Rajanagarindra Institute of Child Development Wheelchair Project (RICD Wheelchair Project)
Rajanagarindra Institute of Child Development
Thailand

The Problem

Rajanagarindra Institute of Child Development under the Department of Mental Health, Ministry of Public Health has been tasked since 1995 to treat and rehabilitate children with developmental delays in the North of Thailand, by providing medical services to young patients with e.g. cerebral palsy, and furthermore to assist them in overcoming their issues of impaired mobility. This is important because these patients are limited in their daily activities and have limitations to participate in social activities.

The National Statistical Office of Thailand estimates its disabled population to be about 2.9 percent in 2007 of the total population of Thailand or 1,278,605 People with Disability (PWD). Furthermore, the statistics of disabled people in Thailand show an increase every year. The main challenge is reaching these disabled with good opportunities, appropriate equipment and tools which would help ease their situation.

PWD in Thailand suffer from the limitation their disability creates. Due to these limitations of mobility, PWD are very often excluded of their family and community. There is still a very strong stigmatization of PWD by their family, caregivers and their social environment. By helping PWD, the caregivers will lose their freedom, cannot generate an income for the family. This situation can create bad feelings inside the family towards PWD.

The problem of mobility limitations can be solved through the aid with many types of high quality innovative devices and equipment, which can be used during a longer period of time to help physical disabled such as artificial limbs, wheelchairs and other mobility aid, etc. By using these new devices, the PWD gets the opportunity to have almost a normal life and in this way it immensely improves the quality of life of PWD.

Before the RICD Wheelchair Project started its activities, it is estimated that over 200,000 PWD in Thailand were not able to reach the right channels for help towards mobility aid due to especially financial limitations of the budget of the PWD but also due to the social class of PWD.

The social groups who are affected most by this problem are the PWD coming from poor families. By already limited financial means, the family members were not able to study and in this way generate a normal income for the family. PWD born in poor families also did not get good opportunities to go to high level education.

Another vulnerable social group that is affected is the disabled ethnic minority groups (social or political refugees) as this group sometimes does not have the normal civil rights as a Thai citizen.

Solution and Key Benefits

 What is the initiative about? (the solution)
The RICD Wheelchair Project got its name through the Rajanagarindra Institute of Child Development where the Project is based .This Project started in 2000 by setting up a network of volunteers. This network of volunteers started with a true heart to serve, motivate PWD to help themselves by training to live more independently

Before the year 2000, RICD was able to provide mobility aid to 10 children with disability/year. This equipment was supplied by Thai Government. The equipment was not always suitable and limited in quantity. Only a small percentage of PWD could benefit through this government program.
When the Project started in 2000, there was 1 organization from USA which sent 1 container/year. Up to today, 7 donor organizations from USA, Japan, Germany, … are sending equipment. This equipment is brand new or second hand refurbished.

In its second stage (2008 till present) the Project expanded the work to a holistic approach.

The holistic approach model is called “TEAM-C Model”: Training, Educational Support, Advocacy, Mobility Aid Distribution and Community Based Rehabilitation. By linking these 5 fields, the Project is able to improve of the quality of life of PWD.

Training is the key component for working with volunteers from all over the world, who have their own field of expertise even though specific technical training is given to these volunteers. Also workshops in Advocacy are set up.

Educational Support: The Project found out that there is a group of disabled children who don’t have access to education. To support this group, the Project networks with Special Education Centers in Thailand. Inclusion education is another strong education tool that is promoted strongly by the Project.

Advocacy is the tool to strengthen / to change and to adapt policy on family level/ community level/national level and resolve issues by means of a series of mechanisms, designed to persuade and influence the public perceptions and attitudes in a democratic and constructive.

Mobility Aid Distribution is the important key to delivery and distribution of the equipment to PWD in Thailand and neighboring countries, including ethnic minority groups, no matter the social, cultural or religious background of PWD.

Community Based Rehabilitation is a systematized approach to support PWD within their family and community by making the best use of local available resources and to help the family, community members & leaders to become aware of their responsibility towards the PWD.

The impact of the Project is huge. Since the start of the Project, over 13,000 PWD received mobility aid. The quantity of equipment received is covering partly the need of PWD. All equipment distributed is all of high standards and good quality.

