Advice line: substandard assistive aids for children in Uganda must end

Alexandra Hejazi argues that donating substandard assistive aids for disabled children to use in countries such as Uganda must end.

On a career break, I volunteered at a centre for children with disabilities in a small town in Uganda. While there, a local organisation asked me to help go through a shipping container full of wheelchairs, walking frames and standing frames sent by its main European donor, as we use similar equipment at my workplace in London. It was an exciting prospect for me because many of the children would benefit enormously from assistive equipment.
My excitement soon turned to confusion, frustration and anger. At first, I thought there must have been an accident because everything was a mess. Most of the equipment was broken or had large parts missing. We spent the time trying to salvage what we could, instead of identifying what would be most useful to the children.
It was clear that much of the container contents had been donated in that state – broken wheels, missing parts, seats and belts ripped beyond repair – and shipped to Uganda. Why? 
The donor has supported the beneficiary from the start. They have visited over the years and receive regular reports, so I assumed they would have a good idea of what would be useful.
I believe these donations were made with the best of intentions but I also think donations that are not clearly planned and managed jointly with the beneficiary can be wasteful, and, for numerous reasons, even harmful. If, for example, a wheelchair is missing brakes or one of its backrest poles, or a walking frame is minus one leg, it is unsafe and useless. Local technical expertise is often scarce, so broken equipment won’t be mended.
The World Health Organization’s Guidelines for Health Care Equipment Donations state: ‘There should be no double standard in quality. If the quality of an item is unacceptable in the donor country, it is also unacceptable as a donation.’
I doubt that any equipment in that state would, or could, be used in the donor country, so why was it acceptable to ship it to Uganda? For more on this and related topics, see here.
  • Alexandra Hejazi is a children’s physiotherapist at Hackney Ark, Homerton University Hospital NHS Trust
Alexandra Hejazi children’s physiotherapist at Hackney Ark, Homerton University Hospital NHS Trust

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