How to review a tour operator after medical emergency?

Give them a 5 star review. It sounds like the guide handled this tricky situation very well. If you are not comfortable disclosing any details just write something like "we encountered an unexpected and potentially dangerous situation and the guide handled it very professionally and calmly and kept me safe at all times"

As a tourist myself who goes on adventures in potentially dangerous areas, knowing how a tour company handles a life-threatening emergency is super important to me, the more details the better.

That information may dissuade some unprepared tourists to take the hike. Or it may cause some unprepared tourists to take better precautions, or to wait until they're in better shape, but either way, it is very valuable information to have.

Having that kind of information in the review under the tour company/tour guide name lets me know that the review is probably authentic as well, since a tour company is unlikely to add fake reviews reminding people that they might get hurt (even if those are 5-star reviews).

And at the same time, seeing such a review would certainly sell me on the tour itself. I've never been to South Africa, but I've been to Death Valley in the US and I am aware that heat strokes are going to be inevitable given the high temperatures and the harsh demands of the environment.

Following Spratty's excellent answer, I'm incorporating some of it into my own answer:

I do also believe that the tour guide is responsible to make sure that the group he leads hydrates frequently enough. However, I'm not sure the entire blame can be placed on the tour guide himself. Nor do I believe that this judgment needs to be necessarily made for your review to be useful to others.

In your review, just describe what happened. How did you feel before the hike even got started? How old were you? How much experience did you have hiking? How good of a shape were you in? What did you eat? How much water did you carry on you? Were you wearing a hat? If you were tired because of a very long plane ride the day before, or because of a sunburn, or because you partied too much, or because you had the flu a couple of days before, be sure to mention that in your review. The same goes if you feel you didn't have time to acclimate to the altitude yet.

Some of those things, the guide should have known, but some of those things he couldn't necessarily have known. Whatever may be the case, just describe the facts. And if you're not sure how to interpret those facts, you can just let the readers of your review make up their own minds. Also, how many people were in your group, or were you alone? How fast was the pace? And tell the reader if the guide reminded you to hydrate frequently. Etc.

Ultimately, I do realize how tricky writing such a review is. On one hand, the guide ended up saving your life, and you should be super grateful, and super grateful for all the trouble he went through, but on the other hand, it was partially his responsibility (in addition to your own) to ensure that this kind of thing doesn't happen in the first place.

I seem to be going against the general flow here, but I'm going to offer a contrary opinion. I've been in that sort of environment in South Africa as well as Zambia and Botswana and I would not give any kind of positive review to a tour guide who didn't pretty much force me to keep well hydrated and take things easily. In places like that (and this is especially true at altitude) it is possible to catastrophically dehydrate without even noticing you are sweating, the air can be that dry.

I would personally consider your collapse as a failing on the part of the guide who I would expect to be perfectly aware of the hazards of the trip. If you had failed to disclose a pre-existing medical condition that's one thing, but to let someone in their care dehydrate and collapse from heat-stroke is quite another.

I would review the whole situation and let the reader make up their mind. Post the positives (the calm and professional handling of the situation, the quite incredible rescue service, of which I have never heard the equal) and the negatives (he took you out into a hostile environment and didn't keep you hydrated).

If I've read this incorrectly I apologise but I do feel he let you down.

What is the purpose of a review? The purpose is to help others evaluate the worthiness of this particular tour guide (versus others or other activities). It is not a travelogue or tell-your-story soapbox; Blogspot gives those away for free.

Most customers will not have a medical emergency. So on one hand, your description of your trouble is totally useless to them. But on the other hand, it does give a rare behind-the-curtain look at the guy's performance under pressure and with the unanticipated, and is useful on that basis. So I think discussing it is constructive to the extent it informs the next booker but no more really.

As far as paragraphs and paragraphs of setting up the story and giving context, I for one find that irksome and tedious - you know the feeling... You pick up an alt-weekly paper, eager to read their music or theater review, and you find yourself in a long-format "piece" which gasses on for 3/4 of the page before saying boo about the event itself. That. Don't do that in reviews.

One of the best things I ever learned is "Ideas used to be a dime a dozen. Now, they're a nickel a bushel." -- Don Lancaster. The conceptual output of a person's brain has far, far, far less value than that brain would like to believe, and only certain very particular things create value.