DEVELOPING COMPREHENSIVE SUSTAINABLE SERVICES IN KENYA THE ASSOCIATION FOR THE PHYSICALLY DISABLED OF KENYA Amman – Jor

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

2. 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

3. 1958 – 2008 50 YEARS OF EMPOWERING PERSONS WITH DIFFERENT ABILITIES

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

5. 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.

6. APDK • Established in 1958 as an NGO • Developed 7 branches in the 1970th • 1992 – NORAD withdrew – 5 branches closed • Nairobi branch survived due to rental income • Coast Branch developed 5 programs – 330 employees • 2002-2006 revived upcountry branches integrated in Government hospitals funded by CIDA and BMZ ( CBM Co-funding )

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

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

9. 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

10. The APDK services

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

12. 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

13. APDK Appropriate wheelchair services

14. Wheelchair Services Nairobi

15. 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

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

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

18. 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

19. 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

20. EU FundingCCBRT 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.

21. 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

22. 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