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People with disabilities

“We advocate rights”

by Harold Shangali
Harold Shangali has been the head of the Tanzania Training Centre for Orthopaedic Technologists (TATCOT) since 1992. In an interview with D+C/E+Z, he discussed the challenges disabled people face in Africa, as well as the challenges the institution he works for will have to meet. [ Interview with Harold Shangali ]

What are the particular challenges for people with physical disabilities in Africa?
They have problems to get assistive devices in their local areas, and they find it hard to pay for such devices. Moreover, they often do not have easy access to public buildings and infrastructure. Finally, public services in general tend to be poor, and that is, of course, particularly hard on people who already face challenges others do not have to cope with.

Why do so many people need prostheses?
Physical disabilities are mainly caused by traffic accidents, but also snake bites, occupational accidents or politically motivated violence. Moreover, we aim to help former polio cases, people with congenital malformation, infectious diseases, diabetes and tumours, to name but few.

How do people with disabilities benefit from your work?
TATCOT trains and qualifies orthopaedic technologists in different categories and at various levels. During the clinical phase of their training, students assess, prescribe and rehabilitate patients with assistive devices which in turn elevates the number of those who are being attended to at the hospital’s Prosthetic and Orthotic Department. The school has contributed extensively to advocating the rights of people with physical disabilities.

Are there other centres you know of in your neighbouring countries that compare to yours?
No, this was the first of this kind to be established in Tanzania; and it still is the only in Eastern Africa.

Why was TATCOT started?
There was – and is – a need for professional training that meets international standards. Up to the late 1970’s, there was only one formal training centre in orthopaedic technology in Lomé, Togo. It served francophone countries, but it did not even meet the demand of West Africa, let alone that of the entire continent. In the meantime, another centre has been established in Morocco, others are planned, for example in Rwanda. There are also some centres that do not meet the international standards of training technical orthopaedic professionals, but it is important to work on an up-to-date basis.

Where are your students from?
Our students come from all over Africa, but also from countries like El Salvador, Vietnam and Cambodia. There are different ways they get to know about of our school – either through different news media or journals or by attending conferences or congresses. Some also find out via the internet or are informed by responsible officials.

What does TATCOT aim for?
Our most important goals are to
- ensure long-term sustainability of quality of training and operational standards,
- increase the number of professionals who serve the needy population,
- keep up with and adhere to technolo­gical progress,
- promote rights and equal opportunities of people with physical disabilities,
- improve their quality of life,
- participate in implementing national and international policies and guidelines related to training, service provision and research,
- embark on research to adopt an evidence-based practice, and
- offer undergraduate and postgraduate courses in the field of rehabilitation medicine.

Who funds TATCOT?
The Tanzanian government pays a lump sum and apart from that, the Centre is financed by tuition fees and cost sharing fees from students. For us, it is tough to have to do without scholarships from InWEnt in future, but we understand that they say our work is going well and that it is more urgent to build capacities elsewhere. We will, of course, stay in touch.

What challenges will you have to face in the near future?
Retention of academic staff, shortage of space for practical training as the number of students is likely to increase and last but not least: sponsorship support, as one of our key sponsor – InWEnt – has dropped its support to long-term training.

Questions by Eleonore von Bothmer