Uhuru Kwa Mjongeo
Freedom Through Mobility
Bishops’ Appeal have continued their partnership with Motivation, funding £10, 000 for this project in Moshi, Arusha and Dar-es-Salaam in Tanzania.
In Tanzania over 200,000 people have some form of mobility impairment with one in every four children being disabled from birth. Tanzania has a high rate of poverty and for the disabled population, this situation is even more acute with a lack of inclusion in the formal labour market, poorer health, reduced access to education, fewer economic opportunities than people without disabilities. One of the main issues for disabled people is the lack of an appropriate mobility device. In many low-income and middle-income countries, only 5-15% of people who require assistive devices have access to them. Without an appropriate wheelchair, fitted to the individual after a proper physical assessment, people with disabilities in Tanzania are vulnerable to developing secondary conditions that can be life-threatening e.g urinary tract infections, pressure ulcers and respiratory complications. Trained rehabilitation services (to World Health Organization standards) and ongoing healthcare and mobility device maintenance are essential for prevention and management of these conditions. In addition to physical barriers to independence, misconceptions and negative attitudes result in the exclusion of many disabled people from full participation in society. Disabled children are less likely than their peers to start school, and once enrolled, less likely to advance. Disabled adults face similar barriers to economic participation, with a global unemployment rate of more than 60%.
This project is part of Motivation’s wider country programme, building on their work in Tanzania to date. To address the national problems of access to appropriate wheelchairs, they aim to strengthen and scale out the established Intermediate wheelchair services through partners CCBRT in Moshi and Dar-es-Salaam. They also aim to develop a Basic service in Moshi for people with less complex postural support needs. They are instigating a pilot mentoring programme where experienced and model wheelchair service specialists will mentor less experienced or less confident staff to build their knowledge, skills and ability to assess, prescribe and fit wheelchairs. 250 disabled children and adults will receive an appropriate wheelchair through either a trained central service or through a mobile outreach programme, helping to meet the huge need for wheelchairs in more remote communities. Local wheelchair repair services will be established enabling people to get their products repaired locally, ensuring they can keep their wheelchairs well maintained and usable without waiting for a community outreach visit or travelling to a central service.
- 250 children and adults are mobile through being fitted with an appropriate wheelchair that meets their needs and suits their environment.
- Wheelchair services have trained staff in place to provide an improved quality of service for disabled people.
- Disabled children and adults are referred for wheelchair fittings and receive follow-up support without having to travel from their communities.
- Patients at KCMC (Kilimanjaro Christian Medical Centre) are mobile, confident and empowered after their rehabilitation through receiving a wheelchair from the hospital’s Basic wheelchair service and from follow-up at home by peer trainers.
- Disabled people can get their wheelchair repaired more easily and at an affordable price.
- Disabled people are more confident and active wheelchair users.
- Service networks are increasing referrals so disabled people can access the appropriate service for their needs.
- Fit 250 children and adults with disabilities with appropriate wheelchairs through trained partner wheelchair services.
- Help 200 children and adults to get or stay mobile through community follow-up visits. Six outreach trips by partner CCBRT in Moshi will re-assess wheelchair users to ensure their chairs still fit correctly and remain in good repair, helping them to stay healthy, mobile, access social services and take an active part in daily life.
- Provide 12 people with spinal cord injuries with vital health information, advice on rights and relationships and mutual support through our week-long Peer Training course led by volunteer Peer Trainers who are wheelchair users themselves.
- To help wheelchair users keep their chairs maintained, safe and useable, we will identify four local bicycle repair shops in Moshi and train 10 of their staff in wheelchair repair and maintenance. This means there will be local repair shops to go to, which will be easier to access than central services.
- Working alongside the National Wheelchair Task Force’s sustainability strategy, we will provide training in wheelchair service provision at World Health Organization (WHO) Basic level for 12 people (these participants will be invited from government, existing partners, KCMC and Peer Trainers). Peer Trainers will then be able to provide follow-up when on home visits to people with spinal cord injuries, so not only support them emotionally and practically but also assess that their wheelchair is still fit for purpose.
- To continue this approach of integrating our work with government clinics and hospitals etc., we will also provide training in wheelchair service provision at WHO Intermediate level for 12 professionals. Intermediate level is to assess, prescribe and fit wheelchairs to adults and children who need more complex postural support. Our partners from Gabriella RC will attend this session so they will be able to identify and refer children with disabilities (predominantly cerebral palsy) who come to the centre and may need a mobility device.
- To reach more people with disabilities, we aim to build and expand Basic wheelchair services in the country. To this end we are conducting a WHO Managers training for 12 professionals to enable them to effectively establish and run wheelchair services.
- We have been working with KCMC hospital for some time, providing peer-to-peer training for people with spinal cord injuries as part of their rehabilitation. However, many of these people leave hospital without a wheelchair. As part of our joined-up approach, we are establishing a Basic wheelchair service at KCMC to link in with our Peer Training programme at the hospital, so people with spinal cord injuries are fitted with an appropriate wheelchair and get support and information from other wheelchair users.
- We want quality services to be available for disabled people long after Motivation’s intervention ends. We are exploring the use of mentors to hand over to and are therefore piloting a 3-day mentoring workshop (for 6 key staff from CCBRT in Moshi, Dar-es-Salaam, TATCOT and KCMC. The aim is that these mentors will then support wheelchair services and their staff, drawing on their own expertise.
- Establish referral networks between services (Gabriella, CCBRT and KCMC) and between services and local repair shops.