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Inclusive Design and Accessibility in Medellín, Colombia. AT2030 Inclusive Infrastructure Case Studies

PATRICK, M
MULDOWNEY, A
ARRUBA PALACIO, M
AGUIRRE, M
McKINNON, I
August 2023

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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

Medellín, Colombia is the sixth and final case study city under the Global Disability Innovation Hub (GDI Hub) led and UK Aid funded AT2030 Inclusive Infrastructure sub-programme. Colombia’s second largest city, Medellín is well-known for its progress in urban development in the last 20 years, moving forward from its violent history. Medellín has been designated a district of innovation and is known for innovative urban projects such as its cable cars and electric escalators that connect higher altitude, low-income communities on the peripheries of the city. This case study explores the current state of accessibility and inclusion in the city for persons with disabilities and helps understand whether such urban innovations are inclusive for all the city’s residents.

Medellín is home to nearly 80,000 persons with disabilities and Colombia does have strong legal frameworks in place to support persons with disabilities. However, this case study found that the numerous laws and regulations are not always well implemented and there is also a need to consider more diverse disabilities in city planning and design.

The research took place in 3 phases between December 2022 and May 2023, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk-based research and interviews. Phase 2 captured the lived experience of persons with disabilities through interviews, photo diaries and co-design activities. Phase 3 then synthesised the findings, running multiple in-person workshops to validate and create actions towards the creation of more inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life for persons with disabilities including, poverty, transport, housing, healthcare, public spaces and recreational activities. Quotes from participants are interwoven throughout the report and strengthen the concluding actions. The report recognises what has worked in Medellin as well as areas for improvement.

Inclusive Design and Accessibility of the Built Environment in Nairobi, Kenya

PATRICK, M
MULDOWNEY, A
KILIMANJARO BLIND TRUST AFRICA
TANUI, G
BUKACHI, V
CAMPBELL CLAUSE, J
McKINNON, I
October 2022

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Prepared by the Global Disability Innovation Hub and partners for the UK Foreign, Commonwealth and Development Office

This case study, funded through UK aid AT2030 programme, explores the current situation of inclusive and accessible environments for people with disabilities living in Nairobi. The research findings detailed in this report describe the current challenges and opportunities for embedding inclusive design in Nairobi’s future, providing priority recommendations and forward-thinking next steps.

The research took place in three phases between July 2021 and January 2022, combining both virtual and face to face approaches. Phase 1 focused on understanding the current state of accessibility through desk research and interviews, phase 2 captured the lived experience of people with disabilities utilising interviews, photo diaries and co-design activities. Phase 3 then synthesised findings, running multiple workshops to create actions towards inclusive environments. Thematic analysis was applied to understand the research data, identifying key themes across three different stakeholder groups of People, Policy, and Practice.

The themes identified span across daily life, poverty, transport, housing, sanitation, public spaces and recreational activities. Quotes from participants are interwoven into this report, and strengthen the concluding actions towards inclusion.

 

A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems

HOLLOWAY, Catherine
MORGADO RAMIREZ, Dafne Zuleima
BHATNAGAR, Tigmansu
OLDFREY, Ben
et al
December 2021

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It is essential to understand the strategies and processes which are deployed currently across the Assistive Technology (AT) space toward measuring innovation. The main aim of this paper is to identify functional innovation strategies and processes which are being or can be deployed in the AT space to increase access to AT globally.

 


Assistive Technology 
The Official Journal of RESNA
Volume 33, 2021 - Issue sup1: Companion Papers to the Global Report on Assistive Technology
 

https://doi.org/10.1080/10400435.2021.1970653

Could assistive technology provision models help pave the way for more environmentally sustainable models of product design, manufacture and service in a Post-COVID world?

OLDFREY, Ben
BARBARESCHI, Giulia
MORJARIA, Priya
GILTSOFF, Tamara
MASSIE, Jessica
MIODOWNIK, Mark
HOLLOWAY, Catherine
September 2021

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From multiple studies conducted through the FCDO AT2030 Programme, as well as key literature, we examine whether Assistive Technology (AT) provision models could look towards more sustainable approaches, and by doing this benefit not only the environment, but also address the problems that the current provision systems have. We show the intrinsic links between disability inclusion and the climate crisis, and the particular vulnerability people with disabilities face in its wake. In particular, we discuss how localised circular models of production could be beneficial, facilitating context driven solutions and much needed service elements such as repair and maintenance. Key discussion areas include systems approaches, digital fabrication, repair and reuse, and material recovery. Finally, we look at what needs be done in order to enable these approaches to be implemented. 

