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       International Journal for Service Learning in Engineering 
       Vol. 2, No. 1, pp. 60-77, Fall 2006 
       ISSN 1555-9033
 
 
  60 
Assessment of Wheelchair Technology in Tanzania  
 
Amos G. Winter, V 
PhD Student, Department of Mechanical Engineering 
Massachusetts Institute of Technology 
Cambridge, MA 02139 
awinter@mit.edu
  
 
Abstract – The purpose of this assessment was to determine the current state of wheelchair 
technology in Tanzania and the factors that prevent Tanzania’s disabled from utilizing 
wheelchair technology. Ninety-nine interviews of wheelchair and tricycle users, wheelchair 
and tricycle manufacturers, and advocacy groups for the disabled were conducted 
throughout Tanzania during the summer of 2005. Technical issues identified included: 
tricycles are more popular and much less expensive than wheelchairs; most disabled people 
rely on do nations to buy a mobility aid; production costs can be decreased by using bicycle 
components and outsourcing tasks; bicycle components are available in rural areas and are 
attractive for use in wheelchairs; and donated wheelchairs are often irresponsibly 
distributed and poorly designed for their operating environment. The assessment was 
conducted under the supervision of the Tanzania Training Center for Orthopedic 
Technologists and Whirlwind Wheelchair International.  
 
Index Terms – developing countries, disability, handcycle, mobility aid, tricycle, wheelchair 
I
NTRODUCTION
 
People with physical disabilities in developing countries face many challenges integrating into 
everyday life. If these people cannot obtain a wheelchair they are sometimes forced to stay 
trapped in their home or use crawling as their only means of transportation. Disability KaR
i
which is helping to oversee wheelchair projects in developing countries, reports that only 2% of 
people in Africa who need a wheelchair actually have one. The Ta nzania Association of the 
Disabled (CHAWATA) estimates there are 30,000 people who need wheelchairs in Tanzania and 
only 2,000 who have one.
ii
 Immobility adversely affects the lives of disabled people by, for 
example, making it near impossible to attend school, participate in the community, or earn an 
income. The terrain in developing countries can further impede integration into society; in urban 
environments doorways and bathrooms are typically not handicapped accessible, and in rural 
settings roadway quality can be hilly, rough, and muddy.  
Efforts have been made in Tanzania to improve wheelchair technology, fabrication, and the 
channels through which wheelchairs are distributed. The Wheelchair Technologists  Training 
Course (WTTC)  at the  Training Center for Orthopedic Technologists (TATCOT)
iii
 in Moshi, 
developed in part by the NGO Motivation,
iv
 is a one-year course for a Certificate for Wheelchair 
Technologists. The WTTC covers manufacturing and fitting of wheelchairs designed for African 
countries, which can be produced in small- scale, self- sustained shops. Whirlwind Wheelchair 
International (WWI)
v
, a US-based non-profit NGO that develops appropriate wheelchair 
technology for developing countries, has helped establish 21 wheelchair manufacturing shops 
around the world. One of the wheelchair designs taught in the WTTC is based on a WWI model. 
Although chairs are being produced in Tanzania, most people only have accessibility to 
imports that are poorly made, improperly fitted, and dangerous to the user. Wheelcha irs need to 
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       International Journal for Service Learning in Engineering 
       Vol. 2, No. 1, pp. 60-77, Fall 2006 
       ISSN 1555-9033
 
 
  61 
be fitted with the consideration of the user’s size, age, and nature of disability, among other 
factors. If improperly fitted, the chair can cause pressure sores – breaks in the skin produced by a 
person’s weight pressing against an unyielding  surface. These sores can develop almost 
immediately upon contact. If left untreated they can become infected and lead to death.  
The purpose of this assessment is to elucidate the factors in current wheelchair design, 
manufacturing, distribution, and use that are prohibiting Tanzanian wheelchair users from 
accessing and utilizing appropriate wheelchair technology. Such factors can be in the form of 
technological inadequacies for the operating environment, inefficient manufacturing practices, 
lack of competitive pricing, ineffective or limited cost subsidizing, inefficient distribution 
practices, etc.  
This document summarizes the findings of the full report written on the assessment, which is 
available for download
vi
. The assessment was supervised by TATCOT and WWI and was meant 
to provide feedback to both organizations to aid in future wheelchair planning strategies in 
Tanzania. To the knowledge of the author, TATCOT, and WWI, such an assessment has never 
been conducted in Tanzania. Written permission was granted from each interviewee before 
interviews were conducted.   
A
SSESSMENT 
S
TRATEGY
 
Interview Content  
The aim of this assessment was to inspect the current state of wheelchair technology from 
multiple angles by interviewing the primary parties involved with wheelchair design, 
manufacturing, and use. Three types of questionnaires were developed by the author, in 
conjunction with TATCOT and WWI, to interview individual wheelchair users, wheelchair 
advocacy groups, and wheelchair manufacturers. In this paper the terms “wheelchair” and 
“tricycle” are both used to describe types of mobility aids. Common examples of these machines 
are shown in Figure 1. 
 
 
 
A)
 WHEELCHAIR
 
B)
 TRICYCLE
 
 
FIGURE 1 
COMMON MOBILITY AIDS
 
 
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       International Journal for Service Learning in Engineering 
       Vol. 2, No. 1, pp. 60-77, Fall 2006 
       ISSN 1555-9033
 
 
  62 
A short content summary of each party’s questionnaire is below. Full versions of the 
questionnaires can be found in the original report
vii
 
 
Individual wheelchair/tricycle users: How was the wheelchair/tricycle obtained; who 
paid for the wheelchair/tricycle, who made the wheelchair/tricycle; at what age was the 
wheelchair/tricycle obtained; what type of mobility is the wheelchair/tricycle used for – 
short or long travel; how functional is the wheelchair/tricycle in the users life; what types 
of technical problems are encountered; what caused the disability; at what age was the 
first and current wheelchair/tricycle obtained.  
 
