Challenges in the Implementation of Appropriate Technology Projects: The Case of the DISACARE Wheelchair Center in Zambia
KURT L. KORNBLUTH
University of California, Davis
PHILIP OSAFO-KWAAKO
Zambian Ministry of Commerce
Lusaka, Zambia
…the most exciting part about these new features is that they do not cost more and we can still deliver a wheelchair for $41.17. Isn’t it astounding that God would lead us to a new manufacturer with an innovative approach to our design needs?
From the Free Wheelchair Mission’s Website, June 2005
The statement above summarizes a major challenge faced by DISACARE1 Wheelchair Centre in Zambia, an organization that fabricates various models of wheelchairs. At a retail price of US$280, DISACARE makes only a slim profit above net costs. DISACARE provides an interesting example of the implementation of an appropriate-technology project that attempts to use locally-available resources to address technological needs.
Since its modest beginning in 1991, DISACARE has grown from a two-man team to an organization with 23 employees, many of them disabled, who now have expertise in wheelchair fitting and manufacturing, machining, training, accounting, carpentry, and sewing and tailoring. DISACARE is a local Zambian nongovernmental organization (NGO) that has proven itself fiscally responsible and maintained excellent financial reporting to its donors. The organization
provides employment for people with disabilities, as well as advocacy and sports programs. DISACARE’s mobility-aid devices are durable and well suited to Zambian conditions, and donors have heralded the organization as a model development project that could be replicated in other economic sectors and other regions. Nevertheless, DISACARE faces some serious challenges.
As a starting point for a discussion of the value of DISACARE as a social-investment scheme, we assess the organization’s net benefits, taking into account non-market objectives, such as local skills training and capacity building and poverty-reduction among the disabled. We focus on several key questions. First, was DISACARE a viable development project? Second, was DISACARE a good investment from the point of view of donors? Third, did the intended beneficiaries (the disabled in Zambia) benefit from the DISACARE project?
DISABILITY AID IN ZAMBIA
After independence, most African states pursued state-led industrialization strategies aimed at strengthening local industries and spurring economic growth. In most cases, “infant, import-substitution industries,” established under highly protectionist economic policies, were inefficient, resulting in large fiscal deficits and rising debt levels. By the 1990s, most developing countries in Africa were in economic decline. Among the adjustment schemes proposed by international donors were a number of market-liberalization programs intended to stimulate general economic growth (Thirlwall, 2003). By the end of the 1990s, however, the anticipated economic growth in most countries had not been achieved. In fact, levels of poverty and inequality had increased in most communities. In addition, most southern African states were subject to an additional drain on government revenues because of the growing prevalence of HIV/AIDs, with donor policies shifting accordingly (Saasa, 2002).
As a least-developed country (LDC) in southern Africa, Zambia, where support for particularly disadvantaged groups is provided mostly by informal family networks and NGOs, remains highly dependent on the international donor community for support of social-investment schemes. In fact, for most sub-Saharan African countries, official national disability policies are either nonexistent or have not been implemented. In a survey of national disability policies in 83 countries (industrialized, middle-income, and developing countries), the United Nations (UN) Social Commission for Social Development observed widespread gaps in support provided to persons with disabilities in developing countries. For example, in Zambia, Michailakis (1997) reports the absence of regulations for making public buildings accessible to people with disabilities and a lack of coordination and dialogue on disability issues.
DISACARE WHEELCHAIR CENTER
In 1991, Zambia was among the poorest countries in southern Africa, and people disabled by polio had no wheelchairs or prospects for mobility devices. David Mukwasa, grandson of then-Zambian president Keneth Kaunda, and Felix Sulimba, a medical student, both polio victims, envisioned DISACARE in the early 1990s. The two approached the Finish International Disabled Development Association (FIDIDA), and over the next decade, FIDIDA’s partner organization, Finish Association of People with Mobility Disabilities (FMD), which played a large role in shaping and supporting DISACARE. They also approached Kenny Mubuyaeta, a polio victim trained in metal fabrication, who left his job in the Copper Belt in northern Zambia and moved to the capital, Lusaka, to join DISACARE and take up the challenge of building wheelchairs.
