The Making of A Wheel Chair Project

Wheelchair projects have been part of the Humanitarian services of the church for many years. The church gives out approx. 40,000 wheelchairs in 70 countries every year. We distributed about 200 wheelchairs when we served in the DRC, all were locally made as we were unable to bring wheelchairs into the country.

Today the wheelchair projects take on a very different approach. Seems the church realized that just giving wheelchairs was not the answer. People with disabilities needed to be matched with the right type of wheelchair and also have it fitted to each individual needs.

We knew the new guidelines when we came to Uganda and knew that if we wanted to complete a wheelchair project in the time frame of our mission we would have to start immediately to find the right partner (all humanitarian projects need a good partner).

Step 1: Determine what is happening in the country with wheelchairs. Search out vendors, unions, Ministry of Health, past projects. . hours of Internet search, etc

Step 2: Find a partner that has the same values and goals that the church does for distribution of wheelchairs.

Step 3: Arrange for LDS Charities Wheelchair Specialists to come in and help you evaluate the partner and write up the project. The church has developed specialists to help us Country Directors on all these major humanitarian projects including Vision, NRT, Water, Family Food Production and Wheelchairs.





Elder and Sister Dow, Wheelchair specialists for Uganda and several other African countries.



After much preliminary work we felt we had a couple of possibilities of partners so the Dows, our wheelchair specialists, came for a visit to help us understand the new guidelines and help us choose the right partner.

We visited three of the best workshops who were making wheelchairs.

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GYDA workshop in Gulu



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Mulago Hospital workshop



When we visited Gulu we met with Fred Semakula (Head of Gulu's People with Disabilities)and noticed that his chair was not a "in country" made chair and we could see why. He had a wonderfully mobile wheelchair that helped him move around the rough terrain with ease and it fit him well.

Step 4: Meet with your potential partner to determine if you are a good fit for a project.

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National Wheelchair Committee Members

Make a tentative plan of possibilities and who will have responsibility for what. Partners have to commit to taking on quite a bit of responsibility such as getting chairs through customs, securing chairs when they arrive and seeing that the chairs are distributed in an appropriate manner.

Step 5: Write up the project and submit it for approval to the Area Presidency.

Project:

• 354 Worldmade wheelchairs shipped from China
• 100 in-country wheelchairs to be made by local manufacturers ( although the chairs are not the standard of the wheelchairs we were bringing in we wanted to help the workshops increase their production and improve their skills.)
• 4 trainers to come to Uganda and train clinicians and technologists in prescribing, fitting and assembly of wheelchairs.
• Wheelchairs would be distributed free of charge by the members of the National Wheelchair Committee who represented 13 different centers all over Uganda.
• Wheelchairs would be distributed to first time users or people without a functioning wheelchair.

Project was submitted and approved in July of 2010. A tentative plan was set to do distribution in January or February of 2011.

Step:6 Wait for shipment of chairs and prepare for delays (we are in Africa, you know)

Delays . . . good thing we planned for them as:

• National Election in Uganda for February 2011 we realized Feb wasn't going to work.
• Back log in orders for wheelchairs delayed shipment
• Wheelchair shipment hung up in Durban for weeks while shipping tried to find the container.

We finally had word that the chairs were found and had been put on a boat to Mombasa and were expected in country June 17. Project training was scheduled for June 21-24. We were cutting it very close.

Step 7: Arrival - wheel chair or team? How about both and on time too.

On Friday night we heard from Rose that the chairs were at the border and Saturday morning when we called her to see if the chairs were processing customs she said they are delivered and we are unloading them at the hospital as we speak..

354 wheelchairs unloaded and stowed away in Mulago warehouse by Saturday afternoon - big accomplishment

That gave us time to stop at Banana Boat (local craft store) where Marcia could do some shopping before we had to head to the airport to pick up the training team. Training team flight on time and the 8 wheelchairs they brought on the plane (just in case the container didn't make it on time).were packed in Ssimbwa's van along with Blake Powell (technologist), Stephen Hunter Physical Therapist), Phil Arnold (Physical Therapist) and Steven Clark technologist).

They were a bit loopy after their long flight . Steve Clark tried to climb in the drivers seat of the van and didn't even notice he was behind the wheel till Elder Dow asked him if he knew how to drive in Uganda (Left side of the road).

Day 1 Setup

Put some demo chairs together to prepare for training.-

some people had nothing to do except pretend to be wheelchair experts - didn't catch a pic of the fall over backwards while trying to do a wheelie - it came right after the big grin.

