ER24 spokesperson Russel Meiring said it is believed that a mother and her three children had been hijacked in their car.
"A security company gave chase as the vehicle fled with the occupants. Some distance later, the driver apparently lost control, causing the light motor vehicle to smash into a bakkie and caravan," Mering said.
He said paramedics, along with other services, arrived on scene to find the car and bakkie, towing a trailer, lying in the middle of the road.
Meiring said paramedics found that nine patients had been injured in the collision. Five were children - four girls and a boy.
The four girls, aged between 1 and 16, were taken to various hospitals with injuries ranging from minor to moderate.
Some of the patients had sustained critical injuries and required immediate treatment.
Paramedics treated them and provided advanced life support treatment.
Meiring said the mother was airlifted by the ER24 helicopter while a seven-year-old boy was airlifted by another private helicopter to a nearby hospital.
The three male suspects were transported under SAPS supervision to Laratong Hospital.
Investigations are ongoing.