 

Sustainability 2021, 13(19), 10867

www.mdpi.com/2071-1050/13/19/10867

Design journey of an affordable manual standing wheelchair

SHAIKH-MOHAMMED, Javeed
DASH, Swostik Sourav
SARDA, Vivek
SUJATHA, S
2021

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Purpose: Only 1 in 10 people with disabilities can access assistive devices, underlining the critical need for low-cost assistive products. This paper describes the design evolution of a manual user-operated standing wheelchair (SWC), translating from prototype to product.


Methods: The SWC design has been refined over 5 years through multiple iterations based on comments from user trials. The SWC product, Arise, provides standing functionality, facile outdoor mobility, afford- ability, customisability, and is aesthetically pleasing. A one-time fitting and training ensure optimal effort for operation, correct posture, and comfortable user experience. The SWC accommodates users of differ- ent sizes and body weights (up to 110kg) and minimises user effort with the use of a gas spring. Incorporating discrete adjustments enables customisation while retaining the advantages of mass manu- facturing, which is necessary for ensuring affordability.

 

Results: The SWC has been field-tested and well received by over 100 wheelchair users, and Arise was launched recently by the industry partner.


Conclusions: It should be noted that RESNA cautions on the use of any standing device without medical consultation. Nevertheless, with appropriate dissemination and awareness, it is anticipated that the afford- able SWC product, Arise, will immensely benefit the eligible users and make a difference in their quality of life.

An inclusive digital economy for people with disabilities

FUNDACION ONCE
ILO GLOBAL BUSINESS AND DISABILITY NETWORK
February 2021

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The objective of this publication is to increase awareness of the impact of a digital world of work on people with disabilities and identify actions needed to shape a future of work in a more disability-inclusive way.

 

Chapters include:

  • Current work situation of people with disabilities
  • Digitalisation: a trend of the future of work
  • A new world of work scenario for people with disabilities
  • Main levers for the digital inclusion of people with disabilities at work
  • A roadmap for an inclusive digital economy

Additive manufacturing techniques for smart prosthetic liners

OLDFREY, Ben
TCHORZEWSKA, A
JACKSON, R
CROYSDALE, M
LOUREIRO, R
HOLLOWAY, Catherine
MIODOWNICK, M
January 2021

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Elastomeric liners are commonly worn between the prosthetic socket and the limb. A number of improvements to the state of the art of liner technology are required to address outstanding problems. A liner that conforms to the residuum more accurately, may improve the skin health at the stump-socket interface. Previous work has shown that for effective thermal management of the socket environment, an active heat removal system is required, yet this is not available. Volume tracking of the stump could be used as a diagnostic tool for looking at the changes that occur across the day for all users, which depend on activity level, position, and the interaction forces of the prosthetic socket with the limb. We believe that it would be advantageous to embed these devices into a smart liner, which could be replaced and repaired more easily than the highly costly and labour-intensive custom-made socket. This paper presents the work to develop these capabilities in soft material technology, with: the development of a printable nanocomposite stretch sensor system; a low-cost digital method for casting bespoke prosthetic liners; a liner with an embedded stretch sensor for growth / volume tracking; a model liner with an embedded active cooling system.

 

Medical Engineering & Physics, Volume 87, January 2021, Pages 45-55

https://doi.org/10.1016/j.medengphy.2020.11.006

 

 

 

Digital fabrication of lower limb prosthetic sockets

OLDFREY, Ben
BARBARESCHI, Giulia
WILLIAMS, Rhys
HOLLOWAY, Catherine
December 2020

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This innovation insight discusses current approaches to digital fabrication of lower limb prosthetics (LLP) sockets aimed at low resourced settings. Digital fabrication of LLPs sockets has been researched for a number of decades, yet these technologies are not widely adopted, and most of the activities within this domain reside in high-income settings. However, the majority of amputees are in LMICs where there is a severe lack of access to services. It is in LMICs then, that the advantages that digital technologies offer could be of particular benefit however little to no progress in digital workflow adoption has been made to date.

