Conservative estimates put the number of people with disabilities in developing countries at close to one-half billion. Of these, an estimated 20 million require wheelchairs to be mobile. While many humanitarian and development agencies implement broad rehabilitation programs, few provide a comprehensive approach to the provision of suitable wheelchairs and the associated training and education that must accompany their distribution. Established in 2007, USAID's Wheelchair Program supports a wide range of projects to produce and distribute wheelchairs and provide services for wheelchair users. In administering this program, USAID applies four (4) fundamental principles:
Appropriate to Environment and Individual
First, when the wheelchair itself is the focus, a provider organization may be tempted to take a “one size fits all” approach and mass produce, or collect donated chairs and conduct mass deliveries. Not only are these wheelchairs generally ill-suited to the rough urban and rural environments of low-income countries, but they do not provide long-term solutions for the provision of wheelchairs to a given population. In some cases, these actions cause the collapse of local wheelchair manufacturing enterprises. USAID therefore supports projects that provide wheelchairs suitable and appropriate for use in developing countries, and that are adaptable to the needs and requirements of each individual. The Wheelchair User Support Program, works with local partners in South and Southeast Asia, East and Southern Africa, and Eastern Europe to design and produce low-cost, environment-appropriate wheelchairs.
Sustainable Local Services
Second, while numerous NGOs endeavor to provide wheelchairs, few attempt to establish sustainable services for users. Shipments of appropriate wheelchairs may benefit a discrete group of users, but the benefit will be short-lived if support services, such as wheelchair repair services, are not available to the user. USAID-funded projects support local production of good quality, repairable, and affordable chairs. Similarly, regional production, coupled with local assembly and repair, offers opportunities for sustainability. The Georgian Wheelchair Production Network, is developing a mid-sized wheelchair production and repair facility in Tbilisi, Georgia. It also is establishing small, networked wheelchair sales, distribution, and repair shops in Gori and Zugdidi.
Training for Service Providers
Third, the usefulness of a wheelchair is directly related to the training and expertise of the technician fitting the chair, proper assessment and prescription, and basic training in safe and effective use. In Kenya, USAID is supporting the Capacity Building for Sustainable Appropriate Wheelchair Service in Kenya project, which provides wheelchair users with access to comprehensive quality wheelchair services, including prescription, production, and fitting and follow-up by qualified professionals.
Quality of Life for Wheelchair Users
Finally, like the provision of prostheses, providing wheelchairs is not just about the chair itself. Rather, it is about increasing the quality of a survivor's life through increased mobility, independence, and integration into society. The provision, or production, of the actual wheelchair is only the first step in enabling wheelchair users to improve their quality of life and participate in family and community. Projects such as the Integrated Wheelchair Provision for Rehabilitation of People with Disabilities in Nepal, invest in local disabled people's organizations and self-help groups. They increase opportunities for wheelchair users to attend school and hold jobs and advocate on a local and national level on behalf of people with disabilities.
