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Wheels to Go - Tanzania
Over twenty million people around the world need wheelchairs to move around. In developing countries wheelchairs are often donated, but many users find these are unable to cope with local conditions such as poor roads and rough ground. Now, local technicians are being trained to build wheelchairs in country. Designed for these specific environments and built with readily available materials, they are dramatically changing the lives of disabled people.
Appropriate Design
In 1989 two Industrial Design students – David Constantine, a wheelchair user, and Simon Gue – won the Frye Memorial Prize for their design of a wheelchair for the developing world. The design was simple, easily adaptable, made from locally available materials and suited to the often rugged environment in developing countries. With the prize money, David and Simon teamed up with a friend , Richard Frost, to visit the Centre for the Rehabilitation of the Paralysed in Bangladesh with their design. They were invited to return to the Centre to establish a wheelchair workshop, which they did in 1991 after they had graduated, and so the charity, Motivation, was born.
Motivation
Motivation works with local partners to improve the quality of life of people with mobility disabilities around the world in Africa, Asia, Central America and Eastern Europe. They offer:
- A comprehensive range of suitable wheelchairs designed specifically for the local environment.
- Associated training and education for the individual users so they can achieve their maximum potential.
Mobility Problems
- The United Nations Statistical Office estimates that 20 million people in the world need a wheelchair but do not have one.
- The World Health Organisation (WHO) estimates the average life expectancy of a paraplegic in a developing country to be 2-3 years. In the UK life expectancy for a paraplegic is normal.
- WHO suggests that 20 to 40 people per million of the population will sustain a spinal cord injury each year, and many of these will require the use of a wheelchair.
- Scope suggests that 1 in 400 people worldwide have cerebral palsy.
- The Mines Advisory Group suggests that 26,000 people are killed or maimed by land mines each year.
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Motivation works by invitation only, collaborating with locally based partner organisations, generally disability organisations that understand the needs of their own communities. However, they have also worked with disabled people's groups, non-government organisations, international organisations, government institutions, and private sector organisations. The primary aims are to understand and meet the needs of disabled people in a long-term sustainable way that improves their quality of life. Generally, an organisation will approach Motivation when it identifies a specific area that it believes Motivation can support, mainly through the design and production of wheelchairs. After assessment of whether the partnership has the potential to achieve realistic long-term results, and having obtained the necessary external funding, the programme can commence.
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| Faustina, here with her daughter, has benefited from the work carried out by Motivation. Credit: Motivation |
In Tanzania Motivation works with a local partner, the Tanzanian Training Centre for Orthopaedic Technologists (TATCOT) in Kilimanjaro, where they have set up the world's first Wheelchair Technologists Training Course (WTTC). Students, many of them disabled people from countries across Africa, attend a one-year course producing wheelchairs matched to users’ needs. Poorly designed wheelchairs can actually make the situation worse, leading to further spinal discomfort or pressure sores, so particular attention must be taken to measure each wheelchair user, analyse the individual’s needs and find out where the chair is going to be used, for example in rural or urban areas. This information is used in the selection of the type of chair and its design. The students are taught designs which are suitable for small-scale local production and also for local conditions. Working with local materials, parts and resources means that here a wheelchair can be produced for just $200. Now these professionally qualified students are returning to their home countries to develop these technologies in their own local communities.
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Work being undertaken at the Tanzanian Training Centre for Orthopaedic Technologists (TATCOT). Credit: Motivation
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The advantage of this kind of activity is that it overcomes many of the problems associated with donated wheelchairs – adjustability, suitability, durability and sustainability. After training, these technicians are able to ensure that the wheelchairs are the correct size for the users; the wheelchairs are suitable for their environment, be it hilly terrain or unpaved roads; they have the skills to carry out repairs to a wheelchair so that it can remain operational; and their work supports a local enterprise which can provide long term support for the user.
Widening the Scope
The wheelchair can be the catalyst to changing the lives of disabled people, but other areas of their lives also have to be considered. Having started with wheelchair production, Motivation's work has grown to cover four key issues affecting people with a mobility disability: economic empowerment; rights; capacity; and services and products. Motivation not only takes practical action but also campaigns on these issues.