An AT Innovator case study: Amparo

WILLIAMS, Rhys
OLDFREY, Ben
HOLLOWAY, Catherine
December 2020

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An interview is reported with Lucas Paes de Melo, the CEO of Amparo, to discuss the journey so far of prosthetics company, Amparo. Rather than focus on the product, this insights paper provides an honest reflection of the journey to establishing an assistive technology company and delves into transferable insights. In doing so, they aim to provide insights to help current and future AT entrepreneurs to see behind the curtain of working in this space.

Look to Speak helps people communicate with their eyes

CAVE, Richard
EZEKIEL, Sarah
GOOGLE CREATIVE LAB
December 2020

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A speach and language therapist talks about "Look to Speak", an Android app which enables people to use their eyes to select pre-written phrases on mobile devices and have them spoken aloud. A text and video guide are available.

Inclusive Design: What if we built a world that was accessible to all?

McKINNON, Iain
CARR, Peter
PATRICK, Mikaela
MONGOLIA RESEARCH TEAM
ASTERINA, Nina
October 2020

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This webinar, hosted by Global Disability Innovation (GDI) hub, brings together a diverse panel of experts to discuss what inclusive design looks like in practice for them, who benefits and how it can offer methods to build a more accessible world that benefits all of us.

 

Speakers presentations were:

  • What inclusive design means to GDI Hub and why it matters, drawing on our experience working in both the UK and globally
  • An overview of inclusive design of the built environment in the UK and Kenya, including the role of access panels to embed the views of disabled people in planning and decision-making
  • An introduction to GDI Hub’s AT2030 programme including our Inclusive Infrastructure research sub-programme that is conducting six global case studies in LMIC cities around the world over the next 2-3 years.
  • The challenges and opportunities for an accessible Mongolia and the importance of Disabled People’s Organisations (DPO) engagement in decision-making
  • The importance of inclusive planning processes for accessible cities in Indonesia

Disability design and innovation in computing research in low resource settings

MORGADO-RAMIREZ, Dafne Zuleima
BARBARESCHI, Giulia
DONOVON-HALL, Maggie Kate
SOBUH, Mohammad
ELLYAN, Nida'
TAKANDI, Brenda T
SSEKITOLEKO, Robert
OLENJA, Joyce
MAGOMERE, Grace Nyachomba
DAYMONDE, Sibylle
HONEYWILL, Jake
HARRIS, Ian
MBUGUA, Nancy
KENNEY, Laurence
HOLLOWAY, Catherine
October 2020

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80% of people with disabilities worldwide live in low resourced settings, rural areas, informal settlements and in multidimensional poverty. ICT4D leverages technological innovations to deliver programs for international development. But very few do so with a focus on and involving people with disabilities in low resource settings. Also, most studies largely focus on publishing the results of the research with a focus on the positive stories and not the learnings and recommendations regarding research processes. In short, researchers rarely examine what was challenging in the process of collaboration. We present reflections from the field across four studies. Our contributions are: (1) an overview of past work in computing with a focus on disability in low resource settings and (2) learnings and recommendations from four collaborative projects in Uganda, Jordan and Kenya over the last two years, that are relevant for future HCI studies in low resource settings with communities with disabilities. We do this through a lens of Disability Interaction and ICT4D.

 

ASSETS '20: Proceedings of the 22nd International ACM SIGACCESS Conference on Computers and Accessibility; 2020

https://doi.org/10.1145/3373625.3417301

Novel lateral transfer assist robot decreases the difficulty of transfer in post-stroke hemiparesis patients: a pilot study

KOYAMA, Soichiro
TANABE, Shigeo
OTAKA, Yohei
KATO, Tomoya
FURUZAWA, Shotaro
TATEMOTO, Tsuyoshi
KUMAZAWA, Nobuhiro
YOSHIMUTA, Hiroshi
TORII, Katsuhiko
TSUKADA, Shingo
SAITOH, Eiichi
et al
2020

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Purpose

The purpose of this study was to clarify whether the novel lateral transfer assist robot facilitates easier transfers compared with a wheelchair in post-stroke hemiparesis patients.

