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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
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
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.
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.
Course (WTTC) at the Training Center for Orthopedic Technologists (TATCOT)
countries, which can be produced in small- scale, self- sustained shops. Whirlwind Wheelchair
International (WWI)
around the world. One of the wheelchair designs taught in the WTTC is based on a WWI model.
Vol. 2, No. 1, pp. 60-77, Fall 2006
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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.
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.
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.
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.
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questionnaires can be found in the original report
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.
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.
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.
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.
found in the original report
common disability observed, at 38% of the interview population. Most polio survivors
interviewed contracted the virus early in life.
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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.
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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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.
interviewees needed to travel multiple kilometers per day, with 36% traveling more than 5km
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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.