Affordability, accessibility, availability, awareness and quality of products- I believe those barriers are resolvable - if we will invest our efforts in them. Following our 6-years research, the results of the latest questionnaire from our visit in Kenya on December 2016, validated our conclusions.
A few days ago I received a question from a colleague. The question was:
What are the barriers to access advanced assistive technology and what are the possible solutions?
During our visit in Kenya in 2016, we conducted a questionnaire among 82 therapists who customize splints regularly. Below a picture of 2 of our affiliates and I with the Coast General Hospital team in Mombasa on December 19, 2016.
Following the research we conducted over the past 6 years and the result of the latest questionnaire who validated our conclusions, this is my answer:
This is a great question which I actually researched for some time now.
I would like to distinguish between the barriers of people in developed and developing countries, and between the patients and the medical personnel barriers.
As written in the WHO report from 2014, the main obstacles are affordability and accessibility. Another 3 main obstacles are availability, awareness and durability/ quality of the accessories.
Affordability in the developed world - While people with disabilities (those who work) earn on average 20-30% less than people without disabilities, prices of assistive devices are too high for them and are often simply outrageously high.
Affordability in the developing world - 80% of people with disabilities live in rural areas. In Kenya, where I researched for about a year and a half, the average monthly income in 2014 was $106 per capita, and according to the therapists there, the average income in rural areas is lower, and farmers often don't have a steady income. Therapists told me that people living in rural areas often cannot afford even an essential accessory such as crutches, even when the price will be as low as $ 30.
Accessibility in the developed world - Accessibility within the city must undergo a significant improvement for people with all types of disabilities. Different cities currently have access to basic services, mainly for people using wheelchairs and for people with visual disability.
Accessibility in the developing world - Many assistive devices are available only in the cities, but there is a very low access in transportation, if at all, and little access inside the cities.
*Comment: When we think about accessibility we usually imagine a picture of a person sitting in a wheelchair in front of a staircase. However, there are many more types of disabilities who do not receive proper consideration in the public space, such as hearing impairments or mental disabilities. But even with wheelchairs, most parts of the world are not accessible to them. In the developing world, we will find more people using crutches than any other mobility accessory because they are the only accessory that allows to move around freely in most areas.
Availability in the developed world - The impression I got while I specialized in recent years in designing assistive devices for people with disabilities, is that entrepreneurs are often looking for new solutions that integrate new technologies, rather then starting from the basic needs and understand what is really missing. Which assistive devices should be improved or redesign? Which products can actually change people's lives? For example, the market today is flooded with wheelchairs (which I also have a passion to design, by the way) but there is too little head support for wheelchairs.
The same happens with many products: the solution is not suitable or does not exist. For many challenges, lack of availability is the main obstacle.
Availability in the developing world - It is a totally different situation. Most of the companies are just not there, even for essential products. Most people with disabilities live in the rural areas of the developing world - without solutions.
Many products need to be customized by medical personnel, however there are so little medical staff in relation to the number of patients, very little time for each patient and little availability for people with disabilities. According to the WHO report more than half of people with disabilities living in rural areas of developing countries have almost no access to health services.
Awareness - I believe than in both developed and developing world people refer to awareness and prevention as tiresome issues. People tend to take care of medical issues only when they occur and not before. I think largest obstacle is the difficulty of the medical staff to deliver this important information to people with disabilities, and especially parents of children with disabilities - when the use in assistive devices and medical and rehabilitative equipment has long-term and significant effects.
Durability/quality - Beyond fairness and positioning of a product, a target audience who earns little, can only buy products that seem durable. As the audience earns less, he grew numerically and so the product should include a greater emphasis on durability. In developing countries people use the product beyond the period of time recommended/ used in developed countries, but products are often not long lasting.
Affordability - If possible - establish an independent distribution chain, control on the margins of intermediaries to ensure your product will reach the end customer in a reasonable price.
Affordability - Use mass production technologies to reduce production costs.
Accessibility - Use mobile clinics to reach the rural areas. Especially in the field of first aid / saving lives.
Accessibility - Teach more people how to look for solutions in the internet, how to purchase. Make online purchases easier for PWD.
Availability - Encourage solutions that meet basic needs first, encourage diversity of solutions. Seek for the unreached markets and match the device price to its financial capabilities.
Awareness - Provide the medical personnel tools which will enable them to present prevention as magical, and care as essential. Work with community leaders/ celebrities.
Durability - Make you product long lasting and resistant. Weather resistant, water resistant, low wear. Solve the durability challenges of existing common products.
Quality - Design the product with the Centered-user-design methodology. Keep in mind that people with or without disabilities have desires as well as embarrassments.
To you, my readers, I will add the following paragraph, to demostrate that we are actually implementing all the above:
Cassit Orthopedics is a company which is a social business. We specialize in design, manufacture and distribution of orthopedic hand supports (splints), and other assistive devices for the well-being of people with disabilities. During the last 6 years we produced variety of hand splints and devices. We work with therapists to create comprehensive solutions. As a result from our belief in mutual responsibility and fairness, our splints are affordable and durable, high quality, long lasting and environmental friendly products. They are easy to customize in just 5 minutes, with no need for electricity, provide strong support, easy to clean and easy to maintain. We want to change the world for people with disabilities and bring joy into their lives, we strive to create inclusion, awareness and brotherhood among all people.