Two drivers are reported to be in a serious condition after their vehicles; a bakkie and a taxi collided on the R56 in the Umkomaas river valley area between Richmond and Ixopo, KwaZulu-Natal on Tuesday afternoon.
"The drivers of both vehicles were found entrapped and two other passengers, who had suffered only minor injuries, had managed to free themselves," said ER24 spokesperson Ross Campbell in a statement on Tuesday.
"The fire department, assisted by ER24, extracted the two seriously injured males, believed to be in their 30s, before administering Advanced Life Support interventions."
One driver was transported to Edendale Hospital. The other was taken to Mediclinic Pietermaritzburg for further medical care.
The two passengers with minor injuries declined an offer for transport.
Meanwhile, in a separate incident, a woman in her 20s died and three others injured after their bakkie collided with a cow and rolled down an embankment on the R612 outside Donnybrook, in the KwaZulu-Natal midlands on Tuesday.
"ER24 paramedics arrived at 16:45 to find the local provincial emergency services on the scene. They had already assessed and declared the young woman dead on arrival," said spokesperson Ross Campbell in a statement on Tuesday.
The injured - two females and a male - believed to be in their early 20s suffered "minor to moderate" injuries.
"All three were treated before we transported one female patient to Mediclinic Howick and the provincial Emergency Medical Services team transported the other two to St Apollinaris hospital for further care," Campbell added.
The cow died of its injuries.
Police were on the scene.