Mobility Disabilities: Tips for Inclusion in International Exchange
Tips and strategies for providing accommodations to individuals with mobility disabilities and planning ahead for inclusive programs.
Quick Guide to:
- Wheelchairs
- Ramps
- Other Mobility Equipment
- Environmental Adjustments
- Accessible Toilet Facilities
- Shower Chairs/Bath Benches
- Luggage/Bags
- Personal Attendants
- Guide Dogs and Service Animals
- Lifting and Transferring
- Policy Adaptations for Organizations Working with People with Mobility Disabilities
Wheelchairs
Wheelchairs are important adaptive equipment devices for some people with mobility disabilities. Most people who have their own wheelchairs are very familiar with their use and maintenance. However, individuals may need assistance with repairs while participating in an international program. When placing a student who uses a wheelchair or a scooter, it is a good idea to identify the nearest wheelchair or bicycle repair shop in case of emergencies. Make prior arrangements with the exchange participant about who is responsible for the cost of any major repairs. Repairs for electric or ‘power’ wheelchairs are more expensive than for manual wheelchairs. Electric wheelchair parts may be difficult to acquire in rural areas or developing countries. Assembling an emergency kit of frequently-broken, hard-to-get parts for power wheelchair users is a smart idea.
Also, exchange participants may wish to change out normal high pressure tires for something with a little more tread. The grip, especially when wet, can improve durability and the ride. Wider front caster wheels can also help, and work almost as well as narrower casters on smooth pavement as on soft or rough ground. Casters smaller than five inches in diameter can easily get wedged in storm grates, cracks between paving stones, or holes.
Electric wheelchairs must be recharged every one to two days depending on use. Compare the voltage requirements in the home and host countries and be sure that the proper type of adapter and voltage transformer are available. For more information read: Guide to Electrical Adapters, Converters and Transformers for International Travel with Power Wheelchairs and Other Electrical Devices
Individuals and organizations should become familiar with airline policies regarding power wheelchairs, as many air carriers have specific policies on how to package electric wheelchair parts. Some types of chairs may need to be dismantled completely for flight. Other airlines may have a ban on the hazardous materials that are found in some wheelchair batteries.
Exchange programs should also explore physical accessibility and the availability of accessible facilities in the host community in order to help the individual decide if a manual or an electric wheelchair is the best choice. It is not always practical to take an electric wheelchair on a program, especially when traveling in a very inaccessible environment or where charging the battery would be a challenge. In this case, an electric wheelchair user might choose to take a manual chair for convenience. A participant who usually uses an electric wheelchair may require a personal assistant to accomplish daily living tasks when using a manual chair. Both the international exchange program staff and program participants need to be flexible in dealing with these issues.
Some people who usually walk or use crutches may choose to use a wheelchair during an exchange to cover long distances or in certain types of terrain. Participants should be encouraged to use whatever adaptive equipment will be most useful and effective during their exchange, volunteer or work experience abroad.
Ramps
Ramps make people with mobility disabilities feel welcome in public places. Whether inside or outside, the slope of a ramp should be no greater than 1:12. For every 1 foot of vertical height there should be 12 feet of ramp. In the United States, federal law guides ramp construction and is enforced in all public buildings. However, because of limited space and financial resources, disabled individuals often build ramps for themselves that are shorter and steeper than 1:12. Before building a short ramp, be sure to discuss strength, balance and clearance issues with the user.
Portable ramps are most often used by people to get in and out of vehicles while remaining in their wheelchairs, or to access buildings where there are no permanent ramps. People use everything from homemade wooden ramps to motorcycle ramps to the more expensive ramps designed specifically for wheelchair use. Portable ramps can be shorter, often around six or seven feet in length. Many ramps have hinges and fold for easier storage.
Portable ramps are ideal for temporary uses such as orientation meetings, short homestays, field trips, etc. These ramps may be purchased or rented from medical supply stores. Moving companies may also be able to lend or rent ramps.
It is important to note that standard ramps may not be sufficient for some types of wheelchairs or three-wheeled scooters. Some users will need ramps that are especially sturdy and built of one solid piece of metal or wood. Scooter users cannot use motorcycle ramps because of the nature of their chairs.
