Isn’t Any Wheelchair Better than No Wheelchair at All? - Erik Kondo

I spend a lot of time talking and writing about the deficiencies of hospital (Fast-Food) style wheelchairs. I am sure there are many that would like me to keep quiet. Afterall, Isn’t Any Wheelchair Better than No Wheelchair at All (IAWBNWA)?

The IAWBNWA? way of thinking is at the root of why hospital wheelchairs are so dominant in LMICs and also so widely available and used in HICs. Society has determined that the hospital wheelchair is “good enough”. Even some people who recognize that the hospital wheelchair is not suitable for people with long term mobility impairments seem to think that it is satisfactory for the elderly, or someone who can walk "a little", or is frail, sick, or will be only using it for a few months.

The thinking seems to be that hospital wheelchairs work just fine for these people as they independently putter around the house. It’s only that it can’t be used for active or outdoor activities unless being pushed by an attendant. While this thought is comforting to those that purchase these wheelchairs (for other people), it is incorrect.

A hospital wheelchair is heavy, bulky, and awkward to sit in and propel for just about everyone. It is difficult for a young/strong person to use and MORE difficult for an elderly/frail person to use. We all recognize that a hospital wheelchair is effectively impossible for an elderly/frail person to self-propel outside. So, what does society think that it is easy for elderly/frail people to use it as they try to maneuver around their homes? 

Someone who spends most of their days inside still needs to use the bathroom, move around in the kitchen, get clothes in and out of the closet and bureaus, open and close doors, etc. All of these activities are made more difficult by the standard (bulky and awkward) hospital wheelchair. 

Imagine that instead of wearing comfortable slippers, you had to wear heavy clunky wooden shoes. Assume that you have to wear them throughout the day in your house. Does the fact that you don’t go outside somehow make the shoes satisfactory for you? Wouldn’t you want a more comfortable pair of shoes to use inside? If your glasses are scratched up and you can barely see, are they acceptable because you don’t drive a car? 

The hospital wheelchair is a suitable transportation device for use only in hospitals and institutional settings where the user doesn’t have to self-propel. It is universally difficult to self-propel and maneuver. The weaker the person is, the more difficult it is to move. It may be that an ultralight active wheelchair is also not a suitable wheelchair for certain people either. But it shouldn’t be one or the other. It is possible to combine the desirable characteristics of an active and hospital wheelchair to create a more functional “hybrid” wheelchair. 

Such “hybrid” wheelchairs exist. But they cost more than the standard hospital wheelchair. Hence explaining the popularity and widespread use of the existing hospital wheelchair. It is so popular because it is so cheap. It is cheap because it has been designed to be mass produced as inexpensively as possible without concern about its functionality because of IAWBNWA? thinking.

If you buy a hospital wheelchair for someone (or yourself), recognize that in most cases, you are purchasing a the least functional (and cheapest) wheelchair available. No different than buying the cheapest car, the cheapest bicycle, the cheapest phone, cheapest TV, cheapest food, or cheapest anything else. 

For example, the average cost of a mobile phone in the US is $790. Yet, the cheapest mobile phone around $100 (close to the price of a hospital wheelchair in the US). The $790 average price shows that few people buy the cheapest mobile phone. Few people buy the cheapest products because the reality of market economics dictates that you get what you pay for in terms of poor quality and low functionality. Conversely, the cheapest wheelchair is so popular because of IAWBNWA? thinking.

Note: Some people who buy a hospital wheelchair have no choice. It is literally all they can afford. But the majority of hospital wheelchairs are purchased by people, insurance companies, government agencies, businesses, nonprofits, and institutions which could spend a little more. They may not want to spend a little more, but they could if they believed that it was worthwhile. My underlying point in this article is that it IS worthwhile.