the advocacy monitor

Independent Living News & Policy from the National Council on Independent Living

Empowerment through Accessibility: International Development of Durable Medical Equipment

Ashton Rosin

Full Community Integration Now 2009 protest signDavid Constantine, this year’s winner of the Guardian International Development Achievement Award, has brought attention to the rampant exclusion of the 80% of people with mobility issues in developing countries that do not have suitable wheelchairs. Fueled by his own experience with disability, Constantine translated his intimate understanding of the vital importance of an appropriate wheelchair into action in the developing world, establishing a campaign to create wheelchairs specialized for people with disabilities in developing countries.

Beyond the extreme poverty faced by the millions of people living with disabilities in developing countries, mobility issues and a lack of accessibility faced by those without wheelchairs result in exclusion from educational and employment opportunities and society as a whole, isolating people with disabilities and stunting their abilities to be productive members of the community. Wheelchairs therefore serve as one of the cornerstones of independent living possibilities for people with disabilities in developing countries.

In recognizing how people with disabilities are some of the most vulnerable in the world, Constantine notes that “being disabled in a developing country is tough enough as it is, and people need the best. A good part of that is getting equipment that is suitable for them, to allow them to fulfill their lives in the way they hope to.” He therefore committed himself to designing wheelchairs that not only look good, are comfortable, well-functioning, but are wheelchairs that people can be proud of. 

Constantine extended opportunities to receive necessary equipment to people with disabilities by developing the organization Motivation, which seeks to empower people with disabilities around the world with the right to mobility. Constantine and his friend Richard Frost established the organization in 1991, building wheelchairs for people in Poland, Cambodia, and Romania. These efforts would eventually extend to the rest of the world as Motivation was quickly recognized as the leading designer and producer of high quality, low cost wheelchairs for developing countries.

These wheelchairs give people with mobility issues independence, focusing on a model based on principles of Survival, Mobility, Empowerment, and Inclusion. Motivation does not promote the use of second hand wheelchairs that are easily broken and hard to repair in the third world. Rather, the organization designs chairs specifically for the developing world as the wheelchairs are durable to overcome rough roads and rocky terrain in rural areas, employ affordable materials that are easy to repair, and are well fitting and adaptable.

Constantine’s involvement in wheelchair design came about as a result of his own experience after he was paralyzed while backpacking in Australia in 1982. After entering a competition to design an affordable wheelchair suitable for developing countries some years later, he was on his way to build wheelchairs in Bangladesh for a disability organization. Eventually in 2012, his organization would come to benefit more than 24,500 people who received high-quality products and training with over 12,500 wheelchairs.

Beyond his physical commitment to providing vital resources to empower people with disabilities in developing countries, Constantine also works on changing attitudes towards people with disabilities, including the attitudes of people with disabilities themselves.

He recognizes the lack of resources and opportunities for people with disabilities in the developing world immediately following an injury. This sort of support is vital for people with disabilities to internalize the notion that they can be productive members of their community. In developing countries, people with disabilities are the least aware of the services available to them and have some of the most pervasive negative attitudes regarding their capabilities as employees or students with disabilities. These negative attitudes and deeply rooted stigma must be addressed alongside the growth of physical resources that support mobility. When both changing attitudes and increased resources are infused into developing countries, progress can be made in terms of the livelihood, independence, and human rights of people with disabilities across the globe.

While Constantine spends his time supporting people with disabilities living in poverty to become mobile and active citizens, he also works with businesses, NGOs, and government agencies to promote the rights of people with disabilities from both a grassroots and institutional level. His colleagues note that, “[Constantine] gives – through his work, commitment and character – a great number of disabled people (especially those recently affected by spinal injury) hope where there is despair and self-confidence where there is a feeling of uselessness and dependency”.

Constantine’s work illustrates how although disability is one of the most neglected problems in developing countries, it is possible to cultivate creative and practical solutions that enable vulnerable populations to be productive members of society and live with more dignity to enhance quality of life.