Advocacy groups: What services are provide to wheelchair/tricycle users; does the 
organization purchase wheelchairs/tricycles; are they donated to the org  – and if so by 
whom; does the org have a need-based subsidizing plan; how many people are in the org; 
how many wheelchairs/tricycles have been distributed; are there any technical problems 
observed with the members’ chairs.  
 
Manufacturers: What types of wheelchairs/tricycles are produced; how much does each 
cost; what types of components are being used; what types of raw material is used; how 
quickly are products produced; what types of manufacturing strategies are in use; how 
many people are employed.  
 
Interview Locations  
Interview locations were chosen in an effort to represent both urban and rural wheelchair 
operating environments. The primary interview locations were Dar es Salaam, Moshi, Arusha, 
and Stone Town, Zanzibar. Visiting remote  villages and interviewing disabled was logistically 
impossible. Advocacy groups working in rural areas provided most of the information about 
rural wheelchair use. Some rural information was contributed by urban interviewees who had 
lived much of their life in a village. The majority of interviews were conducted in the Dar es 
Salaam area because it has the highest population density and concentration of wheelchair 
related organizations in the country.  
R
ESULTS AND 
D
ISCUSSION OF 
W
HEELCHAIR 
U
SER 
I
NTERVIEWS
 
The following section presents critical results from wheelchair user interviews and provides 
discussion on issues the data reveals. The full compilation of data from the assessment can be 
found in the original report
viii
. In all, seventy-one disabled people were interviewed in the 
assessment.  
Causes of Disability   
Figure  2 shows the distribution of disability causes for the interviewees. Polio was the most 
common disability observed, at 38% of the interview population.  Most polio survivors 
interviewed contracted the virus early in life.  
 
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       International Journal for Service Learning in Engineering 
       Vol. 2, No. 1, pp. 60-77, Fall 2006 
       ISSN 1555-9033
 
 
  63 
0
5
10
15
20
25
30
Birth Defect
Polio
Spinal Injury
Cerebral Palsy
Other
N/A
Cause of disability
# of interviewees
 
FIGURE 2 
DISTRIBUTION OF INTERVIEWEE DISABILITIES
 
 
It is important to note that only people who were available or visible to the author were 
interviewed. Survivors of birth defects and polio made up 54% of the interviewees. In 
comparison to the spinally injured, who typically became disabled later in life (~20 years old), 
birth defect and polio survivors had more time to acclimate to their disability by learning to 
crawl or use a mobility aid. Thus, the people who were able to work or beg on the street were 
primarily polio or birth defect survivors and represent a larger portion of the interviewees.  
Pre-wheelchair Mobility 
As a result of the majority of interviewees becoming disabled early in life, most used crawling as 
their primary form of mobility before obtaining a wheelchair or tricycle. This trend is seen in 
Figure  3, with 49% of the interviewees relying on crawling before obtaining their current 
mobility aid.  
 
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       International Journal for Service Learning in Engineering 
       Vol. 2, No. 1, pp. 60-77, Fall 2006 
       ISSN 1555-9033
 
 
  64 
0
5
10
15
20
25
30
35
40
Crawling
Cane
Crutches
Push Cart
Other
N/A
Means of transportation before current WC/trike
# of interviewees
 
FIGURE 3 
MEANS OF TRAVEL BEFORE CURRENT MOBILITY AID
 
 
Figure  4 demonstrates how long people wait before receiving a mobility aid. The average 
interviewee age of obtaining a first wheelchair or tricycle was 22 years old. As a result, most 
people who went to school or had a job before the age of 22 were forced to crawl as a primary 
means of travel, while others were simply unable to attend school or obtain a job because of 
distance.  
 
0
5
10
15
20
25
0-9
10-19
20-29
30-39
40-49
50+
N/A
Age when received first WC/trike
# of interviewees
 
FIGURE 4 
AGE WHEN FIRST MOBILITY AID OBTAINED
 
Usage after Obtaining a Wheelchair or Tricycle 
Figure  5 and  Figure  6 indicate why tricycles are the preferred mobility aid. Most of the 
interviewees needed to travel multiple kilometers per day, with 36% traveling more than 5km 
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       International Journal for Service Learning in Engineering 
       Vol. 2, No. 1, pp. 60-77, Fall 2006 
       ISSN 1555-9033
 
 
  65 
and many more traveling over 1km.  For long distances, a tricycle requires much less energy than 
a wheelchair. Although Figure 6 shows only slightly more tricycle users than wheelchair users, it 
is important to note that the author had to make a concerted effort to find wheelchair users, but 
had to forgo many interviews with tricycle users. On the street, it was much more common to see 
a tricycle user. Wheelchair users were only interviewed in hospitals, schools, and rehabilitation 
centers – places that required small distances of movement per day. During the duration of the 
assessment not a single wheelchair user was seen outside an enclosed facility or organization.  
 
0
5
10
15
20
25
30
35
0 to 4km
5 to 9km
10 to 14km
15 to 19km
=20km
N/A
Distance traveled to work/school
# of interviewees
 
FIGURE 5 
DAILY TRAVEL DISTANCE OF INTERVIEWEES
 
 
0
5
10
15
20
25
30
35
Bus
Taxi
WC
Trike
Friend
Crawl
N/A
Primary means of mobility
# of interviewees
 
FIGURE 6 
MEANS OF TRANSPORTATION USED