Disability Programme at IMI

DISABILITY Services
Society and economics influence one another. While society evolves and sees the need to value, hoard and cost resources for status reasons, the consequential inequalities between the ‘haves’ and ‘don’t-haves’ create new conditions of instability whose failure to address, further create the different forms of disability simultaneously –escalating ignorance, poor physical, mental and heightened levels of instability within the socioeconomically lowly communities.
Disability is known to be more mental than physical as a well adapting mental faculty has the means to overcome challenges at physical level. Disability is relative and minimal bit of it may be motivating rather than socioeconomically challenging.
"Poor socioeconomic conditions are the greatest causes and predictors of disability, preventable illnesses and early deaths."

-Jacob Waiswa
Pilot project for the mentally and physically challenged
Purpose:
The purpose of this project to promote mental health seeking behaviours of mentally challenged members of the community through family/homebased interventions in order to increase access to mental health services and support mental adjustment, recovery, reduce vulnerability and achieve sustainable mental wellbeing.
Main Activities:
-Creating awareness
-Conducting research to know existing mental health problems and inform stakeholders
-Identify partners to support activities
-Identify households that need mental health services
-Conduct mental health assessments for respective households
-Develop interventions for respective households
-Conduct training for field workers
-Allocate resources and coordinate management of interventions
-Daily-weekly-monthly and annual monitoring and evaluations by field staff and organisations
-Share reports with stakeholders and seek their input in next phases of interventions
Specific Actions
-Family visits for general conversations to understand psychological concerns of respective family members and how they affect entire family
-Identify and restore family structures that are psychopathological
-Discuss new old and new family structures with first respective family members and later common roles and responsibilities towards new healing family structures.
-Monitor adaptations to new family structures for 6 to 12 months
-Align and strength community and institutional linkages mentally well families.
-Reconcile family members with missed growth and development stages
-Establish reward systems from within family to keep it developing
-Enact situations to elicit family based solutions under conditions of difficulty
-Supervise daily affirmations to new
-Identify and incorporate nutrients for mental strength
-Identify and incorporate physical exercises for mental and physical strength
-Identify common family roles and responsibilities into new family mental health structure.
Expected results
-Attain an understanding of each family member’s mental health and sources of mental and shared knowledge of how each family member should be handled to achieve individual mental development and wellbeing
-Discard of old relationship treatment patterns that were maladaptive
-Adoption of new relationship patterns that support mental wellbeing of respective family members.
-Realise individual roles and responsibilities for respective family members towards the mental wellbeing of the entire family unit.
-Assertion of each ones identity in the new roles and responsibilities
-Development of individual goals away from environment for personal fulfilment
- Ensure collective support for each other’s new roles to be practiced over time
-Knowledge of supportive links outside family setting that can be sought to support new family mental health structure
-Motivation to seek support both from within and outside family structure to support new family mental health view
-Motivation to take steps towards ones emotional, physical, social and spiritual needs with implication to mental wellbeing
Changes overtime
Discernment abilities of each family member to feed into the mental wellbeing of the family unit.
Happy family life that reinforces healthier family relationships
Development of strong family character that is stronger against external shocks
Better problem-solving mechanism with openness and input of respective family members
Development of appropriate goals for better life outside family(school, work and social relationships)
Greater concentration levels at work
Greater productivity and rewards (academic and occupational)
Better and supportive relations outside family life
Greater positive sense of self and togetherness as family (positive identify)
Complementary and supplementary support to each family members who need it for the greater family life
Easy assimilation of trauma and mental healing in future in current and future trauma encounters.

