IK Monitor Publications (8-2)

Indigenous Knowledge and Development Monitor, July 2000

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Review: 'Nothing about us without us': a plea for mainstreaming IK in rehabilitation technology

by Ezinna Enwereji

This publication contains a heartfelt plea for giving equal credence to indigenous knowledge and Western scientific knowledge, on the grounds that the processes by which indigenous knowledge is generated are as rigorous as those of Western science. Moreover, indigenous devices take into consideration the needs and the customs of the disabled. It is this discussion that gave rise to the term 'nothing about us without us', which is used in the title and throughout the book. This argument is aimed at introducing and perfecting indigenous knowledge within the mainstream of rehabilitation technology for, by and with disabled persons within the rehabilitation institutions.

Werner, D. (1998) Nothing about us without us: developing innovative technologies for, by and with disabled persons. 360 pp. ISBN 0-9655585-3-3. USD15. Health Wrights: Workgroup for people's health and rights, P.O. Box 1344, Palo Alto, CA 94302, USA. (Spanish edition also available.)
Fax: +1-650-325 1080.
E-mail: healthwrights@igc.org
http://www.healthwrights.org
A complete web version of this book is available on the Internet at
http://www.dinf.ne.jp/doc/othr/dwe001/dwe00101.htm

David Werner is a biologist and school teacher who is disabled due to Charcot-Marie-Tooth Syndrome. Since 1981 he has worked as a facilitator and an adviser to the Programme of Rehabilitation Organized by Disabled Youth of Western Mexico (PROJIMO). This book is based on several years of collaborative work in PROJIMO, and the author's collection of life experiences from many communities. It is a highly organized and technical single-volume publication containing true stories about people's creative solutions, as well as a reference book for different disabilities, assistive devices, and methods of problem solving. It has over 800 line drawings and 600 pictures, which help make the information clear and accessible to readers with little formal education. There are also precise illustrations for making pre-designed devices.

The book is divided into six parts. Part 1 deals with special seating solutions, Part 2 presents creative solutions for walking, and for leg and foot problems, and Part 3 focuses on overcoming difficulties with bodily functions that result from damage to the nervous system. Part 4 deals with wheelchairs, Part 5 discusses innovative methods and approaches, i.e., how people can help and learn from each other as equals, and Part 6 looks at how to help children respond to the needs and rights of the disabled child. There is a detailed table of contents, as well as an alphabetical index of topics and names for easy cross-checking. The value of the book is further enhanced by two resource lists: programmes and organizations promoting innovative technologies, and reading and teaching materials.

The first four parts of the book contain documentation on indigenous knowledge pertaining to the development of aids and equipment (hard technology). This documentation is impressive in several ways, and a tribute to the intellectual accomplishments of the volunteer rehabilitation professionals, and the skilled technicians in PROJIMO who design the various aids and equipment for and with the disabled individuals, in an effort to meet their specific needs. The reader is constantly reminded that creating aids and equipment for disabled persons requires inputs from the disabled persons and/or their family members. In the case of children, for example, the best device is the one that makes them happy and helps them to do things better. The lack of appropriate, low-cost mobility aids and assistive equipment is a major barrier to social integration, including schooling, jobs and self-reliant living. It is argued that community-based rehabilitation (CBR) has a negative impact on the self-reliance of the disabled child, since parents tend to be overprotective. If disabled people live together (residential rehabilitation), they are motivated to be more independent by emulating the hard work of others. The author contends that being disabled need not mean a life of dependence, and that many major breakthroughs in rehabilitation technology have been designed and created by disabled people themselves.

Another view voiced in this publication pertains to the role of indigenous knowledge and Western technological knowledge in solving the problems of the disabled. In discussing the development of assistive devices, the author challenges the validity of transposed knowledge, while acknowledging the limitations of indigenous knowledge. He recommends a combination of scientific sophistication and grassroots simplicity in the production of rehabilitative aids and devices.

Other perspectives in the book deal with comparisons between indigenous knowledge and Western science; here the author recommends consolidating them into a hybrid form. We are constantly reminded of the tendency of the more expensive and complex technologies from advanced countries to drive out the simpler and cheaper local technologies. The author advises individuals to identify the valuable elements of these local technologies, and to create possibilities for improvement and adaptation in the new century.

The last two parts of the publication are concerned with activities and methods (soft technology) which help the disabled to integrate into society and learn skills that will help them to earn a living. This section advocates a new approach to indigenous knowledge in connection with the rehabilitation of the disabled. Two basic initiatives have evolved to meet the needs of disabled persons and promote their full integration. These are the Independent Living movement (IL) and Community-Based Rehabilitation (CBR). Here attention is drawn to the differences between the manner in which the Western system and traditional knowledge systems are imparted. While both initiatives respond to the discrimination, limited opportunities, inadequate services, and the need for self-determination experienced by the disabled, IL caters mainly to services for the benefit of the middle classes, while CBR reaches out to all disabled persons, especially the poor. The indigenous knowledge involved in these initiatives relies on oral tradition and mythology. In indigenous knowledge, philosophy and ethical practices are integrated, an approach that demands interdependence between Western science and indigenous knowledge. In this perspective, while Western science stresses precision in the rehabilitative activities for the disabled, indigenous knowledge dwells on personification and use of allegory. In the view of the author, living alone (independently) is a Western value, while strong sense of community, rooted in extended families, living interdependently (together) is a welcome traditional method of rehabilitation. This traditional practice is behind the idea of child-to-child activities, where disabled and non-disabled work, play and learn together, and enrich one another's lives.

This is a perspective worthy of being articulated and promoted. It contains implications for further study which would correlate indigenous knowledge in developing countries with Western scientific strategies for the rehabilitation of children.

This book is organized around individuals and their needs rather than around specific kinds of disabilities or assistive devices. This means that the reader may have to consult different parts of the book to obtain information on a particular disability or device. However, this limitation has been remedied by the existence of an index.

Dr Ezinna Enwereji (Mrs)
College of Medicine
Abia State University
Uturu, Abia State
Nigeria

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