Editor’s note: This post was provided by HVO volunteer and leader Linda Wolff, MPT. Ms. Wolff traveled to Bhutan in May 2016 to participate in the Wheelchair Service Providers Training program.
Despite being classified a Least Developed Country (LCD) according to UN measures, the Bhutanese government places a surprising degree of emphasis on providing its citizens with social services designed to meet the needs of the population. The government proactively works to fill perceived needs, and welcomes the transfer of skills and resources through collaboration with foreign organizations in pursuit of common humanitarian goals.
This is how my fellow HVO volunteers and I found ourselves in Bhutan this past May, delivering the Wheelchair Service Provision Training program, developed by the World Health Organization (WHO), to local healthcare providers and public health officials. Funding and logistical support for this project was provided by Health Volunteers Overseas, Management Sciences for Health, USAID and Bhutan’s Ministry of Health.
The WHO estimates that approximately one percent of the world’s population requires a wheelchair. The WHO’s Guidelines on the Provision of Wheelchairs in Less Resourced Settings states that: “In most developing countries, few of those who need wheelchairs have access, production facilities are insufficient and wheelchairs are often donated without the necessary related services. Providing wheelchairs that are appropriate, well-designed and fitted not only enhances mobility, but also opens up a world of education, work and social life for those in need of such support.”
This is the case in Bhutan, where many in need do not have access to a wheelchair, and those that do are frequently resigned to using extremely ill-fitting chairs that are not equipped for the country’s rough landscape. These poorly designed chairs may cause severe, sometimes fatal bedsores and create more complications than solutions.To begin to address this problem, six trainers (including myself) from the U.S., Argentina, Canada and the U.K, together with two Bhutanese physiotherapists, taught the Wheelchair Service Providers Training program. The program consists of a 5-day Basic Wheelchair Service Training course, a 2-day Management Training course, and a 1-day Stakeholders’ Meeting. The Bhutanese participants included local physiotherapists, physiotherapy technicians, hospital administrators, public health leaders and other officials at the highest levels of the country’s Ministry of Health.
Health Ministry officials, members of the Royal Government (including regional parliamentarians), representatives of local NGOs and members the Bhutanese private sector all provided valuable input during the concluding Stakeholders’ Meeting. In addition, the training portion of the program helped sixteen physiotherapists and physiotherapy technicians improve their skills to carry out appropriate wheelchair assessment, provision and wheelchair user training for children and adults who can sit upright without additional postural support. Each participant was paired with a wheelchair user and by the end of the course, fourteen people were custom fitted with appropriate wheelchairs and cushions. The wheelchairs were allocated through a partnership with CLASP (Consolidating Logistics for Assistive Technology Supply and Provision), and will likely change the course of the recipients’ lives dramatically.
“I can finally go outside now. I will be able to work and earn a living,” one wheelchair user said.
“I am finally comfortable and not in pain,” said another man.
“I will be able to work in my daughter’s shop and help my family now,” a beaming woman stated.
All of the program participants learned and experienced the power of appropriate wheelchairs and appropriate seating. They were able to apply their knowledge and skills to make a difference in the lives of people with disabilities, and they are committed to helping Bhutan source appropriate wheelchairs for everyone in need.
On May 7th, at the conclusion of the program, in a ceremony at the lovely Taj Tashi Hotel in Thimphu, the physiotherapists and physiotherapy technicians proudly received certificates from the honorable Health Minister, recognizing their completion of the Wheelchair Service Provision Training program. The fourteen wheelchair users who took part in the training also received certificates recognizing them for their participation.
Next year, my fellow volunteers and I will return to Bhutan to conduct the WHO’s Intermediate Level Wheelchair Service Training program. This training, which is scheduled for the summer of 2017, will prepare physiotherapists and others involved in wheelchair provision on how to assess and provide appropriate wheelchairs for those who need additional postural support. The training will involve building seating systems from locally available materials and bringing wheelchairs with more supportive options.