Donated wheelchairs in low-income countries - issue and alternative methods for improving wheelchair provision

Statistics show that an estimated 95% of people who need a wheelchair don\´t have one. A common response is to view this lack as an emergency situation which can be remedied by the mass distribution of donated wheelchair products alone. This "anything is better than nothing" approach views any wheelchair as a solution ignoring the complexities of provision and the needs of the individual. This approach is both an inappropriate method to meet the mobility and social needs of wheelchair users and has wider negative impacts for long-term mobility provision and social development initiatives. Comprehensive, responsible and sustainable wheelchair provision must address the following essential criteria: 1) Adjustability of the wheelchair to fit the user and include a pressure relief cushion 2) Suitability to environment and users\´ needs 3) Durability and ability to be repaired locally 4) Training in wheelchair use and health issues 5) Sustainability to ensure wheelchairs provision is long-term and appropriate. This paper advocates for the provision of wheelchairs that maximise disabled people\´s independence and their ability to participate in society. The key is to ensure that wheelchairs are provided through professional services which can assess, prescribe and fit an appropriate wheelchair with corresponding education and follow-up. Ultimately, to ensure that wheelchair services meet the essential criteria, locally appropriate solutions must be integrated into national rehabilitation services and structures.