In a small rented garage, DISACARE began by repairing shopping carts and wheelchairs. Kenny and David, working often without pay, continued trying to get business and raise money. In 1991, Keneth Kaunda’s government gave DISACARE a large plot of land in Libala, on the outskirts of Lusaka. In 1995, money was raised from international NGOs for construction of a workshop and small dormitory-style living quarters. In 1996, the workshop in Libala was officially opened. Since 1991, Kenny and David have convinced many local and international organizations to help DISACARE.
Products
DISACARE currently provides a number of locally built mobility-aid products, including: the Kavuluvulu, a standard folding wheelchair outfitted especially for Africa; a tricycle wheelchair, which is specially designed for long distance journeys; a cerebral palsy (CP) wheelchair, which has cushions and tray tables for CP users; and a sports wheelchair, which is specially designed for outdoor sports, such as basketball. DISACARE prices cover all costs, including labor, materials, overhead, and capitol depreciation.
Disability Advocacy
DISACARE currently operates as a trust governed by a board of trustees with the following mission: “To provide mobility, empowerment, and self-sustenance for persons with disabilities.” DISACARE is the only domestic manufacturer of wheelchairs; the company also repairs and customizes wheelchairs. In addition, DISACARE has been a major advocate for people with disabilities. The organization provides appropriate mobility aids, as well as training and employment. DISACARE has greatly increased the visibility of people with disabilities in the community. Both Kenny and David have polio but drive cars, and DISACARE workers have broken the stereotype that disabled people are
unable to work and are simply beggars. Twice a week, wheelchair riders gather at DISACARE to play wheelchair basketball.
Sales of Wheelchairs
DISACARE began repairing wheelchairs in 1991 and gradually started production in 1993. As a result of poor marketing, high overhead costs, and weak purchasing power in the domestic market, however, sales reached a peak of 200 in 2003, but have gone down since then. DISACARE must sell between 180 and 240 wheelchairs per year to pay salaries. However, to be self-sustaining, the company must sell more than that.
TABLE 1 Wheelchair Sales and Repairs
Year |
Wheelchairs Produced |
Wheelchairs Repaired |
1991 |
— |
15 |
1992 |
— |
200 |
1993 |
5 |
120 |
1994 |
7 |
100 |
1995 |
8 |
60 |
1996 |
12 |
60 |
1997 |
20 |
80 |
1998 |
50 |
100 |
1999 |
70 |
60 |
2000 |
80 |
50 |
2001 |
115 |
40 |
2002 |
190 |
50 |
2003 |
197 |
40 |
2004 |
100 (Aug) |
20 |
TOTAL |
854 |
995 |
Source: DISACARE, 2004. |
The Competition
Wheelchairs produced in Zambia face stiff competition from wheelchairs imported from Asia. In addition, DISACARE has high overhead costs and, because it uses local materials, it does not take advantage of cheaper imported raw materials. The basic DISACARE wheelchair costs $280, is locally repairable, and lasts from two to five years, with proper maintenance. Although this seems inexpensive compared to a typical folding wheelchair, which costs $500 to $1,000 in the United States or Europe, many aid organizations prefer to donate cheaper Chinese-made wheelchairs, although they often have poor ergonomics, are not suitable for local conditions, and have a short life (six months to two years). Nevertheless, many donors have opted to buy them because, at $75 to $200 apiece, they can provide them to more clients for the same cost.
Providing Employment
Providing employment is an important objective of DISACARE. As DISACARE has expanded its operations in the past decade, it has increased the size of its workforce to 23, boosting employment in the local economy. DISACARE is an affirmative-action employer, and more than half of its workers have physical disabilities.
Capacity Building
Donors and volunteers have built the capacity of DISACARE by supplying experts to train staff members in wheelchair design, accounting, fundraising and administration, and sports. As a result, the DISACARE staff not only understands the needs of people with disabilities, but also is adept at running day-to-day operations.