To monitor the success of this model, the Project did research (2007 - 2010) on the impact of mobility aid distributions to PWD. This research showed that 75.7% improved their life and were even happier than normal people.

The most impact of the Project is the recognition and understanding to PWD. The Project can also motivate volunteers in a positive way and create a special interest to work for PWD.

Every year, there is a special event at the RICD where over 3.000 CWD are attending. The emphasis of this special day is to point out the “abilities” and not the disability of these children.

Actors and Stakeholders

 Who proposed the solution, who implemented it and who were the stakeholders?
The solution of the mobility aid problem was proposed by the Director of the Rajanagarindra Institute of Child Development (RICD) in Chiang Mai. The

Project was implemented by a team of volunteers coming from all over the world in cooperation with medical staff of the RICD in Chiang Mai and the donor organization Wheels of Hope from the States.

Up to today, the Project is working together with several donor organizations from abroad to receive brand new and second hand mobility aid by container shipments. During these distributions, the volunteers cooperate with medical staff of the local and provincial hospitals, public health centers and other organizations (GO / NGO) who are interested in helping PWD.

The first stakeholder of the Project is the PWD him/herself and family of the PWD. Also community organizations are working as stakeholders for the Project.

Another important stakeholder of the Project is the Department of Mental Health, Ministry of Public Health who is facilitating duty free import of all container shipments.

Not only governmental organizations are stakeholders but also private organization/companies are supporting this Project e.g. all in-country transportations are facilitated and financed by a private company.

Another strong stakeholder is a private financial donor who provided the financial means to start with the “Mobile Working Unit”, a specially adapted van for working in remote areas.

The highest honor for the RICD Wheelchair Project was that H.R.H. Princess Galyani Vadhana accepted the Royal Patronage over the Project and in this way facilitates many possibilities for future activities of the project.
Unfortunately, in 2008 H.R.H. Princess Galyani Vadhana passed away. Even though in July 2010, H.R.H. Princess Maha Chakri Siridhorn accepted the Royal Patronage over the RICD Wheelchair Project.

All activities for this Project have been implemented by volunteers who are offering their work free of charge. Since the Project started, over 100 volunteers offered their expertise and services completely free of charge. The volunteers are motivated by their love for the PWD and the great desire to contribute meaningful help to the PWD. This spirit of service is found in all religious backgrounds and is a core value of the Global Community where there is respect for every single person no matter what their background is. That is why the Project has a multicultural team which works well together because we share these special values.

Whenever there is a need for assistance to PWD, our volunteers are ready to serve.Timing is no issue for our volunteers as if there is a need during weekends or outside working hours, the team will be ready to help. Not only mobility aid is done but e.g. when PWD need help at home concerning fixing, cleaning, painting, … our team is always ready to assist. Even though all team members are coming from different parts in the world and from different cultural backgrounds, the volunteers work together in a spirit of equality and respect for each other with the goal to help PWD wherever and whenever they can.

(a) Strategies

 Describe how and when the initiative was implemented by answering these questions
 a.      What were the strategies used to implement the initiative? In no more than 500 words, provide a summary of the main objectives and strategies of the initiative, how they were established and by whom.
The objective of the Project is creating an efficient channel to provide mobility aid to PWD and motivates them to help themselves by training, self help groups, to live more independently by using the “NET-KIEM” Strategy.

The “NET-KIEM” Strategy has 6 main topics: Networking, Empowerment, Training, Knowledge Management, Implementation, Evaluation and Monitoring.

N-Networking is a very strong strategy in our project. This networking goes between Governmental Organizations and Non Governmental Organizations on different levels. In Thailand, a network is setup between hospitals, public health centers and other Non Governmental Organization’s to distribute mobility aid. To set up this network, the Project is working with strong stakeholders. We establish several working groups to work together with these stakeholders.

E-Empowerment, the Project will empower PWD, their families, caregivers and community leaders to strengthen their capacities so that PWD’s can become a member of the community and also become part of the Project.

T-Training, The magic word of the strategy is “Training”. This training covers various fields. These training will also increase considerably the value of this Project e.g. this technical training for wheelchair technicians will teach the volunteers how to work with high standards and in a correct way towards PWD. Other training given by the Project are 3-days advocacy workshops and accessibility training.

