and Singapore, but each representative must get authorisations from the Head office, in this case Johannesburg, which causes huge delays. South Africa is seven hours behind Indonesia, so most authorisations came in 1-2 days later. In a life/death scenario we don’t have that sort of time to play with. I noted that with DAN there are no delays. Activation and decisions in an emergency are immediate. Thank you DAN, I wont forget your help.

I also run new medication past the team to ensure that it is safe to use while diving. They always put so much effort into my requests. I am really taken aback by their genuine care and concern for my safety. For those of you who have not learned how to make use of DAN to the fullest, take my advice and start doing so. I never go on any dive trip without letting them know where I am off to. It is a great feeling knowing that if something goes wrong, DAN will prepare the best possible evacuation and safety procedures. I have also attended a number of their dive safety and first aid courses and each one was not only very helpful and informative, but loads of fun too. Thank you DAN for all the effort you put into ensuring that communicating with your team is quick and painless, whether it involves administrative tasks or emergencies. I look forward to my next 10 years of diving knowing that you truly do have my back.

DAN my best dive buddy! I have been diving since 1996 and had never bothered with DAN – probably because I believed that one had to do something really stupid to get the bends. To my detriment I learnt that this is not the case. Early in December 2010, I was on holiday in Indonesia – on my own – and as Murphy would have it my trusted dive computer unexpectedly bombed on the first day. The diving was superb and as I had a dive boat and dive crew to myself, I was comfortable to work with the DM’s readings. We were diving three dives a day mostly at depths of 20-25 m with more than hour-long intervals between each dive. However, on most days during one of the dives we encountered some current, but as I am a particularly strong swimmer, this did not worry me. During all of the dives in current we still had hour-long dives and I surfaced with at least 50 bar so I wasn’t concerned about overexertion.

Then, on the fifth day and after the 15 th dive, I started feeling pains in my body as if every muscle was literally on fire. I also felt a bit nauseous (I didn’t eat my lunch, which normally I would have devoured), had a skin rash and was a bit unstable on my feet. Not remembering anything about the bends from my dive course, I sent an sms to my husband in Johannesburg, who did some research and then suggested that I might have DCS. I was on a small island off the city of Manado, but because I wasn’t a DAN member, the resort manager was reluctant to send me to the chamber on the mainland. She called the dive doctors at the hospital in Manado, who suggested that I go on oxygen for at least two hours and (in between the hourly doses) drink 3 ℓ of warm water (within a half-hour period – yucky!). The manager was particularly pedantic and went through each dive on the DM’s dive computer and all were well within safety limits. As this happened at the end of my trip, I had to delay my flight for three days (at my own cost) and thought, somewhat thankfully, that I had survived relatively unscathed. But, unbeknownst to me, the ordeal wasn’t over yet.

I arrived home in Johannesburg on the public holiday (16 December) and noticed that my foot started swelling to the point that I was eventually unable to walk. My husband got in touch with DAN (yes, in the evening of the public holiday!) and the call centre put him in touch with a DAN doctor who called me immediately. He was concerned about thrombosis, etc. due to the long overnight flight from Singapore, combined with the risk of having had the bends, and suggested we go to the nearest emergency room. I was then hospitalised for four days with a condition called cellulitis (no, this is not when all the cellulite from one’s thigh migrates to one’s ankle!). Stupidly I had ignored a blister on my heel that did not appear infected but was caused by the fin strap rubbing through the bootie during the strenuous swimming. This small, “innocent” blister had infected the soft tissue of my whole foot. During this time the DAN doctor (I wish I could remember his name) from Cape Town phoned my husband every day (weekend included) as did the DAN call centre. The care and attention only stopped when I was discharged from hospital. What impressed both my husband and me was that we were not DAN members at the time. We were both overwhelmed by the level of care as neither of us had ever experienced such superior service before, even from services that we pay for. I know I wouldn’t have received anything like this kind of care from my GP who would have charged handsomely for each consultation or call. I make a living from training businesses to deliver and wish I could model DAN as the epitome of a superb service orientation.

I was lucky to have had a mild form of DCS, but from then on I have never, nor will I ever, dive again without DAN! If you think it will never happen to you consider this: I am fit. I speed walk about 1 000 km a year, successfully climbed Kilimanjaro a few years ago and can get into a pool and swim a kilometre with ease. The dive doctor (recommended by DAN) in Johannesburg assured me that anyone can get the bends at any time and in his words, “Many DMs are either too inexperienced or too stupid to know that diving three dives a day for more than a few days consecutively will virtually guarantee it”.

I want to thank the DAN crew who cared for me and can assure you, I am now a very committed DAN member.

It is always a source of great joy to hear this type of testimonial from our members. DAN was founded on a culture of shared enjoyment of the aquatic realm and the desire to help fellow divers in need. Responses like these are welcome affirmations that the original spirit continues. What is important about this story is that the problem was not specifically diving-related, but it did happen in a diving context. As such it was important that the various professionals involved had an understanding of general medicine as well as diving medicine (and several of us were involved). This allowed us to tease out the important features and facts so as to assure the right treatment, at the right facility, at the right time. That is what makes DAN different.

Alert Diver is read almost exclusively by the members of DAN. As such, important messages like these do not reach non-members unless our members make the material available to them or talk to them about it. As such, we would really like to ask you – as our loyal DAN members – to tell your diving buddies about DAN and the value of being a DAN member. DAN is so much more than diving medical cover. DAN represents a culture of care – a heart for diving. It goes beyond helping in the occasional emergency towards serving and protecting the very enjoyment of this wonderful sport of diving!

Many divers who are away on a diving holiday will perform multiple dives per day for a series of days. They incorrectly assume that staying within the “safe parameters” of diving tables or a dive computer will protect them against developing decompression sickness, but consider the following:

1. It does not matter whether you strap the dive computer on a female, male, fit or unfit person (or even a rock!), it will allow each one the same “safe” dive profile. It is clear that neither a dive computer nor diving tables could accurately model human physiology. In fact, many of these models accept up to a 5% risk (meaning that one in 20 persons will bend if they dive to the limits of the model).

2. To totally desaturate (eliminate all nitrogen from your body) after a dive, requires six half-times, which is linked to a specific tissue type (after one half-time you have eliminated 50%, after two half-times you have eliminated 75%, after three half-times you have eliminated 87.5% and so forth). We usually distinguish between “fast” tissues (e.g. spinal cord and brain) and “slow” tissues (e.g. bones and tendons) when it comes to saturation with nitrogen during diving. When looking at the most commonly used diving tables and the mathematical models used in dive computers, the diver is considered a “new diver” after a period of 12 hours. This would mean that the longest half-life considered in these mathematical models is two hours (since 6 x 2-hour half-lives would lead to total desaturation). Physiologically we know that this is simply not true. There are “slow” tissues with half-lives that far exceed these times! The implication is that with a subsequent dive you will be loading these tissues again, before they have fully desaturated. The resultant effect will be that you have more nitrogen dissolved in these tissues than what is predicted by the mathematical model. So, if you do repetitive dives expect to develop DCS in the tissues that are not adequately taken into account in these models (now you know why you felt the pain in the hip/elbow/ shoulder, even though you stayed within the limits of the table!).

To deal with these concerns, divers should refrain from performing multiple dives without taking a “non-diving” day to relax and enjoy some other activity while ensuring adequate desaturation of the slower tissues. This is even more important if you plan to fly back home. It goes without saying that doing multiple dives in a remote location will also jeopardise your safety.

DAN's Emergency Hotline staff members are on call 24 hours a day, 365 days a year, to provide information, assist with care coordination and evacuation assistance.