Marking 30 years of Motivation, David Constantine reflects on major milestones and future opportunities for wheelchair provision.

10 February 2021

It’s quite incredible to look back on the past 30 years and see how much change has happened in the disability and wheelchair sector. When we started Motivation, disabled people had limited legal rights. There’s still a long way to go, of course – we can see that from the way disabled people have been left behind during the COVID-19 pandemic.

But on Motivation’s 30th birthday, I’m feeling reflective about the major milestones in our sector since we began our work.

When we were starting out, the US had just created the Americans with Disabilities Act, but the UK’s disability discrimination act hadn’t yet been formed. And it wasn’t until 2006 until we saw the launch of the UN’s Convention for the Rights of People with Disabilities (UNCRPD).

This was a key moment of recognition for disabled people around the world and the realisation of a global movement led by committed rights activists. It was important for creating a list of commitments and accountability for governments around the world. Now 182 countries have ratified the Convention.

In 2006, we also saw global discussion of disability at a momentous conference in the wheelchair sector. Three major organisations (ISPO, WHO and US Aid) came together to discuss ways to improve wheelchair provision in lower income countries, which is where we focus our programme work, of course. It shone a light on something we knew well: there was a severe lack of decent wheelchairs being provided. And poorly designed wheelchairs could create dangerous health complications for disabled people. It helped to set in progress improvements to provision and products that continue today.

The biggest impact of this conference was the publication of the WHO's Guidelines on the Provision of Manual Wheelchairs in Less Resourced Settings in 2008. They include the first definition of an appropriate wheelchair alongside guidance on products, service provision and training. They are still the key guide on how wheelchairs should be provided.

When I look back to our earliest days, it’s almost unbelievable to think that we had no global statistics on disability. It would be 20 years until the WHO’s World Report gave us real facts about the scale of disabled people’s needs and the barriers faced. This report gave vital insight to the impact of exclusion, lack of access and lack of mobility products available. It was sobering, but a great catalyst for getting people on board to make change.

Another major moment in the past three decades was the London 2012 Paralympic Games. Not just because we proudly saw Paralympians from many countries entering the stadium in their Motivation wheelchairs. But for the first time, the event had the same level of visibility as the Olympics. The strengths and achievements of para athletes were promoted, rather than their perceived disabilities. It marked a cultural shift for disabled sport and the representation of disabled people. I don’t think we should underestimate its impact for those watching – disabled and non-disabled.

But enough of looking backwards. It’s what we do on our birthdays, but our focus is on the future. And what could be.

Our vision has always been that everyone will be provided with the right assistive technology product – no matter where they come from, or what their income level. And that it is provided in the right way – through an individual assessment of needs and fitting.

What we see changing over the next 30 years is a vital shift towards this happening at a national level, instead of through organisations like Motivation. National wheelchair services and training are so much stronger, sustainable and resilient when provided by governments and other local organisations.

This was the gap we wanted to fill when we set up our first wheelchair projects - and even a decade later, we wouldn’t have imagined government services taking over our work. But consider the first Global Disability Summit in 2018 where 49 governments signed a Charter for Change on disability policy. Could we have ever imagined that in 1991? Not for a moment.

We also now see local DPOs (Disabled People’s Organisations) gaining strength and lobbying for rights. The change is moving in this direction. It feels like a very real possibility in the next 30 years.

What are the possibilities for advances in technology and design?

These possibilities will mean everything for the future of wheelchair design and provision, too. We have new materials, new ways of working and more local production – all of which provide innovations for sustainability.

These bring an opportunity for creating more bespoke products and services. We can begin to provide wheelchairs that are sized and fitted to individual needs, or designed with more adjustable parts that build a bespoke product. This could result in products that are produced more economically and locally, reducing the need for global shipping. They might be more resilient, lasting longer for the user.

Key to this is environmentally sustainability. We can talk about exciting tech like 3D printing and the possibilities it could bring, but we need to consider environmental impact. We need to look at how we design, build and provide products in a way that won’t destroy the world’s resources.

What needs to happen to make that change? It’s the million dollar question!

We’re already seeing a global movement behind investment in assistive technology. ATscale is an example of a fantastic network of global organisations that are providing great evidence of the impact of assistive tech. Their recent report showed that a child living in a low- or middle-income country could increase their lifetime income by $100,000 if they have access to AT. That is a huge incentive to build better provision.

Importantly, we’re delighted by the engagement of larger NGO’s in this vision for greater disability inclusion and assistive technology provision. We see this becoming integral to more work around the world, which means we can reach more people. It also adds more voices to the movement.

We need to keep up this momentum. But we need to keep an eye on how it is being done. It is vital to recognise that one-to-one provision is required, even when we’re working at scale. We’ll always need services for assessing and fitting at an individual level.

And what of Motivation in the next 30 years?

I hope there will no longer be a need for us to exist! This is a conversation we had as a team in Bangladesh at the very start. We always aimed at working in a way that put the user at the centre of design and provision, so we fully understood the problems that needed to be solved. That these solutions were informed by local communities, so knowledge and skills were an exchange.

It will be a true mark of Motivation’s success and influence when we see governments around the world providing decent wheelchairs to the best and most sustainable standards of global provision.

It feels possible in the next 30 years – or even sooner.