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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

Medellín, Colombia is the sixth and final case study city under the Global Disability Innovation Hub (GDI Hub) led and UK Aid funded AT2030 Inclusive Infrastructure sub-programme. Colombia’s second largest city, Medellín is well-known for its progress in urban development in the last 20 years, moving forward from its violent history. Medellín has been designated a district of innovation and is known for innovative urban projects such as its cable cars and electric escalators that connect higher altitude, low-income communities on the peripheries of the city. This case study explores the current state of accessibility and inclusion in the city for persons with disabilities and helps understand whether such urban innovations are inclusive for all the city’s residents.

Medellín is home to nearly 80,000 persons with disabilities and Colombia does have strong legal frameworks in place to support persons with disabilities. However, this case study found that the numerous laws and regulations are not always well implemented and there is also a need to consider more diverse disabilities in city planning and design.

The research took place in 3 phases between December 2022 and May 2023, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk-based research and interviews. Phase 2 captured the lived experience of persons with disabilities through interviews, photo diaries and co-design activities. Phase 3 then synthesised the findings, running multiple in-person workshops to validate and create actions towards the creation of more inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life for persons with disabilities including, poverty, transport, housing, healthcare, public spaces and recreational activities. Quotes from participants are interwoven throughout the report and strengthen the concluding actions. The report recognises what has worked in Medellin as well as areas for improvement.

Purpose

Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries.

Methods

This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized.

Implications and dissemination

The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators’ Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal.

A short blog about disability in Latin America and the Caribbean, disability inclusion in disaster risk management in the region and disability inclusion in development in the region. An example of problems with infrastucture access in the Domincan Republic is given. World Bank projects in various countries in South America are mentionned.

Introduction: 

Wheelchair casters fail frequently in the field causing multiple user consequences and wheelchair breakdowns. To inform caster design improvement, there exists no validated tools that can collect caster failures. This need motivated the development of a user-reported, caster failure inspection tool (C-FIT).

Methods: 

To develop C-FIT, a multistep design and testing approach was used which included face validity testing, test-retest reliability testing and expert review. Reliability testing was conducted with two independent cohorts of wheelchair professionals who inspected caster failures physically and online through pictures. The tool was revised based on testing outcomes and expert feedback. For preliminary data collection and evaluating usability, C-FIT was piloted at wheelchair service centers in Scotland, Indonesia and Mexico.

Results: 

Caster failure items reported in the literature were screened to develop the initial list of C-FIT items. Face validity testing conducted through surveys with wheelchair experts (n = 6) provided 14 items for C-FIT inclusion. The test-retest reliability was found to be high for 10 items with physical failure inspections (n = 12). For each of these items, 75% or more participants had substantial to almost perfect agreement scores (κ = 0.6–1.0). Lower reliability scores were found with online failure inspections (n = 11). C-FIT received positive usability feedback from study participants and data collectors in the field. Pilot field data (n = 31) included comprehensive details about failures useful for manufacturers, designers and researchers to improve caster designs.

Conclusions: 

The C-FIT tool developed in this study has substantial reliability and can be used for documenting caster failures at wheelchair service centers.

Background: Lack of access to mobility for people with disabilities, particularly in less- resourced settings, continues to be widespread. Despite challenges to wheelchair delivery, the benefits to health, employment, social integration and life satisfaction are apparent.

Objectives: Previous studies have explored the impact of receiving a wheelchair on the lives of the users through cross-sectional or short-term longitudinal analysis. The current study was undertaken to evaluate whether previously reported changes were sustained after 30 months of use, and whether results varied between two differing models of a wheelchair.

Method: One hundred and ninety-one subjects from Peru, Uganda and Vietnam received one of two models of wheelchair provided by the Free Wheelchair Mission. Using interviews to record survey results, data were collected at the time the wheelchair was received and following 12 and 30 months of use. Variables of overall health, employment, income and travel were explored through non-parametric analysis.

Results: There was a significant improvement in overall health and distance travelled after 12 months, but these changes were no longer significant by 30 months (Friedman test for overall change, p = 0.000). Employment status showed a small but significant increase at 12 and 30 months (Cochran’s Q, p = 0.000). Reported income increased slowly, becoming significantly different at 30 months (Friedman test, p = 0.033). There was no association between the model of wheelchair received and the incidence of pressure ulcers, pain or maintenance required. There was higher satisfaction with the GEN_2 wheelchair at 12 months (p = 0.004), but this difference was not apparent by 30 months. Overall wheelchair satisfaction and maintenance levels were favourable.

Conclusion: While overall health status, and distance travelled into the community fluctuated over time, receipt of one of two models of a wheelchair in less-resourced settings of the world appears to have a positive sustained impact on employment and income. Further investigations should be carried out to confirm these results and explore the factors responsible for fluctuating variables. This study affirms the importance of long-term follow-up of outcomes associated with wheelchair distribution in less-resourced environments.

The representational history of disabled people can largely be characterized as one of being put on display or hidden away. Self-representations have been a powerful part of the disability rights and culture movement, but recently scholars have analysed the ways in which these run the risk of creating a ‘single story’that centres the experiences of white, western, physically disabled men. Here we introduce and theorize with Project Re•Vision, our arts-based research project that resists this singularity by creating and centring, without normalizing, repre- sentations that have previously been relegated to the margins. We draw from body becoming and new materialist theory to explore the dynamic ways in which positionality illuminates bodies of difference and open into a discussion about what is at stake when these stories are let loose into the world.

This paper presents qualitative research on the use of Facebook by visually impaired people and organizations representing them in Jordan, Peru, and India. We found that individuals and organizations have very different motivations and pathways for using social media. Social media serve as a means to help individuals with vision impairments to expand their social circles, network with casual acquaintances, and find various kinds of social and technical resources independently. However on issues of representation we found that social media have the potential to play a double-edged sword, reinforcing in some cases the same stereotypes that individual users of assistive technology (AT) sought to overcome by using technology in their professional lives. We find that individuals often characterize social media and assistive technology in the same vein — suggesting that for many parts of the global South, the dramatic change in the means and ability to leverage social and professional possibilities has not come from any one technology alone, but from a broader evolution of the technological environment available to people with vision impairments. Access to social media and technology disrupt an environment in which social and economic spaces for people with disabilities are still a zone of contestation between a dominant discourse of vision impairment enforced by generations of negative representations of disability, and a new world of technology users challenging representations and assumptions as engaged, connected professionals.

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

This toolkit suggests strategies and tools to improve disaster recovery and reconstruction practices for disabled people. It is structured around the following seven major thematic areas related to disability inclusive recovery and reconstruction: physical environment; livelihood, employment and social protection; transportation and communication; education; health; capacity building of disabled people's organisations (DPOs); and organisational and operational issues. This toolkit is useful for humanitarian agencies and NGOs in disasters situations