Addressing widespread socioeconomic conditions which impact most on individuals and their families, with emphasis on families that have been hit most, through reliefs such as;
- Reading materials,
- Breakfast to starving women and children,
- Clean water
- Infections prevention kits
- Toilet facilities
- Pads for girls
- Vocation skills training
- Clothes
- Medicine
- Sanitation facilities
- Longterm rehabilitation of those facing addiction to alcohol and other drugs
- Demystify maladaptive religious and cultural dogmas as well as physio/yoga for the physically challenges yet impacting mental wellness.
- Agroforestry (fruit trees)
- Subsistence agriculture for families without food
- Commercial agriculture for livelihood development of families in need
Environmental impacts or benefits the project might have:
- Inaccessibility to safe and clean water, proper food diet and proper household incomes are the greatest challenges to families affected by mental problems, which in many respects are influenced by climate change. Therefore initiatives to preserve the environment and restore degraded cover are one significant motivation for the project. Demonstrations shall be established and seedlings given at affordable price for value addition to this particular activity, in order for families to be actively responsible to the environment by way of agroforestry and fruit tree growing that support efforts to promote food security and agriculture related employment for the majority of women and youths. And institute and promote policy of planting 30 trees for every one cut down.

HOW YOU CAN BE INVOLVED
As client
As volunteer
As service activity sponsor
As client sponsor
As fundraiser
As donor/funder
As ambassador
As development partner
As friend
Visit us
Visit our blog www.integratedmhi.blogspot.ug
Visit our facebook page: www.facebook.com/integratedmentalhealthinitiative
HOW YOU CAN REACH US
Telephone: +256774336277 or +256752542504
Email: waiswajacobo@yahoo.co.uk or dishma.imhs@gmail.com

Regina Kiiza Memorial and Development Fund: A Life Innocently Lived and Beautifully Left

Regina Kiiza Lived A Very Challenging But Innocent and Compassionate Life

"Born innocent, Lived innocent and Died Innocent"

- Jacob Waiswa

Regina Kiiza was born in 1985 and died in 2017, leaving behind great compassion and beautiful life that those around her struggled to keep until limits of human nature led to their untimely end at the physical. In spirit, the beauty and compassion live on. And hopefully, we can help renurture such a life for the disadvantaged others to thrive in such a world that challenges the most vulnerable to cope and find peace.

Regina contracted meningitis, hydrocephalus, and epilepsy conditions at birth. She has since overcome these conditions to reach the age of 32. As a child life was very promising despite suffering from multiple physical and mental challenges, as support systems were readily available. A daughter of a single mother and retired civil servant, Regina was graced with a spacious home as part of the benefits of civil servants that her single parent benefited from. The location and decent house attracted extended family members –who resided there as students, newly employed youths in town and as job seekers. The public house also had tenant houses that brought in friendly people to live with. As such  Regina had a vast social support system between 1985 and 2000. After retirement, her single mother lost only job and got hit hardest as bread winner. She was forced to find lowly jobs in emerging organizations to support Regina and herself as well as rent makeshift house in the town, closes to the main hospital. The strategic location ensured that Regina has access to emergency treatment. The new life was very challenging, as the social support system had soon collapsed and none of the extended family members were in sight,  anymore; no even friends. Loneliness loomed the life of Regina in a very restricted and unhealthy living environment. Even her 3 siblings had long started new families and left her extremely lonely. Her single mother and caretaker spent most hours of the day toiling for a living. At age of 66, she was still running around to farm and work as support employee with local development organizations. The only chance Regina met her was after 9pm. Loneliness, immobility and lack of direct contact of sunrays, left her so vulnerable to infections and it was not so long when she contracted a life-threatening Tuberculosis (TB), which at first was mistaken for regular flu and cough. Malaria fever too joined the list of infections and conditions afflicting Regina. Regina was suddenly thrown back to early-childhood trials and tribulations of life, even worst after she contracted with a very terrifying and resistant TB virus that took her into comma and feeding as well as passing out only from tubes. But thanks to her very resilient single mother and her own experiences of living in unconscious states and facing pain and misery from greatest part of her life. Great Samaritans too came in to offer unlikely support and hope to the single mother threatened by poverty, disease and uncertainty. But Regina’s own resilience brought her back and gave her chance to life again amidst scares of TB deaths in the same hospital wards each day. Upon this victory, the future now has key lessons for Regina, her mother  and the world

Regina was lucky to live again

Her care and support cannot be guaranteed.