People with mobility disabilities who do not use wheelchairs may or may not benefit from ramps. Some people with mobility disabilities have difficulty with steps, while others do not. It can depend on the size and number of steps, how frequently the individual needs to use them, the availability of handrails, and the specific ability level of the person.
Other Mobility Equipment
Many people with disabilities choose to use crutches, braces, canes or adaptive (orthotic) shoes. Individuals with upper limb disabilities may use adaptive equipment to assist with daily activities such as dressing or opening doors. People with limited handwriting ability may use a computer or typewriter instead of pen and paper. Generally people who need these devices already own them. However, participants from overseas may not have had access to some types of adaptive devices in their home country. Also, repairs or replacements for adaptive equipment may be difficult to get in some countries. Crutches and canes generally have replaceable rubber tips, which wear out over time. Depending on the length and location of the exchange, it may be a good idea for participants to bring an extra supply of crutch tips or cane tips with them during the exchange.
Read more from Emily Rapp's memoir, Poster Child, and how she finds a friendly vendor with the right tools after an accidental fall in unfamiliar streets.
If adaptive equipment breaks, it may not be possible to purchase identical replacements in the country being visited. Forearm crutches, for instance, may be difficult or impossible to obtain in some countries. Possible ways to address this include having participants bring extras of their adaptive equipment from home, arranging to ship replacements from home if necessary, or looking at the possibility of having equipment repaired locally (someone with welding equipment, for instance, may be able to repair crutches). If the specific adaptive equipment a person with a disability normally uses is not available in the host country, consider alternatives that are locally available, and what option best suits the person with a disability. Some people might prefer to use a different type of crutch or cane, others to make temporary use of a wheelchair, and still others to go without mobility aids temporarily.
People with mobility disabilities who use walkers, crutches, canes, prostheses or other aids often have varying ability levels. They may be able to walk shorter distances unassisted, find it easier to walk on some days than others, or find navigating uneven, wet, slippery or cluttered walking surfaces more difficult to walk on than others. Heavy doors can difficult for anyone to manage, and people who use crutches, canes or walkers may have extra difficulties. Handrails are often particularly helpful to people who have difficulty walking. Note that handrails should be placed on both sides of a staircase or ramp because an individual may be stronger on one side of their body than the other.
A “short distance” to a program site from a host family’s home for a participant without a mobility disability can be prohibitive for those with reduced stamina or increased pain levels. Encourage participants to ask detailed questions about the location of overseas program activities so that they can anticipate potential barriers to participation and request alternative arrangements.
Low cost taxi services are available in many areas and can take the form of a car, bicycle, boat, or scooter among others. These alternate forms of transportation can be extremely helpful for people with mobility disabilities, and can be used for trips over a moderate distance, which might otherwise be difficult.
Exchange organizations should reach agreement with participants before a program begins about who will be responsible for repair or replacement costs. Some exchange organizations have also provided assistance with taxi fares in countries where the expense can add up and other transportation is not feasible. Read the insights of individuals with mobility disabilities abroad in these stories:An Unexpected Detour in France and Reflection: Being Part of a Group and Having a Disability in Thailand and Outside the Classroom: Environmental Fieldwork in Costa Rica.
Environmental Adjustments
Some people with disabilities may need to have tables or chairs adjusted for their use. To make tables higher, place blocks of wood under the legs. To lower tables or chairs, cut the legs down with a hand saw. Other disabled individuals may need to use a bed of a certain height. Try using a futon instead of a bed or placing the box springs and mattress on the floor rather than on a frame. Many people can benefit from these types of simple adaptations. For other examples, read Helpful (and Low-Cost!) Tips for Accommodating Participants with Disabilities
Accessible Toilet Facilities
Another issue to consider is the availability of accessible toilet facilities. A portable commode can be an excellent solution to this problem. A commode can also double as a shower chair or a seat. Commodes can be rented or purchased through medical equipment suppliers. This simple adaptation can create improved access for people with physical disabilities who are willing to be flexible for the sake of adventure.
Shower Chairs/Bath Benches
Some people with disabilities need to have extra support for showering. Shower chairs make it possible for many people with mobility disabilities to shower independently. Shower chairs and bath benches come in many shapes and sizes. Consult the individual who will be using the equipment for specific requirements.