 

Methods

This cross-sectional study enrolled 20 post-stroke hemiparesis patients, and the task difficulty of transfers was compared between a wheelchair and lateral transfer assist robot. All participants were asked to transfer from either wheelchair or lateral transfer assist robot to a platform table and back. The primary outcome was the transfer score of the Functional Independence Measure. The secondary outcome was the time required for transfer.

 

Results

The transfer score of the Functional Independence Measure was significantly higher with lateral transfer assist robot than with wheelchair (p < .001). The transfer times from these devices to a platform table and back showed no significant differences (to device from platform table: 7.8 s, lateral transfer assist robot vs 7.6 s, wheelchair, p > .05: device to platform table: 7.1 s, lateral transfer assist robot vs 8.0 s, wheelchair, p > .05).

 

Conclusions

Transfer with a lateral transfer assist robot is easier than with wheelchair and facilitates independence in post-stroke hemiparesis patients.

Radical Accessibility: Research and Recommendations. A deep dive into how accessible charities are during Covid-19 and beyond

REASON DIGITAL
July 2020

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Insights are shared into the world of digital accessibility in the charity sector: the attitudes and behaviours of beneficiaries, the accessibility needs of those accessing charity websites, the impact of coronavirus and, what should be done by charities. The authors build on knowledge gained from 12 years in the digital charity sector, their annual research into digital charity trends, a new (2020), bespoke and nationally representative survey of the general public, and insights from some of the industry’s leading minds in making charities accessible. A list of evidenced and sector-specific recommendations is provided.

 

The research and report were part of a virtual event, Radical Accessibility, hosted by Reason Digital, Microsoft UK and Charity Digital on July 9th 2020

Human-centred design in humanitarian settings: Methodologies for inclusivity

HAMILTON, Zoe
CASSWELL, Jenny
ALONSO, Aline
July 2020

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This report documents the human-centred design process used in a project conducted in 2020 in Nairobi, Kenya. It includes research tools that can be used in other contexts, as well as the adaptations that were made to research tools to ensure they were inclusive. These tools are followed by the main lessons learned, and recommendations for others who want to implement a similar process.

The goal of this project was to better understand how people living with disabilities in humanitarian contexts use mobile technology, the barriers they face in accessing mobile services, and the opportunities that mobile might present to increase access to basic services in their daily lives. The target population for this project was urban refugees living with visual or hearing impairments in Nairobi, Kenya. 

The human-centred design tools used included: Location Mapping, User Journeys, Communication Mapping, Future Me and Daily Diaries. 

The digital lives of refugees and Kenyans with disabilities in Nairobi: A human-centred design approach to identifying mobile-enabled opportunities

HAMILTON, Zoe
CASSWELL, Jenny
ALONSO, Aline
July 2020

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This research focuses on disability, using human-centred design methods to better understand how refugees and Kenyans with visual and hearing impairments in Nairobi use mobile technology and potential opportunities that it could provide.

The target populations for the project were urban refugees and host communities with visual or hearing impairments in Nairobi, Kenya. 

 

This report is divided into four main sections, following an introduction, the second section focuses on insights learned from the hearing impaired, the third on the visually impaired and the fourth highlighting issues that were cross-cutting insights across both groups. Sections two and three include insights related to mobile, health and financial services. The fourth section includes insights related to humanitarian and disability support services

 

Microsoft at #DisabilityAdvantage: 2020 Disability:IN Annual Conference

NADELLA, Satya
LAY-FLURRIE, Jenny
July 2020

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The CEO of Microsoft talks about the cultural embedding of accessibility in the company. Topics covered include: building accessibility into technology products; remote working and schooling (particularly in the time of the COVID-19 pandemic); skilling and jobs for people with disabilities; the growth of captioning; the US Americans with Disability Act (ADA); intersectionality; inclusivity; and the future of AI products.

COVID-19 and Disability; Exploring a new innovation landscape

HOLLOWAY, Catherine
OLDFREY, Ben
CHIIRA, Bernard
KETT, Maria
July 2020

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This webinar explored the impact of, and learnings from COVID-19 on Disability Innovation. We heard from those shifting their work in response to the pandemic. We also looked at how learnings from Assistive Technology (AT) are being applied to this unprecedented global environment.

Finally, there was an overview of how knowledge was captured during Ebola can support the response to this latest threat

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