Care and support can only come from outside family circles, from new adoptable families and friends as well as wellwishers, who may be happy to share love, hope and a better future with Regina.

Regina was transferred to Kiruddu from Jinja hospital 3 days ago (July 22). From comma, she was responding well to treatment. The 2 months and 2 drug combinations did well, until 4 days ago when she was set to adopt a 4 drug combinations. Unfortunately for Jinja medical people, the drugs they had were very strong for the liver type. When IMI inquired from main mulago, it was revealed that such cases call simply for 2 weeks break off drugs. Other colleagues suggested same, one other said only 1 of the 4 was problematic and could be withdrawn for sometime, then get reintroduced. Well, I am yet to understand what Kiruddu people have decided. We neglected this disabled girl for some years immobile and deteriorated to levels TB took a chance. It was very regretful since it was such a prevented case. Seeing the pain she is going through alongside other vulnerabilities, we too now have emotional pain to deal with.

Kiruddu is crazy place. At least 20 people die every week. Sunday 23 July was witnessed by me. On 6 floor alone, some 5 people died and left behind fears and anxieties for patients and caregivers. Reason fronted is late transfers/referrals for management after other hospitals have failed. And patients are brought in closest to death. I was among those moved by the deaths, in absence of standby medical person to resuscitate life. ~ Besides, Kiruddu location is disastrous. It is a beach environ, near Lake Victoria. The night long weather is fatal for the struggling patient, far destabilising for the care-giver.

Unfortunately Regina passed-on on July 27, around noon. It was a brave fight by her caregivers, who fell sick around her last 5 days of life from burnout and respiratory infections. It was a painful death that onlooker would experience too. The death itself was worst event as there was greater hopes of recovery before she was transferred to Kiruddu. Whatever the regrets (medical negligence, caregiver burnout, new infections and hazardous hospital environment), Regina (32) is gone, leaving behind a lot of emotional pain and love.

We hope from her loss, the struggle for better health care system, patient justice, vulnerability redress, sharing the love Regina amassed, giving hope to the bereaved families and supporting them through difficult times, and achieve a life she much longed for, will benefit the living so that they can live at peace with the dead through events as funeral and memorial services as well as family livelihood and health improvement activities in their memory.

We appreciate the timely local support from family and friends:

Jinja Medical Center/Dorothy

Jinja Referral Hospital (despite deploying student nurses, helped take Regina out of comma)

Waako Emmanuel (through sickness and death)

Jacob Waiswa (through sickness and death)

Babirye Racheal (through sickness and death)

Namulemo Daisy (Mother, from birth through death)

Matumbwe family

Mama Hellen

Stephen Kisira

Isooba Dan

David Mukunya

Isaac Waako

Waako Richard

Waako George

Kigenyi Mariatah

Uncle Bairu Fred 

And the great Elizephany family

Key areas of interventions are;

-Building decent shelter for affected family.

-Providing land for gardening from which to produce food and meet their nutritional values and employ her single mother as grocery dealer and help support medical bills. 

-Support to family’s immediate nutrition needs.

-Volunteering to train affected family (ies) in life skills, 

-Relief grant (USD1500 per year) to help affected family (ies) run business, supported by 2-4 workers for at least three years.

Rebuilding affected family (ies) and communities with similar socioeconomic and disability challenges shall be run by the Integrated Mental health Initiative -IMI (www.integratedmhi.blogspot.ug and www.facebook.com/integratedmentalhealthinitiative ) was the focus between April and July by IMI, an organization that designs environments and human environments to reduce vulnerability, accelerate healing and achieve sustainable wellbeing. The IMI has been at the forefront of researching and giving support information to Regina mother, mobilizing local support resources from friends and using its own resources to buy recommended medicine and food for Regina, in order to sustain healing. Since longterm wellbeing of Regina was in question, the IMI now establishes a fully-fledged programme under it to extend support to bereaved families and communities faced with challenges as that suffered by Regina and her family – to overcome vulnerabilities towards otherwise fatal preventable diseases as TB, Malaria, liver and Kidney conditions.

