Community-based ambulance services may improve response times and support established healthcare systems, as suggested by the volunteer community-based ambulance service in Cape Town's Hout Bay suburb started by residents in 1994. The Hout Bay Volunteer Emergency Medical Service had an average response time within its own area that was 42.3% faster than the Western Cape government's emergency medical services. It operates with one sponsored ambulance staffed by at least two volunteers. The service interacts regularly with community leaders, offers community first aid training, facilitates fire prevention training, visits schools and provides medical support at community events. Its longevity suggests that the model is sustainable and provides valuable lessons for other communities in South Africa.