KIEM : Knowledge Management / Implementation / Evaluation / Monitoring
The Project set up a working tool “Knowledge Management” to collect learned lessons and to implement this knowledge into practice. This implementation will be evaluated and monitored in a certain time frame. The results of the evaluation and monitoring will be a feedback for the “Knowledge Management” system and this feedback will be again implemented.

(b) Implementation

 b.      What were the key development and implementation steps and the chronology? No more than 500 words
There were 4 key development and implementation steps as follows:

Networking & Partnership Donors & Sponsors:

In the beginning, equipment was just distributed without any fitting of the PWD. The philosophy of the Project is that PWD have to get an accurate fitting according to the special needs and in cooperation with medical staff and mobility aid technicians.
The Project started in 2000 with a capacity of serving only 200 PWD/year and steadily increased its capacity to currently over 2,000 PWD/year through a good donor network / partnership with “Wheels of Hope” USA.
This donor network has been expanded considerably through the years with partnerships with Joni & Friends/Wheels for the World-USA (2004), Helping Hands-Norway (2007), Wheelchairs of Hope –Japan (2009), Tweedehandshulp Middelen -The Netherlands (2011) and Convoy of Hope Germany (2012). Through these partnerships from many countries, a good quantity of equipment was received even though the main objective of the Project is giving a high quality service to PWD by adapting the equipment to the special medical needs of the PWD.

Target Group & Working Area Enlargement:

Start of 2000 till 2002, the Project was first doing mobility aid distributions only in the Northern part of Thailand, specifically for children with disability. Start of 2002, the working area of the project enlarged to all the provinces in Thailand and neighboring countries. At this stage children as well as adults could receive equipment from the Project. All these activities also received the Royal Patronage of H.R.H. Princess Galyani Vadhana and since 2010 the Royal Patronage of H.R.H. Princess Maha Chakri Sirindhorn.
Quality & Satisfactory to the life of PWD
The Project wants to point out to the potentials (abilities and not disabilities) of PWD and create all possible opportunities to give a more value to the life of PWD. Through these activities, the Project promotes love and understanding towards PWD.

The Project gives to every PWD who receives mobility aid safety training since 2004. To improve the safety training, the Safety Manual was published in 2007.

To find out the effect and results of receiving adequate mobility aid by PWD in the field of mental health, the Project did research during the period of 2007 till 2010 with the working tool “Happiness Meter”.
Holistic Program and Advocacy Policy

The Holistic Program “TEAM-C” Model was implemented in 2008.
As there is a special field of “Advocacy” in the holistic program, a Partnership was set up with “Health Link Word Wide” in 2008.
We are empowering our networks to follow our strategy. Through the implementation of the holistic program, the value of life (physically/mentally) of PWD’s is considerably improved e.g. possibility to go working and generate income and accessibility of children with disability to education.
By empowering the PWD, there is also an efficient awareness raising towards members of the community as these community members realize that PWD can integrate in society completely and really contribute in the family and in the community where they live.

(c) Overcoming Obstacles

 c.      What were the main obstacles encountered? How were they overcome? No more than 500 words
The first step obstacles & Solutions:

The quality of equipment: we found that the equipment sent by donor organizations abroad was not suitable and needed to be fixed before distribution for the primary target group.
To solve this problem, before starting a Partnership with new donors, a screening was done to see the capacity of the donor to fix equipment in the donor country prior to shipping the container shipment to Thailand.
Another problem was funding of the container shipments. This funding is needed to guarantee a constant flow of equipment.When the partnerships with the donors abroad were established, another problem raised…

How will the Project get the container shipments duty free into Thailand? For this, the Project contacted the Department of Mental Health Ministry of Public Health to request for duty free import. Up to today, 41 container shipments, from 7-10 sponsors, were shipped into Thailand tax free.

Another obstacle was the transport of the equipment to the distribution venues in Thailand. Before, the local organizations, who were hosting the distributions, had to finance this in-country transport by themselves. A consequence was that organizations which were not financially strong, did not get the opportunity to request for a distribution. To solve this problem, the Project found a donor who is taking care for in-country transport to all distribution venues.

The next step obstacles & solutions:

At the beginning of the activities another problem appeared… How can the Project spread the news in the most efficient way that PWD could apply for mobility aid free of charge? This was done through the existing channels of hospital, public health centers and several media channels such as radio and TV. Within 6 months, this problem got solved as now applications for equipment are received on daily base.