Any material, financial, volunteer and advisory supports are highly recommended, sought and very welcome. Any such assistance will support;

Conduct funeral service for Regina Kizza

Rehabilitate her grave as part of the celebrations of her life amidst lifelong trap within nest - of physical and emotional afflictions.

Champion the life she desired: better shelter, better nutrition, freedom to move from one place to another, right to community participation and socialization, and family health and harmony – through the living as greatest connection with her.

Create awareness about the state of the health-care system and work to improve it through construction of model client-centered health facility, where life comes before money, promotion of pro-patient professionalism, promotion of alternative sources of health care, advocate for basic health care trainings and empowerment of poor communities – who cannot afford quality health care, and promotion of health care task-shifting in the health care system.

Relief aid to vulnerable families: beddings, food, medical supplies, and psychosocial support.

Business development and livelihood support grants for the socioeconomically challenged families.

How else to contribute:

• Volunteering as psychotherapist, physiotherapist, social worker, community mobilise, fundraiser, social change advocates and project administrators – for 3 – 12 months..
• Donate books.
• Support financially for as low as $50.
• Sponsor shelter building project for poor families for as low as $1500.
• Messages of support to affected families.
• Making contact:
• Express interest to volunteer by email to: dishma.imhs@gmail.com
• Donate books by DHL - Plot 15, Narambhai Road, Jinja, Uganda
• Make financial contribution by Western Union - Jacob Waiswa, Jinja or through Barclays Bank, Jinja Branch, Uganda, AC No. 6004667822

DISABILITY FUND FOR AFRICA-AN INITIATIVE OF KIIZA REGIINA DEVELOPMENT FOUNDATION

THE


THE


REGINA KIIZA DEVELOPMENT INITIATIVE (REKIDI)


PROPOSED


BY

DISHMA INC.
P.O. BOX 8885,
KAMPALA-UGANDA
WWW.SITUATIONHEALTHANALYSIS.BLOGSPOT.COM





SECTION ONE: INTRODUCTION
Background
This project comes at a time concerns of the disabled persons are either ignored or unknown by the local and international community. The real face of the disabled people thus remains as ones living in permanent prison behind family houses –with limited or no care and attention to their health and education needs, without opportunities of development being allocated to them, and without a decent shelter to live in.

WHO (2011) puts the world disability figures at 15%. In Africa people with disability account for an estimated 10% of the general population. They represent 20% of the poor, 80% of working age people with disability are unemployed. School enrollment for those living with disabilities is between 5 to 10 percent (Exodus Guild, 2011).

Article 28 of the Convention on the Rights of Persons with Disabilities asks States Parties to take steps towards safeguarding and promoting the realization of the right to an adequate standard of living and social protection, including ensuring “access by persons with disabilities and their families living in situations of poverty to assistance from the State with disability-related expenses –including adequate training, counseling, financial assistance and respite care” (UN Enable, 2008).

Despite existing political representation to parliament in Uganda and prominent non-government organizations, no tangibles are visible to benefit disabled persons. The best they can afford to do for themselves is to languish on streets –begging for a living while those –whose families cannot afford to see that happen, simply lock them up in houses as a protection measure.

That, however, has risks of its own; like in case of a fire outbreak, it is not only a sure way of turning disable person victim, but also makes rescue efforts difficult as the home is left completed locked up.

The Problem Statement
Distributors of the original manual wheel chairs did not make prior inquiries about nature of physical disability, injury or infection-causing disability. They distribute wheel chairs –regardless of their incompatible.

