Wheelchairs are a catalyst for empowerment: integrate assistive technology into health budgets
By Mussa Chiwaula, Director General at Southern Africa Federation of the Disabled (SAFOD), based in Botswana.
At the age of four, I was struck with polio. It left me with paralysis in my lower limbs and my right hand. As a child growing up in Zimbabwe, where my Malawian father worked for many years, I was carried everywhere by my mother and siblings. All through primary and secondary school they carried me there, and at the end of the day, they carried me home.
My mother used to say to me, “Mussa, I want you to go to school so that you can read and write, so that when you have any problems you can write to your brothers who can assist you.” Little did she know that I would turn out to be self-reliant, and even be able to help my siblings too.
Mussa Chiwaula, age 10, growing up in Malawi with his brothers.
The turning point came when I was a teenager and my big brother bought me a wheelchair. You can imagine the first feeling I had when I used a wheelchair. I felt a lot of joy, and I didn’t want to rest. I just wanted to go all over the place. For the first time in my life, I felt a sense of independence and it brought independence for my family too.
Today, I have a family, I have children, and I work in a rewarding job. I was very lucky because my parents understood the importance of education, even if it meant sacrificing their time to get me to school. With the kind of problems I faced when I was growing up, I said to myself, when the right time comes, I will dedicate my life to make sure that future generations will not face the same challenges.
Embedding assistive technology in policy and law
In 1999 my friends and I created a disability lobby group called FEDOMA to demand that the Malawian Government, among other things, provide assistive technology that can help people in need. Since then, this is what I have been doing; making sure that persons with disabilities have access to wheelchairs, and other types of assistive technology that allows them to be independent. It has been quite a journey.
The first thing that we did was to make sure that disability and assistive technology issues become policy issues. We lobbied for the formulation of a National Disability Policy and legislation for years, and eventually it was made into law. We knew that just having a law was not enough, because it needs enforcing. So, we pushed hard to make sure at least parts of the law were implemented.
Since 2014, I have been working for a regional disability organization – SAFOD – and the struggles are the same. At the regional level we are advocating a policy framework to ensure that disability, including issues of assistive technology, becomes part of the regional development agenda. We are in the process of formulating the South African Development Community (SADC) Regional Disability Protocol.
The poorest people cannot afford assistive technology
If a person is given the right type of wheelchair, his or her life will change considerably. Wheelchairs for people who are severely disabled are usually the most expensive type. They are only available for the very few who have enough money to buy them. Many families cannot even afford standard wheelchairs. This is very sad because wheelchairs are a catalyst for empowerment.
Some people access donated wheelchairs through non-governmental organizations (NGOs). While NGOs can play an important role to support persons with disabilities, when assistive technology is donated, it can be inappropriate. Wheelchairs, for example, are often donated in bulk and they are not the right size or appropriate model for people’s conditions. Some of these wheelchairs even end up worsening someone’s condition. But people do not have a choice because they need to be mobile in order to be independent.
Actions by governments, NGOs, development partners and the private sector can promote appropriate assistive technology, ensuring that it reaches the poorest people in society who cannot afford to pay.
Some key ways to achieve this include:
Integrating assistive technology into health budgets
Assistive technology is an important component of primary health care and achieving universal health coverage (UHC). Governments should integrate assistive technology provision into the health budget, so that assistive technology is mainstreamed. This allows people of all wealth statuses to access appropriate assistive technology for their condition through a systemic approach, rather than relying on a chance donation from an NGO.
Supporting local production and manufacturing of assistive technology
Most of the time, the issue of profit rises above the issues of need with the result that poor people are unable to purchase the technology that could transform their lives. Making cheap, low-cost and appropriate wheelchairs for people through local production and manufacturing systems would be an effective solution. This is definitely an area that needs strategic investment and promotion.
Not placing burdensome taxes on assistive technology
Governments should not place taxes on imported assistive technology, or on raw materials that local companies might use for production and manufacturing of assistive technology. I speak from personal experience. When I bought a wheelchair from China, I was told that I needed to pay taxes on it. But for me, the wheelchair is not a piece of luxury, it is a necessity for me to be able to work and survive. Another time, a friend donated a wheelchair to me from Norway. When it arrived, customs detained it and told me to pay taxes. I complained to the Ministry of Finance in Malawi, and eventually they obliged and waived the fee.
Still too many challenges
When I look back to when I was growing up, I can see that things are now slightly better but there are still far too many challenges and battles to fight. In the Southern Africa region, poor families simply cannot afford to pay the prices of assistive technology. This is unjust, and this is why I am working to ensure that the rights of disabled persons are upheld, and that assistive technology is available for all who need it.
Find out more about SAFOD by following them on social media (LinkedIn, Facebook and X).