DEVELOPING COMPREHENSIVE SUSTAINABLE SERVICES IN KENYA THE ASSOCIATION FOR THE PHYSICALLY DISABLED OF KENYA Amman – Jordan 8 th to 11 th of December 2009

Kenya East Africa – Capital Nairobi Population 39 Mio. 52% population live below 1$ per day 4.7% prevalence of disability (1.8 Mio.) 38% physical disability Disability Act passed in 2003 Ratified UN Convention May 2008 Rehab services very limited in Government – largely NGOs and faith based organisations

1958 – YEARS OF EMPOWERING PERSONS WITH DIFFERENT ABILITIES

The APDK Vision An inclusive society where persons with different abilities enjoy equal rights and have access to comprehensive quality rehabilitation services

The Mission To enable persons with disability to overcome their physical limitations and empower them socially and economically to become self reliant and fully integrated members of their communities.

APDK Established in 1958 as an NGO Established in 1958 as an NGO Developed 7 branches in the 1970 th Developed 7 branches in the 1970 th 1992 – NORAD withdrew – 5 branches closed 1992 – NORAD withdrew – 5 branches closed Nairobi branch survived due to rental income Nairobi branch survived due to rental income Coast Branch developed 5 programs – 330 employees Coast Branch developed 5 programs – 330 employees revived upcountry branches integrated in Government hospitals funded by revived upcountry branches integrated in Government hospitals funded by CIDA and BMZ ( CBM Co-funding ) CIDA and BMZ ( CBM Co-funding )

Network of nine main branches in largest towns in Kenya integrated in Government hospitals Network of nine main branches in largest towns in Kenya integrated in Government hospitals 15 satellite branches 15 satellite branches Extensive CBR programs in slums of Nairobi and Mombasa Extensive CBR programs in slums of Nairobi and Mombasa 330 Mobile outreach clinic stations 330 Mobile outreach clinic stations 440 employees (221 persons with disabilities) 440 employees (221 persons with disabilities) 54 Government attached Therapists and Technologists 54 Government attached Therapists and Technologists

Impact in 2009: Reached 56,000 people with disabilities in the country through various services Reached 56,000 people with disabilities in the country through various services Undertook 1,650 orthopaedic surgeries Undertook 1,650 orthopaedic surgeries Corrected 820 clubfeet –PONSETTI- Corrected 820 clubfeet –PONSETTI- Produced 15,400 orthopaedic appliances Produced 15,400 orthopaedic appliances Produced 4,600 appropraite wheelchairs Produced 4,600 appropraite wheelchairs Collaboration with 220 CBOs with 4,400 memerbs for economic empowerment (2,800 received loans) Collaboration with 220 CBOs with 4,400 memerbs for economic empowerment (2,800 received loans) Rights based model through twin track Rights based model through twin track

APDK FUNDING 2009 Sales crafts and furniture € 700,000 CBM € 450,000 USAID –Wheelchair services € 200,000 Ministry of Health personnel € 100,000 Kindernothilfe € 100,000 Latter Day Saints Charities € 200,000 Other Wheelchair sales/sponsors € 300,000 Various other int. & local donors € 240,000 Rental income Nairobi € 50,000 Total € 2,340,000

The APDK services

Bombolulu Handicraft Centre Established in 1971 Established in 1971 Jewellery, Textiles, Woodcarvings, Leather Jewellery, Textiles, Woodcarvings, Leather Cultural Centre Cultural Centre 140 employees 140 employees Exporting to 20 countries Exporting to 20 countries

Employment bureau Established in August 2009 in Nairobi Lobby private and public sector to employ persons with disabilities in line with Disability Act Collects and disseminates CVs from qualified and interested persons with disabilities seeking formal employment Training, counselling and follow up of persons with disabilities who secure employment

APDK Appropriate wheelchair services

Wheelchair Services Nairobi YearWheelchairsTrikes Sports wheelchair.Total August Proj Proj

USAID Support 2005: $ 50,000 Funding of wheelchairs, testing and research 2006: $ 200,000 Construction of wheelchair workshop, machines, training, capacity building 2007/8: $ 422,000 Showroom, machines, stock of materials, training, research, national stakeholders conference, special seating departments, micro finance 2009/11 $ 600,000 Capacity building, national distribution network 22 hospitals, outsourcing, research, product development Capacity building, national distribution network 22 hospitals, outsourcing, research, product development

KAIZEN RESTRUCTURING Lean manufacturing based on Toyota model of constant improvement Improve manpower productivity and skills Improve manpower productivity and skills Increase quality and reduce wastage Increase quality and reduce wastage Result : Production increased from 100 to 300 wheelchairs and trikes per month

Partnership with Latter Day Saints Charities USA Lobbied representative at WHO Bangalore conference in November 2006 Lobbied representative at WHO Bangalore conference in November 2006 Signed MOU for funding of 1200 appropriate wheelchairs in 2007 Signed MOU for funding of 1200 appropriate wheelchairs in 2007 increased to 1800 per month in 2008 increased to 1800 per month in 2008 Reduced to 1000 in 2009/2010 Reduced to 1000 in 2009/2010

Customers of APDK HANDICAP INTERNATIONAL Kenya (Refugee camps) Sudan Democratic Republic of Congo Latter Day Saints Charities Sudan ICRC CCBRT Dar Es Salaam and Moshi Kenyatta National Hospital Nairobi MADE Uganda DISACARE Zambia AIC Cure Kijabe LOREWO Namibia and Zimbabwe Medical care development international Rumbek Southern Sudan Sudan Evangelical missions

Tenwek Hospital PCEA Kikuyu Hospital NAD Ustratuna Juba Sudan Sierra Leone MAP (Malawi against polio) GYDA Guru Uganda Techno Relief services Médecins san frontieres GTZ Care International Katalemwa Cheshire Home Uganda Eritrea Several government hospitals in Kenya Prospects: HI Rwanda and Burundi, CORSU Uganda

EU Funding CCBRT and APDK Reducing the prevalence of disability and mitigate the effects of impairments by increased community awareness, strengthening maternal and newborn care and providing comprehensive early intervention services.

Research Setting up Research department in APDK Undertake global research to identify most appropriate high quality low cost technologies Organizing consensus workshops to develop most appropriate P&O products and wheelchairs for East Africa Standardize technologies, materials and products Field and lab testing Central souring, warehousing and regional distribution

Sustainability Strategy Integrate services into Government hospitals funded by Ministry of Medical Services for sustainability Lobby National Hospital Insurance fund for funding of rehabilitation services Lobby National Disability Fund for funding of wheelchairs and appliances Develop social business model as global distributor of appropriate appliances and wheelchairs