This contributes to more co-morbid cases –more deformations or defects than the already existing medical case of disability. The spine-cords and the back bone can get abnormally postured due to incompatibility of wheel-chair with the shape, comfort needs and size of the disabled person.

Care involves lifting the heavy disabled person on and off of the wheel chair at some point, care takers and most family member’s experienced burnt-out syndrome –sometimes leading to rejection and abandonment of the disabled children or persons. That renders them helpless as no one else helps them out to use toilet or bathroom –which increases infection on another hand.

The impoverished family members cannot afford meeting the necessary resources to access special education, to acquire accommodation space enough for rehabilitation exercises and facilities that enhance proper hygiene and sanitation, like appropriate toilet and bath place.

As a result, it also increases the risk of infection related to poor hygiene and/or improper disposal of waste “products,” and above all, they were left to sit stationary, which -with time affects locomotion in the limbs as arms and limbs rigidity ensues.

Justification
It is anticipated that the creation of the multi-purpose wheel chair will not only create a big sigh of relief for families and caretakers, but it would also increase and sustain hope of disabled-persons living a more fulfilling and productive life.

They, for example, would be able to roll of the multi-purpose wheel-chair onto the normal sleeping bed, adjust the back-rest to a rest bed when fatigued and comfortably sleep -as though on the normal bed.

With the three bottom support-seat layers, he or she would be in position to use the top layer for official purposes –as to go to school, make visits, and to socialize or play, while the last layer would have a potty or toilet provision and bathing safety and support seat structured in a way that drains out water as the disabled persons bathes.

The product can be cheaply produced using local resources and donated to rehabilitation projects twice a year. The multi-purpose wheel-chair, also, would help the disabled person pursue are physical developmental activities like washing, helping out in the job, brush his or her teeth, arts and crafts, support socialization, attend school with confidence and with far lessened burden to care-takers.

The multi-purpose design would ease the development of the disabled person –mentally, physical, (able to do basic self-help ventures as going to bed, toilet, bathroom, being able to change clothes, economic (attend to economic endeavors as selling items, crafts making, for career development and the confidence to try and succeed in all ventures of life), and relief caretakers and families from the stress of physically lifting off and one the disabled person from the wheel-chair, and have the disabled person enjoy sustained hope and love from his or her family.

Finally, it is a model that could go on to cover Eastern Uganda and further to help millions of other disabled persons in Uganda and world at large.

Purpose of the Project
To design and manufacture disabled person’s wheel chairs that are characteristic to humans and supportive to human natural growth and development processes as well as rehabilitation efforts for dignified living.
Specific Objectives:
To create hope and sustain it in the lives of the disabled persons so that they can think more positively about the future for self-advancement

To transform disabled persons into healthy, more productive, and responsible members of the global community -socially, politically, economically and spiritually

To prevent accelerated deformities due to wrong wheel chair prescription, lack of qualified consultants and inappropriate wheel chair designs

To ease families and care-takers of stress having to face the burden of lifting disabled persons on and off their wheel-chairs

SECTION TWO: THE TECHNOLOGICAL REVIEW AND ANALYSIS
The New Wheel Chair Design and the New Lease of Disable-person’s Life
The multi-purpose wheel chair would constitute; a back-rest -also adjustable to a resting bed, triple bottom seater -one cushioned for formal use as to visit, go to school; draining seater for bathing and potty shelf seater –for use above toilet or latrines; side-by-side balcony for rolling off the wheel-chair to the bed or to normal chairs; front dining and study table; adjustable legs and foot-rests; tubeless tires. Original technologies of motorized and electric types could be integrated as well as the varied weight and size compatibility wheel-chairs.

The design would have greater considerations as supportive interventions like spacious accommodation, home-based learning, home-based health care, rehabilitation clinic, life-skills training, enable socialization, gardening (and rearing of animals), and adventure –side-by-side –aimed at creating a meaningful lives above mental and physical disabilities.

