Role of the Wheelchair

Original Editor - Priya Gulla

Introduction

The wheelchair is one of the most commonly used assistive devices to promote mobility and enhance quality of life for people who have difficulties in walking (for e.g. : a person with spinal injuries resulting in quadriplegia or paraplegia, muscular dystrophy,etc). Mobility open up opportunities for wheelchair users to study, work, engage in social activities and access services such as healthcare.

To ensure effective mobility, wheelchair users need a wheelchair which fits them correctly and meets their specific needs. However statistics show that about 10% of the global population, i.e. about 650 million people, have disabilities and of these, some 10% require a wheelchair. It is thus estimated that about 1% of a total population – or 10% of a disabled population – need wheelchairs, i.e. about 65 million people worldwide.

In addition, it was estimated that in 2003, 20 million of those requiring a wheelchair for mobility did not have one. There are indications that only a minority of those in need of wheelchairs have access to them, and of these very few have access to an appropriate wheelchair.

Wheelchair

Users of Wheelchair

Users include:

• children, adults and the elderly;
• men and women and girls and boys;
• people with different neuromusculoskeletal impairments, lifestyles, life roles and socioeconomic status; and
• people living in different environments, including rural, semi-urban and urban.

Users represent a wide range of mobility needs, but they have in common the need for a wheelchair to enhance their mobility with dignity.

Rights to a Wheelchair

The United Nations Convention on the Rights of Person with Disabilities (UNCRPD) entered into force on 3 May 2008.

There are human rights that apply to everybody. The UNCRPD focuses on ensuring that everybody recognises that these rights also apply to people with disabilities. There are 50 different articles in the Convention.

One of the articles, article 20, is about "personal mobility" which says: " States Parties shall take effective measures to ensure personal mobility with greatest possible independence for persons with disabilities".

Wheelchair service personnel can help to implement article 20 of the UNCRPD by:

• providing an appropriate wheelchair for wheelchair users who visit their service;
• assisting wheelchair users in learning how to get in and out of wheelchair y themselves;
• supporting wheelchair users in learning how to propel themselves;
• encouraging family members to support wheelchair user's to be as independent as they can be.

There are other human rights that people with mobility impairments can enjoy more easily if they have an appropriate wheelchair. These are:

• living independently and being included in the community (article 19) ;
• right to education (article 24);
• right to the enjoyment of the highest attainable standard of health (article 25);
• right to work and employment (article 27);
• right o participate in political and public life (article 29);
• right to participate in cultural life, recreation, leisure and sport (article 30).

Benefits of a Wheelchair

A wheelchair is the catalyst to increased independence and social integration, but it is not an end in itself. The benefits for using an appropriate wheelchair are:

Mobility

Wheelchairs help people to get around with the greatest possible independence and do the things they want to do.

Independence

A wheelchair that is functional, comfortable and can be propelled efficiently can result in increased levels of activity. Independent mobility and increased physical function can reduce dependence on others. Thus, wheelchair user's can be more independent and more in control of their own life.

Physical Health

A wheelchair can improve the user's health in many ways. A wheelchair that is functional, comfortable and can be propelled efficiently can result in increased levels of activity. A well fitting wheelchair with cushion can reduce common problems, such as pressure sores or poor postures. A wheelchair that works well, fits well and can be propelled easily can increase the physical activity of the user, thus improving physical health. Other benefits, such as improved respiration and digestion, increased head, trunk and upper extremity control and overall stability, can be achieved with proper postural support.

Self esteem

Wheelchair users may become more confident and have more self esteem when they have a wheelchair that fits them and which they can use well.

Quality of Life

With maintenance of health there is increase access to opportunities for education, employment and participation within the family and the community. These factors also contributes in increasing quality of life of wheelchair user.

Access to Community Life

With a wheelchair, wheelchair users can be more involved in community life. For example, it enables the user to go to the work or school, visit friends , attend places of worship or other community activities.

Appropriate Wheelchairs

An "appropriate wheelchair" is a wheelchair hat:

• meets the user's needs;
• meets the user's environment;
• is the right mach for the user;
• ensure postural support;
• can be maintained and repaired locally.

Challenges for Wheelchair Users

Financial Barriers

Some 80% of the people with disabilities in the world live in low-income countries. The majority of them are poor and do not have access to basic services, including rehabilitation facilities. The International Labour Organisation (ILO) reports that the unemployment rates of people with disabilities reach an estimated 80% or more in many developing countries. Government funding for the provision of a wheelchair is rarely available, leaving the majority of users unable to pay for a wheelchair themselves.

Physical Barriers

Majority of wheelchair users are poor, with inaccessible surroundings. They also live where road systems are poor, there is a lack of pavements, and the climate and physical terrain are often extreme. In many contexts, public and private buildings are difficult to access in a wheelchair. These physical barriers place additional requirements on the strength and durability of wheelchairs. They also require that users exercise a high degree of skill if they are to be mobile.

Access to Services

In many developing countries, only 3% of people with disabilities who require rehabilitation services have access to them. According to a report of the United Nations Special Rapporteur, 62 countries have no national rehabilitation services available to people with disabilities. This means that many wheelchair users are at risk of developing secondary complications and premature death that could be avoided with proper rehabilitation services.

Education and information

Many users have difficulty in accessing relevant information, such as on their own health conditions, prevention of secondary complications, available rehabilitation services and types of wheelchair available. For many, a wheelchair service may be their first access to any form of rehabilitation service. This places even more emphasis on the importance of user education.

Personal Choice

Users are rarely given the opportunity to choose the most appropriate wheelchair. Often there is only one type of wheelchair available (and often in only one or two sizes), which may not be suited to the user's physical needs, or practical in terms of the user's lifestyle or home or work environment. According to the Convention on the Rights of Persons with Disabilities, “States Parties shall take effective measures to ensure personal mobility with the greatest possible independence for persons with disabilities … by facilitating the personal mobility of persons with disabilities in the manner and at the time of their choice, and at affordable cost”.

References