Equipment Conundrum in Sarajevo

In Sarajevo, although adaptive aids such as walkers, wheelchairs and cushions are available through government funding to people with disabilities, there is very little training for those health professionals recommending the equipment. Therefore, suitability and use of the equipment may not be functional for the individual. Furthermore, there are limited resources for people with disabilities to maintain, monitor and adjust the equipment as their disability progresses over time.

Many of the individuals we met with had developed medical complications directly related to the poor choice of equipment that was provided or incorrectly set up. These complications included back pain from back rests installed incorrectly, increased spasticity in the lower extremities due to poor support (or often no support) of the lower extremities and neck pain and muscle contractures from lack of head support.

We met this woman who had developed a large pressure ulcer on her buttock from a poor seating system that was provided to her with lack of follow-up and monitoring. She was typically an active woman and spent much of the day in her wheelchair. The pain she experienced from her wound led to decreased tolerance for sitting in her wheelchair. As a result she spent much of the day in her bed and quickly became depressed and isolated from her family and friends.

Volunteers with Team Canada Healing Hands assessed her seating system. It was determined that the leg rests were too high for her resulting in her knees being positioned higher than her hips. This position creates an increased pressure isolated to one point on her bottom causing the tissue to start to break down and die over time. Simple adjustments were made to the foot rests and Team Canada Healing Hands provided her with a pressure reducing cushion to replace the basic foam cushion she was using. She immediately noticed a significant improvement in pain and her ability to sit comfortably.  Before we left Sarajevo we had heard reports that she was out in the community again and socializing with her friends.