The Idea of Appropriate Paper-based Technology (APT)

Many disabled children, especially when young, can benefit from special seating adapted to their individual needs. This is particularly true for children with cerebral palsy, which today is one of the commonest disabilities in children. Because of spasticity, weak muscle tone, uncontrolled movements, or a combination of these, such children often have difficulty assuming and sustaining the stable position they need in order to do more things and learn new skills—such as control their head, use their hands, self-feed, etc. Sitting in a good position often may help reduce or “break” the spastic pattern, allowing the child to relax, sit more comfortably, and do more things.

But the needs and possibilities of every child with cerebral palsy are different. Sometimes a seat carefully designed for an individual child can make a notable difference, not just for sitting in a healthy position, but in the child’s overall comfort, body control, and functional development.

Effective seating for such children is an art as well as a science. Unfortunately many children never get the individually designed seating that could benefit them most. Professional special seating tends to be expensive. Children from low-income families are often left behind. For these reasons, the Habilítate team decided that its main service project should be the production of custom-designed special seating for children who need it, at low cost. As their main building material, they use recycled cardboard. This low-cost method, called “Appropriate Paper-based Technology” (APT), was first developed in Zimbabwe, Africa, by Bevill Packer for furniture, toys, and household items, as well as for seating and assistive devices for disabled children.

Not only are old cardboard cartons free or low-cost, but cardboard is much more malleable, adaptable, and easy-to-work-with than is wood or metal. APT is now being used in many countries—including England, where families learn to make adapted seating and other equipment for their disabled children.

The first step toward making cardboard seats is to glue several layers of corrugated cardboard from cardboard cartons together and press them under weights to form flat plywood-like sheets one to one-and-one-half cm thick. Cheap glue can be made by mixing flour and water. Or white wood-glue, thinned down with water, works well, but is more costly. The finished seat can be painted with water-resistant lacquer to prevent soiling.

Picture Presentation: A Special Cardboard Seat For Susi—Designed and made by the Habilítate Team

Susi is a six-year-old girl with cerebral palsy. She has “extension spasticity”: her whole body tends to straighten stiffly, and more so when she is nervous or excited.

Examples of Other Special Seating Made in Habilítate

Generous Souls

One of the challenges of the special seating project has been how to cover costs. Although the cardboard is cheap or free, the process of evaluating the child’s needs, designing and constructing the seat, and making the necessary modifications entails a fair bit of meticulous work. Most members of Habilítate are otherwise unemployed and have a hard time making ends meet. For their meticulous work on these special seats they need—and deserve—some form of income. However most of the children’s families are too poor to pay more than a small token.

Fortunately a humanitarian doctor, Dr. Carlos Miyazaki—who has collaborated with Habilítate from the first—has contacted some of his well-to-do, good-hearted friends. Some of these are now stepping in as “sponsors” of individual children. They cover the cost for the seat, including a modest wage for those making them.

In addition to financial help from individual donors, the municipal “Integral Family Development” program (DIF), which runs a rehabilitation service for disabled children, has become an energetic advocate for Habilítate’s special seating project. DIF now helps supply large sheets of cardboard and other supplies—as well as refers children who need special seating. DIF has also made a physiotherapist (PT) available to help with the evaluation of the children’s needs and to make suggestions for seating design. The young, highly motivated PT who is filling this role is both contributing and learning a lot.

The president of DIF, who always is the wife of the municipal president, has become so enthusiastic about Habilítate Mazatlan and the quality of its specialized cardboard seats that she makes frequent visits to the work-site. And each time a new seat is delivered to the child, she arrives with a covey of key people and a photographer. Shortly afterwards articles come out, both in the DIF public newssheet and in the local newspaper.

In this way the rehab programs of Mazatlán are learning about these new ways of assisting disabled children. Of equal importance, perhaps, the larger community is learning about the remarkable social contribution that can be made by disabled persons who have battled drug addiction.

Hopefully this service project will have an impact, not only on how the larger community looks at disabled people and at recovering drug users—and at those who are both—but also on how our group of disabled recovering users view themselves. These latter will acquire, we must hope, a new self-respect … which comes with their doing something worthwhile and admirable, and with the joy of helping enhance the possibilities of children with exceptional challenges.

Much of the accomplishment of Habilítate, and its rewarding liason with DIF, is thanks to Dolores Mesina, a disabled social worker whom we at PROJIMO have known since adolescence, when we helped her get spinal-cord surgery. Dolores was one of the first wheelchair-riders to get a university degree in Mazatlán. As a long-time social worker with DIF, Dolores has helped open many doorways for collaboration with that institution. She is a dynamic member of the Habilítate team. Though she has never used drugs herself, she has a lot of experience with habitual users and is sympathetic to their struggles. Dolores has played a central role in Habilítate’s logistics and public relations, for which we warmly thank her.