The Project was confronted with a certain stigmatization towards PWD. To decrease this stigmatization, the Project constantly pointed out to the “abilities” and potentials of the PWD and tries to integrate PWD in Thai society e.g. by stimulating PWD (children) to go to mainstream education. In this way, young children with no disability will get in touch directly with CWD and find out that these children with disability are equal to people with no limitations. These children will take these experiences to their own children. In this way, a mentality change towards this disability stigmatization can be achieved.

As the project was growing, there was a urgent need to set up a transparent management system towards finances, volunteers, statistics, etc. which would show accountability to the high moral standards of the Project, e.g. a database system was set up linked with the equipment inventory system; Pictures were taken of PWD who receives mobility aid and was used as proof for the donors that the mobility aid has been distributed in a good way.
To keep this management system on the right track, there should be a monitoring and evaluation system. The lessons learned out of this monitoring and evaluation should be implemented again into the Project.

(d) Use of Resources

 d.      What resources were used for the initiative and what were its key benefits? In no more than 500 words, specify what were the financial, technical and human resources’ costs associated with this initiative. Describe how resources were mobilized
Human resource:

At the beginning, the project was working only part time through volunteers who gave out occasionally mobility aid. The project increased the number of volunteers. Up to today, the team is working fulltime on daily base at the RICD Wheelchair Project with volunteers from all over the world. Over the years, more 100 volunteers were offering their work and expertise free of charge for this project. These volunteers are coming from all different continents from countries such as USA, Iran, China, Germany, United Kingdom, The Netherlands, Australia, Japan, Kenya, etc... . these volunteers are all working free of charge and in a spirit of helping the PWD who are in need.
Another human resource of the Project is the local volunteers in several branches of the RICD Wheelchair Project all over Thailand who are working extremely motivated and free of charge to assist and serve PWD in their region.

Financial Resource:

Even though all these volunteers are working free of charge, the necessary financial means have to be found to make the Project sustainable. The funding is mostly received from donations from private donors. There are two kind of donations that are important to the Project. First there are the financial donations; second the logistical support. One of the main donors (who also became a stakeholder) is donating logistical support by organizing all container shipments coming from abroad as well as all „in-country“ transport of the equipment coming from port to warehouse to distribution venues all over Thailand.
The key benefit of the supported „in-country“ transport to the distribution venues is that local organizations in more remote areas who do not have the financial means to support the transport by themselves, can now request for distribution.

Tools & Equipment Resource:

The thirth important resource in this Project is the mobility aid. All this mobility aid is donated by charity organizations abroad. The Project started with 1 donor organization and is now receiving equipment from 7 different organizations from USA, Japan, The Netherlands, Norway and Germany. In the near future, the Project would like to expand the number of donor organizations and is negotiating with charity organizations in Canada and Switserland. The project is now reeiving between 7 to 10 container shipments/year. The total value of equipment received is now over 122 milj. Baht (= 4 milj. US Dollar).
All these container shipments are shipped into Thailand duty free by the Department of Mental Health.
By receiving this increasing amount of equipment, the Project could expand the target group who could receive mobility aid from children with disability to also adolescents and adults,
In 2013 the Project has the intention to start to produce mobility aid in Thailand in cooperation with a generous private donor. The benefit of this project is that all equipment that is needed, can be made locally and every can be custom made.

Sustainability and Transferability

  Is the initiative sustainable and transferable?
The Project is now running for over 12 years. It is constantly expanding towards the number of container shipments received/year and PWD reached/year.

Through partnership with organizations abroad and in Thailand, there is a constant flow of equipment so we can continuously serve PWD in Thailand and neighboring countries. The financial arrangements for transport of the equipment (containers / in-country transport) are also guaranteed for the upcoming years.

Through setting up branches in Thailand, the Project creates the opportunity where local groups can work independently even though under the main office of Project in Chiang Mai. The advantage of these branches is that the accessibility to the Project becomes easier.

Since 2011, the Project rolled out internationally to Malaysia, Laos and Burma. The Project has a Memorandum of Agreement with organizations in the neighboring countries. These organizations are working with the same mission and goals as the RICD Wheelchair Project but adapted to the local standards and culture.

The partnership with governmental and non-governmental institutions sets a good example for other countries in South East Asia especially with the start of the ASEAN Community in 2015.