The current products are specially designed for different tasks like separate one for bathing, separate other for toilet and high mobility for the more incapacitated disabled-person. It would mean the care-giver buying a whole set at an average of $500, which not any one affords -especially our resource-limited friends of the southern hemisphere.

Depending on affordability, there exists the manual and the automated wheel-chairs (Wikipedia, 2009). They are used by people, for whom walking is difficult dues to sickness or injury. They where first introduced in China in the 6th century and later in Europe (Wikipedia, 2009).

Some Existing Wheel-chair Designs Today

1: Manual Wheel-chair $99 -most in use.

2: Mobility scooters

3: Power Wheel-chair

Source: www.wheelchairdepot.com

Wheel-chair are a variety and of varied prices depending on the quality. Also available on the market are accessories depending on functionality. For example; transport chairs, bathroom safety products, transfer chairs, shower wheel-chairs etc.

Fig. 1: Transport Wheel-chairs

Fig. 2: Walking Wheel-chairs

Source: http://bestwheelchairs.com/

Children are counseled before joining others to school wondering how colleagues would react. They find themselves different from the rest, by the fact that they cannot walk. Part of the orientation is to explain to fellow scholars about their disability. It can really be involving to relieve disabled-person and care-takers or families concerned of entrenched depression and agony.

Experience, however, has showed that disabled people go through a lot of confusion –amidst misunderstanding from their family members –and there are no counseling services available for them.

In addition to the fact that families can be impoverished to afford education, medical care, a balanced diet, perception of the important roles of physical exercises, and spacious residencies to facilitate rehabilitating movements; the mental health issues too become the very first obstacle.

And, rehabilitation experts could use personalities like former United States (US) president Franklin Delano Roosevelt as inspirational figure, who in 1945 used a wheel chair, and at the same time remembered as one of the strongest presidents in U.S. history -who contracted polio at 39 years.

Luckily for children the wheel chairs are light, faster and easier to use meant to suit their weight. A child would use his or her wheel chair smoothly; brake -especially for electronic wheel chairs (Kidshealth, 2009).

Power wheel-chair has wheel-chair designed for comfort, easy mobility and, even for disabled persons with active lifestyles -more so with a taste for sports. There also exists a specialized department for those –who want specialized designs and firms can work around one's requirement in order to bring out the best results (Wheelchairspower, 2009).

The scooter store helps thousands of people regain their mobility and independence at no cost with their guaranteed freedom program (The scooter store, 2009). Some organizations are helping transform lives through the gift of mobility to the disabled poor in the developing countries.

Uganda is one of the beneficiaries. It partners with a vast network of humanitarian, faith-based and government organizations –sending wheel chairs to hundreds of thousands of disabled people providing not only the gift of mobility; but of dignity, independence and hope (Freewheelchairmission, 2009).

The Wheel-chair Foundation is a non-profit organization leading an international effort to create awareness of the needs and abilities of people with physical disabilities: to promote the joy of giving, create global friendship, and to deliver a wheel-chair to every child, teen and adult in the world –who needs one, but cannot afford one. Indeed, to the vulnerable community as disabled people, the Wheel-chair Foundation delivers Hope, Mobility and Independence (Wheel Chair Foundation, 2009).

Selecting a wheel-chair depends on age, disability and abilities. Professionals like occupational therapists and physicians make some of the initial decisions of the selection process (Abledata.com, 2009).

Experts argue that environment and health are intertwined. “Environment (s) can determine the level of your health…” –Simon Nantamu (PhD), Global Health, Trinity College, Dublin, Ireland.

Current Wheelchair Components
Flames -are made out of a variety of materials including stainless steel, aircraft aluminum, titanium, chrome alloys and other light weight composite materials. Materials used determine wheel chair strength and capacity.

Seating systems -are removable and frequently separated from the wheel-chair. Include the sitting posture support systems. Sitting must allow the person to fit.