But, others really did have to work to get prepared. Training was held at the Kololo

Finished in time to go to "The Source of the Nile". Well, some of us did but John and Farrell stayed at the chapel waiting for Mulago crew to bring wheelchairs for the training. We needed about 40 wheelchairs to have the trainees work on.

Day 2 First day of training

Opening Ceremony conducted by Rose Bongole, chairman of the NWC with guest speaker Pres. of the Ugandan People with Disabilities.

15 Clinicians, PTs and OTs, from 13 different organizations came to train on prescribing wheelchairs.

16 Technicians also came to learn how to assemble, adjust and fit wheelchairs.

Everyone, clinicians and technicians got a chance to see what it was like to be confined to a wheelchair.

We asked all the trainees if anyone had ever sat or tried to move around in a wheelchair. Surprising as it may seem, none had ever even sat in a wheelchair. It might be because of the superstition that if you sat in one you might end up needing one.

Ssimbwa struggled with the chair but eventually got it moving but going up a curb was not an easy task, possible but not easy.

True to the nature there was a wheelchair race egged on by Phil and Steve. Thought we might have a bloody finish but everyone stayed in their chairs that time.

New skills for the technicians. One technician said he had attended a training in Tanzania for 9 weeks but he learned more in this training than in all of the nine weeks in that training. Could be that our trainers had a great approach. Instead of telling everyone what to do they had them solve problems together and work out the best solutions. This certainly got everyone thinking and gave them great confidence.

It was logical that the clinicians learn about patient approach but one of the technicians when asked what new things he learned that would be most helpful he stated, " We learned to respect the patient, to kneel down and get on their level to speak to them, not to stand behind them and talk to them but to come around front where they could see us. We also learned to ask permission before we touched them. This was all new information to me and it will certainly affect the way I practice in the future."

Sis. Dow was a patient for the practice session. it was rather scary as they tried to figure out the best and safest way to get her on the platform.

Each Technician was given a tool kit. A technician and a Clinician will work together to prescribe and fit a wheelchair.

Each member organization of the National Wheelchair Committee will be given a certain number of wheelchairs to distribute. A clinician and Technician from the organization will interview the user and determine which type of wheelchair is needed - 3 wheel very maneuverable over rough terrain or 4 wheel which has the ability to fold up.

Rose Bongole, our partner and new friend needs a rest, she has worked very hard to get a contract negotiated, get the wheelchairs through customs without delay and arrange for a dignitary to attend the closing ceremony of our training. She is a doer - got to love doers - doers make things happen.

Day 4 The practical part of the training, THE DISTRIBUTION
Training is finished, time to prescribe some wheelchairs. The trainees are ready, they can't wait to go to work.

Thirty recipients were asked to come to this distribution for the trainers to practice on. We had specified that those receiving wheelchairs should be either first time users of a wheelchair (never owned a wheelchair) or not have a functioning chair at this time.

And they came . . .

Out front there was a band playing, there was excitement in the air. Not sure who ordered the band but nonetheless it played on welcoming the recipients as they came through the gate at the church. there could be something happening across the street at the Pres. of Uganda's personal airstrip but we appreciated the welcome to our training distribution. It fit right in.

They came who wanted to play wheelchair basketball. He was on the team but they play scooting around in the dirt because they do not have a wheelchair that is maneuverable enough to play basketball so they just scoot around on the ground. They are very fast but they kind of loose that competitive edge.

We tried to learn their background and how they were managing without a chair. For each one, life was hard and a chair would make life so much better, improve their ability to work and to enjoy family activities.

1. THE INTERVIEW

2. DETERMINE WHICH IS THE RIGHT CHAIR

3. MEASURE FOR A CUSTOM FIT

4. BUILD THE CHAIR PER THE Rx WRITTEN BY THE CLINICIAN

5. CLINICIAN AND TECHNICIAN WORK TOGETHER TO MAKE FINAL ADJUSTMENTS FOR THE BEST FIT.

.6. TAKE A TEST DRIVE AND LEARN SOME SKILLS

"Thankyou, this is my first time to have a wheelchair."

"I'm so happy"

"You have given me my dignity. God bless you."

This young man repairs shoes for a living he is divorced and has a young son. He has never had a wheelchair. He contracted polio 20 yrs ago and never walked again. A wheelchair opens up new opportunities for him.

This recipient left and returned to express his appreciation. He said, "I . . .I just don't have the words to tell you how grateful I am to receive this chair. Thank you."

Not sure who is the happiest, the technician and clinician or the recipient.

Wheelchairs are just one of those projects that gives you instant gratification. It is an amazing experience to see people's appearance and confidence totally change as they sit in their new wheelchair.

In the end what had we accomplished?

