Health post: An academic viewpoint

The other morning, I attended a lecture at the Chalmers University of Technology here in Göteborg. I tagged along with Lisa, who is getting her Masters in Industrial Design Engineering there. The lecture, given by a user experience architect who used to be an industrial design student at Chalmers, focused on the way engineers can design for people with disabilities around the world. The day before this lecture, the masters students had done an exercise in which they traveled across town in a wheelchair, seeing Göteborg from the perspective of the mobility-limited.

Me at the famous entrance to Chalmers’ main campus. (Thanks, Lisa!)

The first part of the lecture, called “Alter the Wheelchair: Achieving Social Inclusion in Developing Countries Through User Centered Design,” was about the lecturer’s thesis project for the industrial design engineering degree. Along with another student, he designed a wheelchair for rural areas in Indonesia and Kenya. I was really excited to visit this lecture as part of my project for two reasons. First, a lecture provides me with a new, more abstract way to look at medical device design and development compared to the specialized, more commercial perspective I get from meeting with individual companies. Now I have the opportunity to compare cultural attitudes towards medical devices in both companies and academic institutions, which tend to illuminate certain ideals and traditions of theory.

Second, this would be a lecture taking place in a healthy, wealthy, “developed” nation about how to “fix” a problem in a so-called “developing” nation. I put these terms in quotes because there is always the danger of the white savior complex coming into play. I was curious to see how Sweden views the challenge, and perhaps the responsibility, of designing products for completely different and resource-poor environments; especially before I travel to such environments to see the difference in available medical technology. When I was studying in South Africa, one of my classes placed a large emphasis on “site-specific solutions,” meaning that for a product to be successful, it must be designed for its intended environment, and the resources in different areas require different techniques. For any problem, there is no “one-size-fits-all” solution that works everywhere, even if the problem is present everywhere (people need wheelchairs all over the world). Thus it can often be problematic when wealthy foreign designers try to apply the same products to areas working with a different toolbox. I was interested to see how Sweden tackles this complicated process.

I was impressed with the care and consideration the lecturer had put into the “Alter the Wheelchair” project as a student. He and his partner worked with Whirlwind Wheelchairs at first, a US-based company that builds durable wheelchairs for use around the world and emphasizes user independence above all. This is especially important when the wheelchairs are not motorized. Due to the lack of a reliable power grid in the rural areas of Indonesia and Kenya, the wheelchairs had to be manual (non-electric). However, this can mean that the person in the wheelchair needs someone to push them around more often than someone in an electric wheelchair might. So, the students were focused on enhancing independence so that everyone in a manual wheelchair could self-maneuver well enough to get around completely on their own.

Most importantly, the students were not creating their design from far away in Sweden. They traveled multiple times to their project sites in the two countries, observing the illnesses there that caused wheelchairs to be necessary, as well as where the wheelchairs would be used: inside, outside, on rough terrain, and up steep ramps. They discovered that ramps proved the biggest challenge for wheelchair users. While the ramps were put over stairs to make them accessible for wheelchair users, they were still often far too steep for manual wheelchairs to maneuver. Some of the patients were wheeling up to a ramp, only to hoist themselves out of the chair, drag themselves up the ramp, and then reach back to pull the wheelchair up behind them – a frustrating, often humiliating process that could take several minutes, just to get home.

Being industrial designers, the two students found a way to solve this. They decided to build the wheelchair seat so that it had two possible positions, forward and back/normal; this became the main aspect of their design. Users could shift the seat forward using levers, which moved their center of gravity closer to the front of the chair. With the center of gravity closer to the front wheels, the patients were able to get up steeper ramps than they had ever managed before, all by themselves. The students also interviewed community members via a translator during each of their visits, and they learned about unexpected benefits to this shifting seat. With the seat in its forward position, people had an easier time getting in and out of the wheelchair. This is because they laterally slide in and out, which is hard to do when they also have to lift over the tall back wheels. Sliding the seat forward meant that they didn’t have to hoist themselves over so much of the back wheels. This is all more evident with a photo:

The product resulting from the “Alter the Wheelchair” project (taken from lecture slides). Here you can see the design of the manual wheelchair, with the two possible positions for the chair. Also, you can see the bicycle-like parts in red.

Finally, the students wanted to make the wheelchair easy to repair, with parts that were easy to replace. This was another topic we talked about in South Africa. One of the reasons these projects fail when brought in by outsiders is because there is no way to sustain the projects. If cellphones are developed to a community, great; but what about 2 years later, when the cellphones fail? If there is no way to buy upgrades, or spare parts, or new chargers, the entire project fails. The Chalmers students considered this and made an effort not to use any specialty parts; in fact, the main body of the wheelchair can be replaced with metal bike parts. I was really thrilled to hear that they had considered the sustainability aspect of their project.

The second half of the lecture, titled “Design Meets Disability,” was about the intersection of fashion and assistive technology. The lecturer made a really interesting point about eyeglasses: they were once considered to be medical appliances. Now, designers call eyeglasses “eyewear,” and they come in lots of fashionable styles, some ridiculously expensive. The brand is almost more important than the functionality; we don’t consider people who wear glasses as being “disabled.” But as a user-centered device that corrects a medical issue, glasses nearly fit into my project as medical devices.

So, the lecturer posed the question: why can’t we do the same thing for hearing aids? Why is there no field of “hearwear?” Glasses were able to transcend their label of medical appliances, and now people can feel cool wearing them; why can’t hearing aids transcend their label as well? They correct a hearing impairment, just as glasses correct a vision impairment. And yet hearing aids are always designed to be invisible and hidden so that no one knows you wear them.

I thought that was a great point, except that he missed one thing: contact lenses. There are definitely people who need glasses but who would rather not show that fact. Still, despite this personal choice, the broader social stigma for wearing glasses is basically extinct, whereas needing hearing aids is still somewhat stigmatized. At least, there isn’t a brand of Dolce & Gabbana hearing aids. The lecturer suggested that we need both a change of attitude on society’s part as well as an effort on the part of industrial designers to make cool-looking hearing aids, just as designers have made cool-looking eyeglasses.

That’s enough for now. I’ll be going back to Chalmers next week for another lecture in the same class, “Ergonomics Design for All,” on the challenges of blindness. It’s both fun and weird to be back in a university setting, learning about these topics in an theoretical and academic context.


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