Upholstery must be rugged enough to withstand daily use and a variety of weather conditions. A number of materials are currently available, including nylon, velour, polyester, vinyl, and leather. They and flames come in variety of colors.

Brakes – are usually applied manually when braking. They can be mounted at different heights depending on the users needs. Powered chairs have electro-mechanical or dynamic brakes.

Wheels and tires -They are of a variety of types and styles. Most wheel chair use a four wheel system –compromised of two larger wheels in the back and smaller casters in the front. They are generally aluminum and molded composites.

The most common rear wheel is 24 inches in diameter, but all other wheel sizes are available. There are also the over-sized wheel tires, offload tires, steel-reinforced, semi-pneumatic tires -a combination of solid rubber and air-filled tubing.

Foot-rests -Incorporated on the rigid flame chair offer a range of options -fixed, detached, swing-away, or elevating legrests, or legrests featuring a combination of these elements.

Arm-rests
Armrests are generally available in full- and desk-length styles, and may be detachable, height-adjustable, flip-up, have a combination of features, or be fixed. Some chairs, especially lightweight or sports models are designed to be used without armrests.

Controls for powered chairs and scooters -regulate speed and direction. However, most manufacturers offer customized control options to accommodate the varied abilities of the user. Many chairs also have programmable control features which allow the user or a dealer to adjust or set the chair's speed and control limits as the user's abilities change.

There are also manufacturers, who do not make wheel-chairs, but who offer specialized control systems for powered wheelchairs –including voice-activated controls. When purchasing controls and switches from a source, other than the chair's manufacturer, it is essential to determine that the selected control is compatible with the chair.

Drive system for powered chairs and scooters -the drive system refers to the means by which power is delivered to the chair's wheels. Standard drive systems include; gear drive, direct drive, and belt drive. The type of drive system affects the power available to propel the chair and the amount and type of maintenance the chair requires.

Batteries for powered chairs and scooters -Batteries are a determining factor in the range and power of a powered chair. The larger the chair's batteries, the greater the power and the longer the chair's duration-in-use between time it is charged. Many chairs require two re-chargeable 12-volt batteries.

Most wheel-chairs utilize U1, group 22 or 24 batteries, although other batteries are also used. More manufacturers are designing chairs around the group 24 battery because it affords a longer range. The type of battery required is also an important consideration in terms of safety, maintenance, and transport.

Powered chairs may utilize lead acid, gel cell, or sealed wet batteries. Gel cell batteries require the least maintenance and have less danger of leaking than do the other battery types. Gel cell batteries are also required by a number of airlines when transporting powered chairs.

Existing Resources to Exploit
There exist permanent structures close to health centers that can be accessed through a purchase bargain to provide rehabilitation and learning space, gardening and animal rearing space (for food security), home-based care, and access to medical services and for the disabled persons.

There are identifiably abundant underutilized professional services to assist in training (in life skills like handicrafts) and rehabilitation needs of the disabled person.


SECTION THREE: PROPOSED DESIGN
Multi-purpose Wheel-chair Constituents

A single wheel-chair
Either automated or manual –with several distinct functions put together for detailed or all-round well-functioning of the disabled person. This would help prevent extreme cormobid cases due to lesser mobility, psychological depression and discomfort.

Cushioned arms-rests/adjustable balcony
They would be shaped out to steel and aluminum to act as safety accessories as well as small emergency doors. The arms-rests will be cushioned on either side for sudden napping anytime the disabled-persons feel fit.

Adjustable back-rest
This, as has been the case could act as back-support component of the wheel-chair. But on the most important note, would be its side-by-side purpose of easily having it adjusted to a resting bed –when the disabled-person finds it easiest to provide for it, more than having to shift to a normal bed. They could as well be called temporary beds for disabled-persons. It shall have two stands to be pulled out for use when bed option is made.