There are now 31 clinicians and technologists from 13 organizations who are trained in assessing, prescribing and fitting wheelchairs. These same organizations will be able to serve their clients by giving them a wheelchair that is custom fit for them.

The work is just starting. We have only finished the training now our partner will distribute 542 wheelchairs and three of our partners will make another 100 chairs in their own workshop. All these chairs will be given out in different areas of Uganda to people who have never had a wheelchair or people who do not have a functioning wheelchair.

A lot of work goes in to these wheelchair projects. To think we started planning this project over 1 year ago and the project won't be over until the last wheelchair is given out.. . . and that is the 2010 Wheelchair Project. We still have a 2011 project to get going on. Who ever said humanitarian work is easy.

Thanks to the Dows for their great leadership in putting this project together. Thanks to the trainers for taking time to come and offer an incredible opportunity in training to our partners.

Thanks to our partner, the National Wheelchair Committee, for their tireless efforts in carrying out their part of the agreement. And most of all, thanks to all of you who donate to LDS Charities making it possible for over 100 wheelchair projects just like this to happen every year all over the world.

We may be tired but we are having a great time serving in Uganda.

Wheelchairs - big, big, big project

On July 12th we welcomed John and Marcia Dow to Uganda.

They have come in answer to our request for a wheelchair specialist to help us plan a wheelchair project. The church’s wheelchair program has changed focus and instead of giving out wheelchairs to those in need it involves finding a partner and distributing wheelchairs through the partner. The partner has to be someone with the ability to produce wheelchairs, assess recipients, custom fit the chairs, and then train recipients in using the wheelchair helping them to become more independent.


We spent a couple of days visiting wheelchair production sites in Kampala. Uganda has a National Wheelchair Committee that has outlined the same goals for recipients that we have and it looks like we will be able to partner with them and meet all of our requirements.
We met with Rose, Chairmen of the National Wheel Chair Committee, and asked her to help us visit the wheelchair production sites in Uganda. We had a sit down meeting with some of the members of the committee and made a plan.

Patrick gave us a tour of Mulago Hospitals wheel chair production. Wentz gave us a tour of Katalemwa Cheshire Homes Rehab. Center and we made a trip north to Gulu to evaluate Gulu Youth Development Association's workshop.

Mulago's workshop is housed in the old hospital that was built in 1935. The new Mulago Hospital is the largest government hospital in Uganda it is the hospital that receives referrals from all over Uganda. It has a lot of good things going on but as all hospitals in Africa it has great needs.

A well used old wheelchair from Mulago workshop

Can't get this to load upright but you get the picture. This chair can be made in two sizes. It is patterned after an old design called "the Huckstep."

The wheelchair design being made at this workshop has not changed for many years and needs upgrading. One of our objectives is to strengthen the local producers so we will have them make a limited number of chairs to help them grow. They will also supply the warehouse and security for the chairs when we get the shipment in the country.

Katalemwa Cheshire Home has an amazing rehab. center where they bring children for recovery after surgery and provide them with a place to stay and give them extensive therapy while they recover. They require that a parent or guardian stay with the child the whole time they are at the home. This allows the mother to learn to care for their child, the child will not be so frightened of procedures and the parent can guarantee the security for their child.

Mothers are given a chance to learn crafts and have a chance to sell their craft and earn some money to sustain them while at the center. Care is free or what ever the family can pay.

Katalemwa's wheelchairs are all of one design and they make the chair 3 different sizes.
They also have school for the children as they are often there for a long time. The day we were there the class was making jewelry and having a choir practice. The choir performs and helps the center with fundraising.

We met a mother and her baby at the center who lives in a remote village. The child's foot got infected and they tried folk medicine to help the baby but eventually the mother was directed to Mulago hospital but the foot was septic and they had to amputate the baby's foot. The good news is that Katalewma will follow this baby and support the mother with proper orthotics and therapy as the baby grows. This baby was beautiful and was doing well when we saw her.

We also met the poster child for the center. She is featured on their brochure. We could see why as she has a winning smile and a personality to match. She has cerebral palsy and is being cared for by the center. She certainly won our hearts.

We had to let the Dows go. They had other countries to visit and plan more wheelchair projects. They will continue to work on our project with us but from their home in California.

The next day we headed up to Gulu in search of GYDA.

The Gulu area has quite a history and has been ravaged by war many times and especially in the last 30 years. In 1986 local man, Josephy Kony brought together a cohort of rebel groups under the umbrella of the “Lord’s Resistance Army.” Kony claimed to be possessed by religious powers enabling him to be a medium. Having no known agenda or direction, the violent, unpredictable, and impulsive LRA movement began terrorizing the Acholi people.