Economic Empowerment: From birth disabled people face inequalities: as children they are more likely to die young, be malnourished or neglected; often denied education they are unable to find employment and fall into a cycle of poverty. Their families can be excluded, placing additional strain on all family members. Motivation works with mainstream employers and local partner organisations to pass on vocational training that will lead to income generation and a better quality of life.
Rights: Disabled people have a right to engage in all aspects of life, but often they are isolated and excluded. Their ability to claim their rights is limited until their practical needs, such as mobility aids, have been met. Once empowered they can fight for the right to inclusion, for access to basic services such as education, and to influence policy and legislation. In partnership with regional and national organisations, Motivation works with local organisations to lobby governments to address disabled people's rights to be treated equally in society.
Capacity building: Building the capacity of disabled people's organisations is vital if their concerns are to be heard in the community and with governments. Sometimes, they need support to deliver their products and services to disabled people. Motivation helps these grassroots organisations by empowering them with the means and methods to become even more effective, enhancing their competence and sustainability. For example, it works with another Tanzanian organisation – the Kilimanjaro Association of Spinally Injured (KASI). This organisation helps people with spinal cord injuries to integrate back into society.
Motivation is supporting KASI to develop its effectiveness and efficiency and to expand its membership by providing training and support. The average life expectancy for someone who sustains a spinal injury in Tanzania is less than two years, compared to normal life expectancy in more developed countries. KASI helps to address this by providing education and information to people soon after their injury, helping them to understand their disability and integrate back into society and achieve a good quality of life.
Services and Products: Disabled people need to receive equipment that is the correct size and meets their individual needs – this work is undertaken by the assessment and prescription service. Key staff are trained to ensure everyone receives appropriately prescribed and fitted equipment, as well as education about their disability and support from other disabled people.
| Wheelchair users have differing needs that need to be taken into account when choosing the appropriate design. For instance, stable three-wheel wheelchairs and supportive seating have been developed for children with cerebral palsy. Workshops must train local people to build quality equipment matched to individual needs. Motivation is always keen to hear feedback from users that could improve the designs. |
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| Wheelchairs produced by students at the Tanzanian Training Centre for Orthopaedic Technologists (TATCOT). Credit: Motivation |
Four-wheel wheelchairs are generally more suited for active use in urban environments. They can have features such as folding backrests, folding frames or quick release wheels for ease of transportation by bus, train or car. Some four-wheel wheelchairs can be modified for sports use.
Three-wheel wheelchairs are more stable and more manoeuvrable over rough terrain, making them more suitable for rural or mountainous areas. Motivation also designs tricycle attachments for three-wheel wheelchairs.
Tricycles, whether attached to a wheelchair or as stand-alone products, make travelling longer distances more easy, possibly permitting users to go to work, to the shop or to visit family. Tricycles are also extremely effective over rough terrain and in mountainous areas.
Supportive seating provides added support for children who have more complex needs, for example children with cerebral palsy who are physically affected in many different ways by their disability. An emphasis is put on producing lightweight and manoeuvrable systems suitable for children with the ability to self-propel to offer good support and highly adjustable seating.
The Future
Through partnerships with TATCOT and KASI, Motivation is addressing the different areas that impact on wheelchair users. As with any charity Motivation is dependent on donated funds to continue and expand this work. Its mission is to improve the quality of life for wheelchair users, seeking to ensure that they are able to lead independent lives and claim their rights in society.
Acknowledgements
Hands On would like to thank Christine Cornick from Motivation for her help in putting together this case study.
Further Information
Participating Organisations
Motivation
Brockley Academy
Brockley Lane
Backwell
Bristol BS48 4AQ
UK
Tel: +44 (0)1275 464012
Fax: +44 (0)1275 464019
E-mail: info@motivation.org.uk
Website: http://www.motivation.org.uk/
TATCOT (Tanzanian Training Centre for Orthopaedic Technologists)
PO Box 8690
Moshi
Tanzania
Tel: +255 27 275 3986/7
Fax: +255 27 275 2038
E-mail: tatcot@eoltz.com
KASI (Kilimanjaro Association of the Spinally Injured)
Moshi
Tanzania
Tel: +255 27 2754217
E-mail: kasi_kili@kilionline.com
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