The Challenge & Solution
Children with disabilities and their parents and caregivers in rural areas of South Africa have limited access to the medical devices and services they need. Appropriate and comfortable seating is key to achieving independence and social inclusion. Without a proper wheelchair, individuals may develop secondary medical challenges such as pressure ulcers. In fact, this condition is one of the leading causes of death among paralyzed people in the developing world.
The World Health Organization states that as many as 80% of those who need wheelchairs live in low income and developing regions, such as Africa. Only a small percentage of those who need a wheelchair have one. Studies have shown that assistive technologies, such as wheelchairs, when fitting for the user and the user's environment, have a significant impact on the level of independence and participation which people with disabilities are able to achieve (WHO, 2011). They have been reported to reduce the need for formal support services (WHO, 2011) as well as reduce the time and physical burden for caregivers (Allen et al., 2006).
The use of mobility devices, in particular, creates opportunities for education and work, and contributes to improved health and quality of life (May-Teerink, 1999; Eide & Oderud, 2009; Shore, 2008). Wheelchairs, thus, provide children with disabilities with the opportunity to become participating members of society ("Guidelines on the provision of manual wheelchairs in less resourced settings", WHO 2008).
Other challenges in the disability sector in South Africa include: a shortage of experienced and specialized providers in rural areas, lack of funding by the government, and stigma or lack of understanding about the nature of disabilities. Through Uhambo's grassroots and holistic programs, some of the most vulnerable people in the world, children with disabilities, are served and these issues are addressed through the provision of appropriate devices and equipment, customized training and community development.
The Huis Talje Children's Home in Bela Bela (or Warmbaths), in the province of Limpopo of South Africa, provides care for approximately 50 severely physically and mentally handicapped children. The Warmbaths Rotary Club helped to establish this home in 1999 and plays an active role with the home with fundraisers and sitting on the Board. Since its founding, over 100 children have been served.
Children with disabilities at the Children's Home are seated in ill-fitted wheelchairs which can cause secondary medical problems, shorten their lifespan and impact their quality of life. Some children with disabilities at the home do not have a wheelchair at all. Uhambo provided 29 wheelchairs in Grant #1 and an additional 10 children need devices who were not served initially.
In addition, the home does not have enough beds for all children -many are sharing beds; and the beds that are on site are outdated and in ill-repair. The caregivers have received training in Grant #1 on how to properly seat and position children in the devices and maintain and use the devices, however additional training will be necessary. Uhambo has found that the skills need to be reinforced every few months through training to ensure the safety and wellbeing of the children.
In addition to providing proper wheelchairs and training, this project will address the stigma of people with disabilities by creating public awareness in the community through its outreach. These activities will build a foundation for future opportunities for children, older youth and adults with disabilities to reach their full potential by creating educational, developmental, social inclusion opportunities.
With Rotary support for this grant, the following will be achieved:
1. Provide approximately 10 children with new custom wheelchairs.
o All children are assessed and prescribed a customized wheelchair that is designed for their specific medical needs.
o Wheelchairs are supplied by Shonaquip, a local designer, manufacturer and distributor of appropriate wheelchairs customized for children. Shonaquip is based in Cape Town, South Africa and has over 25 years of experience in the wheelchair business. Their products are award-winning for appropriate design technology for the user, environment and medical conditions. As a social enterprise, Shonaquip hires and trains people with disabilities.
o Manufacturing of the customized chairs takes approximately 2 months.
2. Conduct training for caregivers and staff at the home including:
o Wheelchair seating and positioning per WHO (World Health Organization) recommendations to prevent (or delay) unnecessary secondary health complications, to learn about the necessary physical accommodations and adaptations needed for each child based on their physical disability and their rehabilitation needs and how to maintain the wheelchairs.
o Human rights, stigma of disabilities and management strategies.
o Training is provided by Shonaquip's nonprofit arm, Uhambo, that has qualified, trained staff.
3. Provide approximately 42 new beds that are appropriate for children with disabilities. Beds will be procured at a local distributor of medical and hospital supplies. Uhambo staff will advise on best quality and most economical products that will serve the home's purposes.
4. Increase public awareness about disability issues in the community in order to destigmatize disability and create inclusion opportunities for children with disabilities at the home and throughout the community. Increased public awareness about disabilities is crucial to improving the conditions and rights and policies for children and people with disabilities in developing regions of Africa. Public awareness will be developed through Rotary's involvement with the community and local media.
5. Monitor the project to ensure sustainability, proper use of devices and training and to lay the groundwork for the successful development of future and optional phases of the project.