We are convinced that the activities of the Project can be reproduced by any organization willing to work together with volunteers with the spirit of serving PWD.

The benefit to PWD by receiving mobility aid is very crucial and life changing and volunteers get satisfaction from their work. Especially young people are interested in investing their time to serve the disabled community. Volunteers returning to their countries, can function as ambassadors for the Project and recruit new volunteers, funds and other resources.

We acknowledge that the basic stakeholders need to come together so that the work of the Project can be reproduced. The strength of the work is that we function as a team where each person shares their knowledge to the benefit of the whole team. As everyone has the chance to experience many roles, tasks and challenges, it creates a synergy effect with valuable insights and input of new ideas to improve the system of the project. In our experience, this synergy is the motor for the expansion of the Project over the years. This has been the driving force for quantity and quality improvements in the service towards the PWD.

The Project is now planning to produce mobility aid in Thailand. This activity will make the Project even more sustainable. The project will not have to rely completely on container shipments. This will have a considerable consequence towards finance but also towards the availability of equipment. This activity will be done in cooperation with the main financial and logistic donor.

The RICD Wheelchair Project is established in Thailand for always through a strong network of Partnerships in Thailand and abroad, surrounded by a beautiful group of loving volunteers from all over the world who all have one goal in life and this is helping and serving our PWD in Thailand and neighboring countries, no matter their cultural, ethnic or religious background.

Lessons Learned

 What are the impact of your initiative and the lessons learned?
Since the start of RICD Wheelchair Project over 13,000 PWD could benefit from the Project by receiving mobility aid. The donated mobility aid has a total value of 122 million. Thai Baht

By distributing mobility aid, the Project also gives a more value to the life of PWD. By increasing the mobility of PWD, they are able to integrate more easy in their family and/or community.

Adult PWD will be able to go out working to generate an own income for their family. This will considerably increase the self esteem of PWD but also the status of PWD towards their own family and/or community.

By giving mobility aid to children with disability, the accessibility towards education resources increases considerably. Now, many children who received mobility aid from the RICD Wheelchair Project, are going to school such as Special Education Centers all over Thailand. Several children with disability even get fluently access to the mainstream education facilities through inclusion education.

A lesson learned here is that not only the practical ‚non-accessibility‘ towards education and other disability topics has to be battled but also the mind of the public has to be made accessible for all different disability topics.

Through constructive and good organized advocacy awareness work, it is possible to increase the understanding of the general public towards the problems of PWD. There is still a big lack of knowledge that can lead to stigmatization but also be solved with these kind of advocacy campaigns.

The advantage of the „NET-KIEM“ strategy, used in the RICD Wheelchair Project, is that this strategy can easily be implemented in other organizations, of course adapted to the special goal of this organization.

The RICD Wheelchair Project foud out that this project and the NET-KIEM“ strategy can also easily be implemented in other countries as the RICD Wheelchair Project is now also working in 3 neigboring countries even though the strategy should always be adapted to the local traditions and culture.

It is possible to work together with Governmental and Non Governmental Organizations in one project as both kind of organizations can bring in their own expertise and help and by joining hands together, many problems can be solved.

It is necessary that the volunteers of the RICD Wheelchair Project should be able to communicate in the same language as PWD to improve communication and relationship from team member to PWD.

The impact on the lives of the volunteers of the RICD Wheelchair Project is quite considerably as the Project found out that several volunteers made their final choice in the Project what they wanted to do in their further life as profession.

The volunteers of the RICD Wheelchair Project have to work in an environment of love, understanding and the highest respect towards PWD and their family. The team can learn a lot from PWD and their family. These people are confronted with limitations every single day and they know the best what their real needs are.

Contact Information

Institution Name:   Rajanagarindra Institute of Child Development
Institution Type:   Government Agency  
Contact Person:   Dr. Samai Siritongthavorn
Title:   Office of The Director  
Telephone/ Fax:   + (66) 53-890238, + (66) 818818918/ + (66) 53-121-
Institution's / Project's Website:   www.ricd.go.th
E-mail:   samais2001@yahoo.com  
Address:   196 Moo 10 , Chiang Mai-Fang Rd. Tambon Don Kaew
Postal Code:   50180
City:   Mae Rim
State/Province:   Chiang Mai
Country:   Thailand

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