TABLE 2 Capacity Building
Year |
Specialty |
Comments |
1991-1997 |
Prothetist |
FMD volunteer |
1993 |
Wheelchair designer |
WWI paid consultant |
1997 |
Wheelchair sports |
FMD paid consultant |
1997-2001 |
Wheelchair designer |
WWI paid consultant |
1997-present |
Wheelchair designer |
WWI paid consultant |
2001, 2004 |
Product designer |
DEKA volunteer |
1999-2001 |
Administration/Fundraising |
VSO volunteer |
2002 |
Administration/Fundraising |
VSO volunteer |
2002 |
Accounting |
VSO volunteer |
Source: DISACARE, 2004. |
Financing of DISACARE
Throughout its short history, DISACARE has relied heavily on external donor support for financing and capitalization (Table 3).
Current Assets
Much of the donor investment in DISACARE, such as the buildings and land near Lusaka, is still owned by the DISACARE trust. The estimated current value of DISACARE’s assets is shown in Table 4.
TABLE 3 Sources of Funding
Year |
Donor |
Monetary value |
Description |
1991 |
FIDIDA |
$80 |
Tools |
1991 |
Meal-a-Day |
$3,500 |
Tools, equipment |
1991 |
Dutch Embassy |
$3,000 |
Equipment and materials |
1992 |
Gov’t of Zambia |
$200 |
3.5 acre plot |
1992-1997 |
FMD |
$10,000 (est.) |
Equipment, materials, machinery |
1993 |
FMD |
$15,000 |
WWI training |
1995 |
Beit Trust |
$25,000 |
Accommodation blocks |
1997 |
FMD |
$1,000 |
Basketball court |
1999 |
Abillis |
$5,000 |
Office equipment, materials |
1999 |
British Embassy |
$7,000 |
Office equipment, materials, building |
2000 |
German Embassy |
$9,000 |
Lathe |
2001 |
Irish Aid |
$11,000 |
Milling machine |
2001 |
Danish Embassy |
$8,000 |
Materials, equipment |
2001 |
Beit Trust |
$6,000 |
Workshop extension |
2001 |
FMD |
$4,500 |
Vehicles |
2002 |
US AID |
$5,000 |
Office equipment, furniture |
1998-2002 |
FMD |
$60,000 (est.) |
Wheeling wheels project |
2003 |
FMD |
$8,000 |
Capital, building, shop upgrade |
2003 |
Barclays Bank |
$400 |
Machine tools |
2004 |
FMD |
$1,000 |
Vehicles |
TOTAL |
|
$182,680 |
|
Source: DISACARE, 2004. |
TABLE 4 Current Assets, December 2003
Item |
Value |
Land |
$25,000 |
Buildings |
$80,000 |
Sports toilets |
$2,500 |
Basketball court |
$2,000 |
Inventory |
$12,000 |
Containers |
$4,000 |
Machinery |
$30,000 |
Office equipment |
$10,000 |
Cash |
$7,000 |
Furniture |
$2,000 |
Vehicles |
$7,500 |
TOTAL |
$182,000 |
Source: DISACARE, 2004. |
SUMMARY
Whereas many donor investment projects end up bankrupt after five or ten years, the current assets of DISACARE are roughly equal to the total donor investment. A brief summary of the benefits and costs follows.
Costs to Donor Community
-
Total cash investment equals $182,000.
-
In-kind services are provided by volunteers.
Benefits to Zambian Disabled Community
-
More than 1,750 disabled people have been provided with wheelchairs.
-
Currently, 26 Zambians are employed.
-
Industrial capacity in Zambia has increased.
-
Capacity in the eastern/southern African region has increased.
-
Awareness of people with disabilities in Zambia has increased.
Including repaired wheelchairs, DISACARE’s has provided mobility for 1,750 people with disabilities in its 14-year lifetime. This translates to $182,000/1,750 people, or a little more than $100 per person.
REFERENCES
Michailakis, D. 1997. Government Action on Disability Policy: A Global Survey. Stockholm: Liber Publishing House.
Saasa, O. 2002. Aid and Poverty Reduction in Zambia: Mission Unaccomplished. Uppsala, Sweden: Nordic Africa Institute.
Thirlwall, A.P. 2003. Growth and Development: With Special Reference to Developing Countries. London: Macmillan.