Rehabilitation Engineering

Rehabilitation Engineering 15th December, 1993
A talk was given by Mr. E. Lane (visitor), S.E. area co-ordinator for R.E.M.A.P. at the Durrington Community Centre. Contrary to our request, it was not his intention to talk about engineering for the disabled, because it covers such a wide field, e.g. bio-engineering research, design of prosthesis and implants, equipment for invasive and non-invasive surgery. In any case, he is not qualified in such matters.
He therefore confined his talk to rehabilitation engineering, i.e. the design and manufacture of equipment, gadgets and devices, to restore, to some extent, the life of people with disabilities and to make them more independent.
There are a large number of companies, mostly small, engaged in making a whole variety of devices. One example is the wheelchair, of which there are over half a million in use in this country to-day. However, many other disabilities require very special equipment, e.g. aids for eating, drinking, dressing, bathing, toileting, aids for education for some of the many children who are born disabled; in fact, one percent of children born in this country have a serious disability, although few are seen. Overall, there are a tremendous number of existing devices available, that enable people to lead better lives. Unfortunately, disability is an individual problem and, therefore, despite there being many devices already in existence, many people need tailor-made equipment.
We are all aware of the cost of design, development and manufacture of prototypes and, as a consequence, commerce quite understandably cannot be interested in individual problems.
Local authorities and the N.H.S. do employ technicians to do work in specific places, but their time is mostly spoken for and, in any case, generally their expertise cannot encompass all the necessary aspects required to produce a unique piece of equipment. As a consequence, solutions can only be supplied by groups of people whose capabilities cover a wide range and who work on a voluntary basis.
This is where R.E.M.A.P. comes in. They have over 2,000 members, all volunteers. The majority are professionally qualified engineers, occupational therapists, physiotherapists, scientists, managers, technicians, craftsmen and members of the medical profession, who form about 100 panels throughout England, Scotland and Wales.
Most panels handle between 20 and 90 cases a year. The majority of these will have been referred by occupational therapists, local social services, community nurses and other community workers. Many panels have close links with teachers and therapists in special schools. Some requests come direct from people who are disabled or infirm.
Of the many voluntary organisations in the country, there is only one connected with the engineering profession, and that is R.E.M.A.P. This is a unique organisation in the world. Australia has something similar, but that is government funded, whereas R.E.M.A.P. is not.
R.E.M.A.P. is very conscious of the fact that, should anybody have an accident due to a device supplied by a member of R.E.M.A.P., that person is liable for heavy damages; as a consequence, every member of R.E.M.A.P. is covered by an insurance policy, up to a figure of £2 million.
Individuals who are helped are not asked to pay. That is possible because R.E.M.A.P. members work for nothing, often use unwanted or discarded industrial materials, and sometimes get help from private and government engineering workshops and apprentice schools, colleges of further education, polytechnics and similar organisations.
Local charitable trusts and government departments sometimes make grants for specific projects. Panels raise their own funds locally.
R.E.M.A.P. are great scroungers; the speaker was not aware of any centre that pays a rent for its meetings. Rubbish tips are a great source of material supplies, but in many cases they are able to obtain supplies from sympathetic companies. Many devices have been taken up by industry, but the economics are such that there is absolutely no justification for patenting any of the designs produced.
The R.E.M.A.P. organisation completely lacks bureaucracy, but nevertheless requires something like £50,000 p.a. This is achieved via a small grant from the N.H.S., most of the remainder from grant making trusts, the remainder from advertising and proceeds of the sale of a Year Book.
The second half of the presentation consisted of slides illustrating some of the devices produced by R.E.M.A.P. These included:
a) A simple wheelchair adaption, enabling it to be taken on to the beach.
b) A walking aid for a child with severely restricted growth.
c) A device that enabled a patient with severe arthritis in the neck, shoulder and arms
to place drops in her eyes. This was subsequently adapted for another person’s requirements of eardrops.
d) A device for loading a wheelchair patient into a caravan, making use of a car jack for extreme simplicity.
Stan Renew