Luggage / Bags
Many mobility aids require use of one or both hands, and make it difficult to carry objects and walk at the same time. People with a disability affecting their hands may have limited abilities to carry objects. Backpacks, shoulder bags, and other bags may be an important adaptation in these situations. Reminding participants with disabilities to bring bags or backpacks of whatever style works for them into different situations can be a simple way to provide accessibility. For more information read Equipment and Tools that Make Traveling with a Disability Easy.
Personal Assistants
Personal assistants or personal care assistants/attendants are individuals hired by some people with disabilities to help with everyday personal activities, such as dressing, bathing, bathroom needs, cooking, shopping and other household chores. At home, some disabled adults use assistants for difficult chores. For US citizens, many state and federal programs provide personal assistant services. Participants interested in hiring a personal assistant abroad may wish to contact individuals with disabilities and/or disability organizations in the host country for resources and suggestions. Local people with disabilities may be able to assist with identifying accessible lodging and transportation services as well.
Most people with disabilities, including most wheelchair users, do not use personal assistants. Many people use electric wheelchairs because of weakness in their arms that prevents pushing a chair. These individuals can often complete everyday tasks without assistance. For more information, read Personal Assistants on International Exchange Programs
Guide Dogs and Service Animals
The option of entering into a partnership with an animal trained to provide services to assist a person with a disability is becoming increasingly common for people with a wide variety of disabilities. A service animal provides a person with a disability an opportunity to have round-the-clock access to the assistance they need in order to lessen the affect their disability has on daily life. An animal can adapt to environments, adjust how it performs its duties and respond to changes in its partner like no other piece of adaptive equipment can. Find out out more about participating in international exchange programs with Guide Dogs and Service Animals.
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Lifting and Transferring
For many people being carried is an uncomfortable experience, both physically and in terms of dignity and independence. Lifting someone up stairs or around obstacles is not an acceptable alternative to appropriate accessibility measures. Most people prefer to be lifted only as a last resort. There may be times, however, when a person with a mobility disability may choose to tackle environmental barriers that require lifting or transferring.
A proper lift and transfer should be a comfortable and safe experience for the lifter as well as the individual being lifted. Everyone involved must work together to ensure that all transfers will be comfortable and safe. The person being lifted should direct the lift, as he or she knows what will work best. The people lifting need to have a good understanding of safe lifting techniques, as well as specific instructions from the individual being lifted, to protect their own bodies.
People with mobility disabilities generally do not benefit from being unexpectedly grabbed or steadied when they are attempting to balance. Often times, a person may be most capable of balancing when moving in a specific way, and having sudden weight on their shoulders, or being unexpectedly pushed in a certain direction may worsen their balance. It is best to ask before offering any assistance with standing, walking, rising, or other activities, and make it clear that the person can ask for assistance when they need it. If assisting with balance, take direction from the person being assisted about his/her specific needs and what works best. Many people do better if they can use the other person as a support rather than being held in another's grasp.
Policy Adaptations for Organizations Working with People with Mobility Disabilities
Policy adaptations for organizations including people with mobility disabilities in their programs should be based on providing reasonable alternatives to regular program expectations.This might mean waiving a requirement that a student carry their own luggage, providing extra logistical assistance to a participant in a wheelchair or allowing someone whose disability affects their fine motor skills to answer evaluation questions on tape instead of in writing. For academic programs, the option to live in a centrally located residence hall may be appropriate to minimize walking distance to classes, particularly in locations where accessible off-campus housing is scarce. A room on the first or second floor may be important as well in the event that individuals need to evacuate the building quickly in an emergency.
After applicants have been accepted to a program, international exchange organizations should be sure to send accommodation forms to all participants regardless of disability status. Accommodation forms are useful in identifying participants with disabilities and learning how much assistance each individual will need. A sample accommodation form can be found in Appendix B of the Building Bridges publication. It should be noted that as a participant adapts to his or her new environment, less accommodation may be necessary.
When working with people with disabilities from other countries, it is important to recognize that at home personal assistance may be provided by family members. When advising foreign students, encourage them to think about how much support they will need on a program where family members are not present.
Organizations should also consider evaluating all program policies to determine if they should be altered to reflect greater inclusion of participants with disabilities in the program.
Information condensed from Building Bridges: Including People with Disabilities in International Programs.