The three bottom seat plates
They would be set to allow swift pulling forward and pushing of particular seat plates in use and out of use, respectfully.

The first one, above the rest, would be a comfortable, well cushioned seat (of any color design). It would be an official seat for social occasions -including education.

The second one, only second to the first cushioned seat, would be one adjustable to work as a bathroom accessory plate, made on stainless steel and slightly inclined to allow water from the showers to drain out.

The last seat plate to mention would be that below the first two. It would work as toilet accessory -allowing the disabled person to easily activate adjacent to the toilet seat or hole.

And all shall be adjustable to the ground and back to the recommended height. Adjusting it to the ground will be in an effort to let the disabled-person down to the floor, while adjusting it up-wards will be to let disabled-person climb up for ultimate use.

Front wheel-chair table
This would works as a dining table for the disabled person, a school desk and a protective balcony against injury. The first 5 centimeters of it, too, shall be cushioned for napping purposes.

This, like other wheel-chairs, would be used to support feet when disabled person is seated. However, for the purposes of the multi-purpose wheel-chair, the foot-rests would be held in-between by a tough, thick letter material, along with which the foot-rests could be adjusted by 180 degrees to allow legs to stretch out straight, and for comfortable sleeping or resting using a bed provision on the multi-purpose wheel-chair. This, too, would have stands to support leather material and the bars -all purposed for holding legs during sleeping or resting time.

Tyres
Strong rubber tires could do, but for the multi-purpose wheel-chair, tubeless would be most appropriate.

Testing the wheel-chair
At completion of assembling the wheel-chair would be put to road-test with disabled persons on trial –which would be preceded with numerous other tests by renowned medical firms to test further the multi-purpose wheel-chair efficacy and effectiveness.

It would be at the end of that that results could be compiled and report readied for publication, and product -for marketing and use. To note, also, is that the multi-purpose wheel-chair could suit one -who is either opting for a motorized wheel-chair or manual.

Multi-purpose Home Environment –to act as a rehabilitation center, life skills training center, home-based care center and, at some point, be open to organizational roles like advocacy, research and development –regarding disabled persons’ concerns –regionally, nationally and internationally.

Monitoring and Evaluation
Monitoring and evaluations shall be conducted to improve on the products working efficiency annually –to the disabled person's comfort and ease to use –as well as the health developments in their lives.

SECTION FOUR:
CHALLENGES, CONCLUSIONS AND WAY FORWARD
This section details the challenges, conclusions and way forward for the Regina Kiiza proposal, and are indicated below:

Challenges to Overcome
It is not yet known where raw material, as steel, aluminum and leather could be obtained, lack of the right team to take on the project to its end, and above all; considerable amount of money will be needed to oversee the implementation of the project, yet no funding institution has been identified to cater for the emerging financial challenges.

Conclusion and Way Forward
A lot of existing wheel-chair technologies would help fastens the development of the multi-purpose wheel-chair. Much of the old wheel-chair components not indicated here could be used as well, for example, the brakes and others -which obviously must constitute the new design.

The multi-purpose wheel-chair design would be presented hand-in-hand with an environment-fit design for the disabled-persons, supportive community linkages –as to and from policy makers, or have the design integrated into the usual environment systems of social interaction.

Such supportive systemic elements eventually enables disabled person to attain basic education, to have decent housing, to have love and respect, to access medical care, to get applied life skills training, attend rehabilitation workouts, and access to new technological advancements that improve their lives further. Such is a model other helpless physically or mentally handicapped children can benefit from as the project grows.

There are possibilities of striking partnership with existing research agencies that could be honest enough to protect the copyright reserved only for Dishma Inc., as well as making use of the local artisan community in Katwe, Uganda.

And, it is all hopes, through prayer that the financial challenges will be overcome. We could see friends and well-wishers rise up to that occasion, while also some research has to be made on potential sources of cheap raw materials stated above for swift project implementation.