Assistive devices include a variety of tools and equipment that enable disabled people to be independent. A wheelchair can enable a person who cannot walk to move around their home, or to work or school. A white cane may make it possible for a person with a visual difficulty to be mobile, and a hearing aid can enable a deaf person to use a telephone. Provision of such devices help to ensure that people with disabilities function as active members of society.
The World Programme of Action Concerning People with Disabilities, launched by the United Nations in 1983, identifies three major programmes that are central if the marginalisation and oppression of disabled people throughout the world is to be addressed. These are:
Included in "rehabilitation" is the provision of measure which compensate for loss or limitation of function - and these include technical appliances. In addition, a precondition for the equalization of opportunities is the provision of support services for disabled people, in order to enable them to participate on equal terms (UN 1994).
Assistive devices are a means by which disabled people can achieve their individual lifestyle goals and ambitions.
What prevents assistive devices from assisting disabled people to be independent and achieving their goals? Some of the major barriers are being investigated by the Disability Action Research Team (DART) and include:
It is often extremely difficult for disabled people (particularly those in rural areas) to have access to a rehabilitation service, and to obtain an assistive device. Long waiting periods and transport costs mean that many people are not able to obtain them.
Even when a disabled person does not get an assistive device, it may not be the most appropriate one for the situation in which she/he lives. For example, a "standard wheelchair" may not be able to withstand the rocky paths and harsh conditions of a rural area, or it may be too wide to enter a peri-urban shack toilet door.
The cost of an assistive device may be prohibitive for a disabled person who is not in receipt of a disability grant. In addition to the device itself, transport and other costs may make it extremely difficult for the disabled person to obtain an assistive device.
Servicing and maintenance
Even if a person does get an assistive device- what happens when it needs to be repaired or serviced? How are batteries for a hearing aid replaced? How are callipers repaired? Much of this service is provided by hospital, but again long waits and costs of transport are practical problems that are constantly being encountered.
The study by DART is looking at the size of the problem in KwaZulu-Natal, and has found that of every 1 000 people in the province, 58 would have difficulty with seeing, communication or movement. This is a total number of approximately 50 000 people who have disabilities and it is estimated that half of them need assistive devices (WHO 1994) to enable them to function independently in the society. However the present lack of rehabilitation services in the province means that coverage is very limited and the service is not comprehensive.
DART is also exploring the nature of the problem, and the different perceptions of disabled people, service providers and suppliers of assistive devices. Some of the difficulties that have been voiced include the unequal access to services between urban and rural areas; bureaucracy and a poor system of referral, co.-ordination and follow-up; the cost of assistive devices; inappropriate technology; the limited options available and the neglect of servicing which implies increase cost in the long- term.
Recommendations will be made as to how the service can be improved, in the line with the rights of disabled people (Disability Rights Charter) and the World Programme of Action Concerning Disabled Persons (UN 1983). This will be done in consultation with the disabled people, policy-makers, service providers and suppliers of assistive devices in KwaZulu-Natal.
Disabled People South Africa 1991 Disability Rights Charter
United Nations 1983 Word Programme of Action Concerning Disabled Persons.
World Health Organization 1994Community based rehabilitation and the health care referral services; a guide for Programme managers WHO/RHB/94.1 Geneva
Pam McLaren, SuePhilpott; Richard Hlophe Disability Action Research Team (DART) 44 Main Street, Howick, 3290 KwaZulu-Natal. Telephone : 0332 - 305693