Ensuring Access to Mobility Devices: the ICRC Approach and Strategies

Over time, the International Committee of the Red Cross (ICRC) has acquired a leadership position in physical rehabilitation, mainly because of the scope of its activities, the development of its in-house technology, its acknowledged expertise and its long term commitment to assisted projects. Between 1979 and 2014, the ICRC's Physical Rehabilitation Programme (PRP) provided support for more than 190 projects in 50 countries. In 2014, the PRP assisted 112 projects in 30 countries and 1 territory and more than 315,000 people benefited from various services at ICRC-assisted centres. These services included the provision of nearly 20,000 prostheses, more than 71,000 orthoses, 4,245 wheelchairs and 18,032 pairs of crutches, and the provision of appropriate physiotherapy treatment to more than 150,000 people.

Physical rehabilitation is an indispensable element in ensuring the full participation in society of people with disabilities. It includes the provision of mobility devices such as prostheses, orthoses, walking aids and wheelchairs together with the therapy that will enable the fullest use of their devices and also include activities aimed at maintaining, adjusting, repairing and renewing the devices as needed. Restoration of mobility, through the use of mobility devices is the first step towards enjoying such basic rights as access to food, shelter and education, finding a job and earning an income, and, more generally, having the same opportunities as other members of society. Ensuring access to appropriate physical rehabilitation is the core objective of the ICRC's Physical Rehabilitation Programme.

ICRC physical rehabilitation projects are planned and conducted with the primary aim of improving the accessibility of services for persons with physical disabilities, upgrading the quality of those services and ensuring their long-term availability. Enabling a person with physical disabilities to gain or regain mobility is an important step toward inclusion; however the ICRC acknowledges physical rehabilitation alone is often not enough to ensure patients' full participation. It thus strives to assist, in a more comprehensive manner, disabled persons by addressing their rehabilitative needs and by helping them reintegrate socially and economically.

In order to achieve these aims, the ICRC takes a twin-track approach: assistance is given to both the national system and the users of its services. ICRC projects are designed and implemented to strengthen the overall physical rehabilitation services in a given country. For that reason, the ICRC supports local partners (governments, NGOs, etc.) in providing these services. Ninety per cent of the ICRC's projects have been, and continue to be, managed in close cooperation with local partners including government authorities, local NGOs, National Red Cross/Red Crescent Societies or private entrepreneurs. Since the quality and the long-term availability of services depend largely on a ready supply of trained professionals, the training component within ICRC-assisted projects has gained in importance over the years. Over the years, support from the ICRC, either through scholarships or through formal training programmes, has led to nearly 450 people becoming P&O professionals and to more than 70 becoming physiotherapy professionals.

The ICRC has developed a technology using polypropylene as the basic material, thus bringing down the cost of rehabilitation services. Recognition for the vital role played by the ICRC in making rehabilitative devices more widely available – by introducing appropriate, affordable, high-quality technology – came in 2004 in the form of the Brian Blatchford Prize awarded by ISPO. It is now standard practice to use the technology developed by the ICRC in the production of prostheses and orthoses; the technology has also been adopted by a significant number of organizations involved in physical rehabilitation.