The LRA would abduct children, maim people in grotesque ways, and raid schools, health centers in the day and at night. The descriptions of the crimes constitute some of the most vile ways of treating fellow humans. Ironically, the LRA claimed to be protecting the Acholi people as it terrorized them. Over 400,000 persons were internally displaced in Uganda in Gulu and Kitgum Districts. In 2000 the area suffered an outbreak of Eboli.
Fast forward to 2010 and you enter Gulu to see many people trying to put their lives back together. There is much rebuilding going on and the town only has a vestige of its past. There are many disabled people in the city and many in the outlying areas resulting from the wars and landmine accidents.

It's a three hour drive to Gulu. A beautiful drive where we pass right by the national reserve where there are several safari parks. You cross the Nile at a site where there are great rapids

and you often run into baboons sitting on the side of the road.

Gulu Youth Development Association (GYDA) is an organization that was started in 1992 by a group of youth with an interest in creating employment opportunities for the under-privileged youth in the district. The organization aimed at finding the means by which the youth could address their unemployment problems through a concerted effort and active participation in feasible economic, health, apprenticeship and training programs. It is a vocational school for underprivileged youth targeting street youth, orphans, disabled youth, school drop-outs, war effected youth and youth parents. They expanded their skills and in 1999 started making wheel chairs.

We had previously met Fred, the director of Gulu Persons with Disabilities Association, a wheelchair user himself. He is also a member of the National Wheelchair Committee. He met us at the center to introduce us and pave the way for a tour.

Upon entering GYDA's complex we were overwhelmed by the activity going on. Most of the youth were preparing for dinner. The center feeds its members a meal every day. All the kids were happy, joking with each other, and anticipating dinner. They all wore GYDA tee shirts and it was evident that everyone had been working that day. We visited a sewing room where kids were learning to sew the cushions for the wheelchairs.

There was a welding shop, a wood shop, an area for sealing and painting and a storage area with many wheelchair frames ready for assembly.
A graduate of the center, Thackery, was welding when we entered the workshop.

He had no legs and sat in a wheelchair. He was protected from the welding by goggles and a blanket. Kilama Robert, the administrator of GYDA, told us that Thackery was able to do welding because it didn’t take much strength and it was a good job for him. Farrell, looking at the young man’s muscular upper body told Robert that it didn’t look like he was lacking for strength as he had muscles bulging everywhere. Thackery grinned real big and we are sure we saw him blush.

The center has two Peace Corp. volunteers who will help their training center for two years. Drew had developed their website making it look very professional. They are a great asset as they give their service and expert advise.

This chair is for a student with a desk that can flip up while in the classroom.

Their wheelchair design has been modified and upgraded several times and looks much like the WORLDMADE wheelchair which is one of the chairs that the church has shipped in for projects. They receive most of their funding through USAID and are limited on their production of wheelchairs because of monies but estimate that their are 3,000 people needing wheelchairs at this time.

We left the center with Fred and went over to the Gulu Disabled Persons headquarters.

Fred was paralyzed at age 15 due to the treatment he received after falling out of a tree. He has dedicated his life to being an advocate for the disabled. He runs a peer training program for disabled people. It is a week course where the person receiving a wheelchair is brought to his center to live for a week and learn how to live with their disability. It is a do or die type training, something you might call boot camp. A person is removed from their caregivers and have to learn to survive. They are trained and taught by a peer, disabled person, to help them learn to be independent and care for themselves. They learn to live in a wheelchair and learn what they can do, not what they can’t do. It is a great program and will add a lot to our wheelchair project.

Fred works in Gulu with this association for the disabled but his home is just outside Kampala. It must be a labor of love as it certainly is real convient for him as he travels home by bus taking his wheelchair with him. This association works hard to meet the needs of the blind, the deaf, women with disabilities and landmind victims.

We have a lot of work to do. This is just the beginning. We are grateful for the Dows and their expert knowledge on developing the project. The project takes time and we project that distribution will not be until January of 2011. We can’t wait to get the project submitted. The changes in the program make it more complete. We plan on having local production make half the chairs and have the other half shipped in from World Made, a great wheelchair for this terrain. The only obstacle we can see is getting wheelchairs through the border. All things imported for the disabled come duty free and without any tax but for some reason things get held up at the border and in the past this hold up is lengthy. We pray for smooth sailing but will not be surprised if there is some difficulty; after all we are in Africa..The church has given away thousands of wheelchairs in the past and they have come to realize that more is needed by the beneficiaries than just receiving a wheelchair. The new program tries to give the best designed wheelchair, one that fits well and the type that works the best in the recipient’s environment.