Rolling towards inclusivity: Local heroes champion accessible wheelchairs and awareness

For years, like many others, I was unaware of the critical distinction between a generic wheelchair and an appropriate wheelchair tailored to individual needs.

It’s a realisation that has come with a heavy dose of regret, knowing the unnecessary suffering endured by countless individuals, especially those with disabilities.

The assumption that all wheelchairs are created equal couldn't be further from the truth.

While a wheelchair is meant to provide mobility and independence, for many, it has become synonymous with discomfort and pain.

The harsh reality is that numerous people continue to use ill-fitted or inappropriate wheelchairs, simply because of a lack of awareness.

Imagine relying on a wheelchair that, instead of offering relief, exacerbates physical discomfort and limits mobility.

Witness Mulokozi, for instance, suffered from pressure sores for six years due to an unsuitable wheelchair.

A social worker and gender equality activist, her story highlights the urgent need for appropriate wheelchair provision.

“During the time I faced the challenge of disability, I didn't know anything about wheelchairs. I thought any wheelchair would be suitable for a disabled person. However, when I started using one, it began causing problems with the pressure sores, which resulted in additional costs for treating that issue,” she shares.

“I eventually came here to CCBRT to be assessed in order to get an appropriate wheelchair, which is what I'm using now.”

On the other hand, Malcolm Kipanya’s mother, Sarah Chande, says she also dealt with the challenge of having inappropriate wheelchairs during the lifetime of her son.

“I had a very difficult time understanding which wheelchair was right for my child because during his time, the one he was using had many challenges, so much so that he had to leave school in third grade. This problem is still very big, and that is why I decided to be a champion to ensure that education reaches many people and that the environment is also friendly for those using wheelchairs,” she explains.

It is a reality that far too many individuals with disabilities face daily, yet it remains largely overlooked by society at large.

The recent Wheelchair Stakeholders Meeting at the Comprehensive Community-Based Rehabilitation in Tanzania (CCBRT) on Friday, April 19, 2024, shed light on these issues.

Led by Kyaro Assistive Tech, a local company in Arusha that specialises in crafting suitable wheelchairs, the meeting highlighted the significance of appropriate wheelchair provision and its transformative impact on the lives of individuals with disabilities.

The gathering brought together a diverse group of stakeholders, including representatives from government agencies, non-profit organisations, healthcare professionals, and individuals with disabilities themselves.

Through insightful discussions and shared experiences, participants emphasised the pivotal role that appropriate wheelchairs play in enabling independence, mobility, and social inclusion for people with disabilities.

Speaking to the stakeholders, Co-founder and Chief Executive Officer (CEO) at Kyaro Assistive Tech, Colman Ndetembea shares that as local a company, it is important to create the system that will help the availability of appropriate wheelchairs in the country.

“We have been witnessing donors donating wheelchairs, but a large percentage of these wheelchairs end up being unusable for people with disabilities because they’re not appropriate for them. These further exacerbates challenges and prevents many individuals with disabilities from carrying out their activities,” he shares.

He further added that most of the donated wheelchairs are hospitals wheelchairs which are designed for short-term use and mostly used to transport patients from one room to another on smooth and level ground.

“When it comes to navigating on rocky roads, it is difficult for them to navigate and these chairs do not support the change in postures, which often leads to more medical problems than they solve,” he explains.

According to World Health Organization (WHO), appropriate wheelchairs are those that meet users’ needs and environmental conditions, provide proper fit and postural support, safe and durable, are available in the country of need and can be obtained, maintained and serviced in the country at an affordable cost.

Wheelchair technologist in the country, Abdullah Munishi who is also living with disability, asserts that improperly fitted wheelchairs frequently inflict serious harm on individuals with disabilities, particularly those with spinal cord injuries who have lost sensations.

“An inappropriate wheelchair can cause a person to develop pressure sores. Pressure sores are wounds that take a long time to heal, often taking a month to a whole year to recover. Sometimes these sores claim the lives of many, especially those who have spinal cord injuries because they lack sensation. When they sit for a long time, they may not realise they are developing sores,” he shares.

