Full medical travel insurance, including air evacuation from remote areas, is highly recommended. Be aware that some insurance policies may not cover activities deemed to be hazardous, for instance, paragliding or scuba diving.
When traveling to South Africa, we always recommend you speak to a local travel consultant to ensure you have all the proper documentation and cover.
These policies and procedures may change, and therefore, your local operator cannot be held responsible in cases of a medical emergency.
There are a couple of fantastic resources for both, such as Just Landed, that can guide you through the process.