top of page

The Assistive Technology People with SCI in Developing Countries Really Need – Erik Kondo

Updated: Feb 5, 2023

Wings for Life World Run fundraiser promotional photo

I think the quest to seek a cure for spinal cord injury (SCI) is a worthwhile cause. I highly support it. When the general public thinks of a cure for spinal cord injury, they think in terms of millions of wheelchair users around the world being able to walk again. In this case, walking provides the increased mobility which raises the person’s quality life. Many people with spinal cord injury on the other hand, prioritize the return of the bowel, bladder, and sexual function over walking. In either case, the goal is to raise the quality of life of people with SCI. The prospect of providing a cure to the millions of people around the world with various degrees and type of spinal cord injury is a very compelling vision.

A “cure” is really some type of medical intervention that provides some degree of return of bodily function lost to spinal cord injury. Such a procedure would likely be extremely expensive. It is reasonable to assume it would be in the tens, if not hundreds, of thousands of dollars per person. But to a person with spinal cord injury, the money (if available) would be well spent.

In the meantime, the majority of people who have severe SCI use wheelchairs. A wheelchair is in essence, a mechanical intervention that provides a degree of the mobility lost to spinal cord injury. Unlike a “cure”, wheelchairs are available now. In fact, the first known wheelchair was invented in 1595 for King Phillip II of Spain.

Just like a cure would provide different degrees of return of function, so does a wheelchair provide different degrees of return of mobility. This is not obvious to the general public who see wheelchairs as all pretty much the same. Wheelchairs are in fact vastly different in the amount of functionality they provide.

Functionality depends upon how they are designed, manufactured, and optimized for the user. The most common type of wheelchair is a derivative of the “hospital” wheelchair. This situation is particularly true in developing countries where cheap hospital wheelchairs are the norm regardless of the physical capability and individual needs of the user.

China and India have the manufacturing ability to produce and sell inexpensive wheelchairs well under $100. As a result, they flood the market. China and India also have the capability to produce much more functional wheelchairs in the $500 range. While these better designed wheelchairs provide the user with more functional mobility, the increase in price of a few hundred dollars means that they are unobtainable for many people with SCI in the developing world.

And now we come to the point of my writing. There already exists a means to vastly increase the quality of life of people with spinal cord injury in the developing world. It does not cost tens or hundreds of thousands of dollars. It is readily available and only cost a few hundred dollars per person. “It” is a suitable and functional wheelchair. Yet, despite this low cost per person, society is not willing to invest this sum. If society is unwilling to spend such a relatively small amount of money to dramatically improve the quality of lives for people with SCI by providing them with a suitable wheelchair, it seems clear to me that there is no hope of society providing these same people with an extremely expensive medical procedure in the form of a “cure”.

Now let’ take a look at the photo at the top of the page with a more critical eye. It is a promotional photo for the Wings for Life World Run which raises money for a cure for spinal cord injury. I have participated in this fundraiser multiple over the last few years. The smiling young woman being pushed in her wheelchair is presumed to have spinal cord injury. The impression the photo provides is that she and others like her would directly benefit from the discovery of a cure.

But let us be brutally honest here. She and others like her are unlikely to benefit from the discovery of a cure for SCI based on the fact that society does not even think is worthwhile to provide her with a decent wheelchair. If society does not think it is beneficial to invest a few hundred dollars into improving her quality of life, right now, by providing her with a suitable wheelchair, why would it invest so much more in the future to provide her with the “cure”?

The same logic applies to exoskeletons which will allow paraplegics to “walk”, and to future high tech “smart” wheelchairs which will perform all sorts of wonderful mobility while the user relaxes while watching Netflix on his phone. Proponents of these mobility devices claim they will change the lives of millions of wheelchair users around the world. If a person cannot afford a functional automobile, how will the invention of a flying car help him or her? If your city government will not pay to fix a giant pothole on your street, do you think they will pay to completely rebuild your road?

The easiest and fastest way to improve the quality of life for the majority of people in developing countries with SCI is to provide them with suitable wheelchairs that enables functional mobility. If society is unwilling to make this relatively minimal investment, then let us at least stop pretending that the discovery of a “cure” for spinal cord injury and invention of high tech mobility devices will benefit them too.


bottom of page