Resource Mobilisation for Assistive Technology in Community Based Rehabilitation

Original Editor - Mahbubur Rahman Top Contributors - Mahbubur Rahman

Introduction

Photo 1: Standing frame

According to a recent report by WHO, it is estimated that 1.3 billion people – or 16% of the global population – experience a significant disability, and this number is growing day by day as non-communicable diseases and people's life span increase.

Assistive devices and technology are linked with everyone in the world who experiences functional difficulties, either for short or long periods or permanently, including children and adults with disabilities, older people, and people living with chronic conditions.

It is estimated that about 85-95% of people who need assistive devices and technologies in low and middle-income countries (LMICs) are unable to access them.

Purpose

The most commonly reported barrier to assistive product access is affordability and lack of availability, as well as expensiveness. A rapid assistive technology assessment (rATA) survey of individuals with disabilities in refugee camps in Cox’s Bazar District, Bangladesh, found that about half of the respondents reported unmet needs for assistive products.

To fulfil the unmet needs of assistive devices and technologies, rehabilitation professionals can innovatively use locally available resources in community-based rehabilitation. This also strengthens the capacity of the community people to utilize the affordable and available resources to maximize the functional abilities of individuals who require assistive devices, especially mobility devices. It is also recommended during the early rehabilitation in disasters and conflicts.

The video clearly described the assistive devices and technologies, including how simple and tiny changes may have a big impact on the life of a person with a disability.

Materials can be used

There are lots of locally available material's can be used as assistive devices and technologies. From the practical experience of a rehabilitation professional with community-based rehabilitation for more than five years, here a list includes the common items which can be used to produce assistive devices or technologies locally and cost-effectively.

The list includes, but is not limited to,

• Bamboo
• Wood
• Rope
• Plastic bottle
• Branch of tree
• Cloth
• Cotton
• Foam
• Sandbag
• Mud
• Sand
• Old motor vehicle tyres, etc.

Role of rehabilitation professional

Rehabilitation professionals are required to consider different factors as part of their professional reasoning process when making assistive device and technology selections. Some factors should be kept in like environmental factors, financial ability of the family and acceptance by the user and the community. One important thing is that rehabilitation professionals must be aware of their influence on assistive devices and technology selection.

The rehabilitation professional is the expert who knows the strengths and weaknesses of the individuals, which is why they are the first ones to make innovative ideas for suggesting or advising the best appropriate assistive device and technology while considering all factors. In-depth observation during field visits is highly recommended to identify the resources available in the surroundings.

Bamboo wheelchair: A case presentation

The bamboo wheelchairs, also known as African Chairs, were tested by Ghanaian manual wheelchair users for daily use. The wheelchairs come in two designs - one for urban areas and the other for rural areas. Both designs use bamboo-rod skeletons that are bonded by a hot-glue gun, jointed and wrapped with epoxy-soaked fibres, and upholstered by a local tailor. The chairs are equipped with basic standard wheel components. The design process was iterative, incorporating expert deliberations and feedback from users. The study also recommended increasing the access to mobility and physical activity and remove or reduce the barriers to for the persons with disabilities to maximize their independence in an efficient and cost-effective way.

In low-resource settings, people with disabilities often face abrupt barriers to mobility and physical activity due to social stigmatization, high equipment costs, and limited adaptability. Bamboo wheelchairs can potentially improve access to mobility and physical activity by allowing for efficient and cost-effective production according to the user's needs. Interestingly, bamboo wheelchairs can also help reduce social stigma by avoiding the "medicalization" of traditional mobility devices like wheelchairs. For more information about the bamboo wheelchair project, please visit here.

Resources

• Community-based rehabilitation: CBR guidelines by WHO
• Disabled Village Children By David Werner
• Early Rehabilitation in Conflict and Disasters Field Handbook, Humanity and Inclusion (HI)
• The Role of Physical Therapists in Disaster Management, World Physiotherapy
• Assistive technology in Tajikistan: situational analysis, WHO Europe, 2019.