He further added that, apart from developing sores, inappropriate wheelchairs also reduce the ability to perform tasks such as going to school, work, or exercise and other activities they may enjoy.

“My wheelchair enables me to travel from Moshi to Dar es Salaam on my own without assistance, I navigate the city on my own, meaning I can conduct my activities without the help of another person. This because the wheelchair meets my needs and is an appropriate wheelchair,” he explains.

Getting the right chair

Abdullah explains that it is important that every person with a disability, with their specific needs, have access to a wheelchair that meets these needs.

This also must factor in the environment in which a person lives, their size and age so it is able to support their posture and give them balance.

Furthermore, he added that the wheelchair must be safe, which means it must have brakes, a comfortable seat and it must be easily accessible along with its spare parts.

Abdullah also explains that there are steps that have been put in place by WHO to ensure that the user gets the right wheelchairs.

The first step is the referral and appointment where a service provider helps the user to collect all necessary information and provide to organisations so they can provide the appropriate wheelchair.

“An example of these places is CCBRT, so you can provide a referral, set an appointment and get all the help you need,” he explains.

The next step is the assessment of the patient that helps to determine the type of disability and the environment where patient comes from.

“After the assessment, the next step is prescription, where they look at what type of wheelchair will fit and meet the user’s needs. Then, they consider the costs and where the wheelchair will be available,” he elaborates.

Abdullah continues by mentioning fitting as part of those steps, ensuring that the user sits comfortably where the final step is to ensure that the users also are provided with training on how to use the wheelchairs.

“After all those steps, it’s important and necessary for follow-ups to be scheduled and consistent to deal with any issues that may arise or adjustments that may be needed,” says Abdullah.

Robert Show is one of the stakeholders who benefited from getting an appropriate wheelchair after an accident that made him think it was the end of his farming business in Moshi region.

He didn't expect to get a wheelchair that would be able to take him to the farm and back home because the one he was using before required him to get assistance from people to push him.

"There are many people, I believe, who are suffering because they lack sufficient education and awareness about these wheelchairs. It's important to have more organisations in place that help provide these wheelchairs,” says Robert.

The root of this issue lies in the misconception that all wheelchairs serve the same purpose and offer the same level of comfort.

Appropriate wheelchairs, crafted with meticulous attention to individual needs, can make an immense difference in the lives of users, offering not just mobility but dignity and comfort as well.

Speaking to International coordinator at the Tanzania Training Centre for Orthopedic Technologist (TATCOT) and an expert in orthopedic devices and assistive equipment, Longini Mtalo shares that there’s a need to continue producing more local professionals who can manufacture appropriate wheelchairs.

“Due to the shortage of wheelchair experts, we decided to establish a program here at the university (TATCOT) in 2000 to educate young people locally. At that time, when walking in hospitals, you would easily find wheelchairs left behind. So, this program aimed at providing education using materials already available at home,” he says.

Despite the challenges of appropriate wheelchairs in the country, hospitals like CCBRT and KCMC have been providing this needed training and education.

They also supply wheelchairs that meet the needs of people with disabilities to enable them to continue with their daily activities as normal individuals.

The Coordinator for Wheelchair and Occupational Therapist at CCBRT Moshi, Neophita Lukiringi, urges the government to ensure that insurance services prioritise assistive devices for people with disabilities.

“Despite the challenges we have, we still continue to serve people in need in Tanzania through continuous seeking of donors and partners to support and continue training more people who provide wheelchair services. We would appreciate it if the government put assistive devices into insurance policies so that people with disabilities can access them easily,” she shares.

The government, through the Ministry of Health, is in the process of revising the National Policy on Development and Services for Persons with Disabilities.

The policy has been in place for a very long time (since 2004).

The process has already begun to ensure that some policies are changed but also to ensure the inclusion of disability-friendly services, including issues related to appropriate wheelchairs.

It's time for society to awaken to this reality and recognise the importance of advocating for appropriate wheelchair provision.

Awareness campaigns, education initiatives, and policy changes are all vital steps toward ensuring that individuals with disabilities have access to the right equipment, tailored to their specific needs.