One of the basic and most important adaptive equipment for people with mobility problems is a wheelchair. A wheelchair is not just a piece of steel and rubber, it is the engine for individual freedom, dignity and independent living.
According to WHO, the key functions of wheelchair services include assessment, provision, training, support, and referral, unfortunately the ground reality in India is very different.
GOI has a system to make mobility devices available to persons with disabilities through the Assistance to Disabled Persons (ADIP) scheme, for purchasing/ fitting of aids/ appliances, however I could not find any literature regarding safe use and maintenance of wheelchairs.
As per an article (A Narrative Review of the Government Wheelchair Provision System in India), persons with disabilities who earn less than a specified monthly income are entitled to receive a free wheelchair that can be replaced after three years. However, there is no system to repair or replace parts.
Wheelchair design options are limited and there is limited scope for customization and fitting. These wheelchairs are designed based on national standards but the standards have not been regularly updated.
User experience of wheelchair services suggests that most persons with disabilities lacked the knowledge, or found it hard to submit eligibility documents or participate in the wheelchair distribution camps. Even if they did participate at times, they got the equipment after a year, especially in places where the implementing agencies may not have a head or are understaffed.
According to available data, only 20% of persons with disabilities requiring such devices have been advised to acquire one, of which, only 16% have a device. Only one-fifth of them acquired their device through a government scheme while almost two-thirds purchased the device themselves
The users are unhappy with the durability of the wheelchairs and felt these did not last three years after which they could be replaced. Moreover, the wheelchair they received was not always suited to them or their environment. This could not be used indoors and it was difficult to transfer themselves into it. The wheelchairs could not be adjusted to meet individual requirements, as only basic models were available.
Reading the research paper, it is obvious that as a country it is important that all stakeholders facilitate the existing environment through knowledge sharing and plug the gaps in the distribution and service delivery system.
For the benefit of the larger cause a booklet on Wheelchair user safety (website of Cardiff and Vale University Health Board) is being shared.
The document can be accessed on https://cavuhb.nhs.wales/ or downloaded here (Wheelchair User Safety Guidelines) or can be viewed below