Wednesday, March 11, 2015

Something From Nothing

My favorite project in OT school was called "Something From Nothing." Professors gave us a box of assorted junk like a piece of string, a screw, a scrap of cloth, and a knub of a pencil, and our assignment was to make something useful using only the items from the box.

I am embarrassed to admit that I don't remember exactly what I made, but I do remember the inspiration I felt when I saw the box. It gave validation to the quirky ideas I always had for repurposing discarded items. This has become quite a trend lately in the Global North for purposes of ecology and design, and it is a very valuable skill when working in areas with few material resources.

While Ethiopia is rich in human capital, the financial and material resources to obtain specialized adaptive equipment can be beyond reach for most people. The World Bank reports that in 2013 (latest data available at time of this writing) the per capita income in Ethiopia was $505 per year. To give context to this number, here are a few estimates of daily costs:
  • Bus rides within the capital city cost $.10-$.20 each way (many people must transfer and take more than 1 bus each way to work)
  • Meals in an average restaurant with a soft drink or bottled water cost approximately $3.00
  • An out of town round trip bus ticket costs approximately $40.00-$60.00, depending on the distance
  • A flight between cities within the country costs approximately $300 round trip
  • Cellular phones cost between $20 for a simple phone to around $150 for a (non iPhone) smartphone
  • Cellular phone service is prepaid and costs approximately $.04 per minute. (landlines are rare in private homes)
One of the requests we had while working with at a local school for children on the autism spectrum, was for strategies to help them eat more independently. The first child demonstrated a high motivation toward self feeding but decreased hand coordination and strength. Because the standard spoons in Ethiopia tend to have long and thin handles like this:


We decided that a built up handle might do the trick. The challenge was how to obtain one.

One alternative might be to order specialized utensils, such as these available from Good Grips:


for anywhere from around $8.50-$31.00 (plus shipping cost) which would 3%-8% of the average Ethiopian annual salary. Percentage-wise, this would be equivalent to an American spending $1591-$4243 on this spoon. (World Bank reports $53, 042 as 2013 per capita income in the United States) It was not a viable alternative.

A less expensive (but also less durable) alternative might have been to add a piece of foam to the handle of the child's spoon for around $2.00 (plus shipping). This was more affordable, but in this context, still not attainable locally or sustainable (meaning even if we obtained funding, it still wasn't a reasonable alternative because the child would always be dependent on external funding).


Our challenge was to find a material which was locally available for a reasonable price and was durable. I thought the circumference of a garden hose might fit well, so I asked a staff member if they had a hose. It turns out that although they use jerry cans to water their plants, they did have discarded "tubo" (clear plastic tubing) in a pile in the courtyard. After cutting a length, thoroughly washing it, and trying it on the child's spoon, there was only one more problem to solve. The spoon handle was so thin that it slid around and the tube was too wide. We toyed with the idea of taping, plugging it, and stuffing it but decided that those ideas were less hygienic and too labor intensive for daily maintenance/cleaning.

Luckily, in the classroom they had some plastic spoons with thicker handles (which they use for matching with photographs and words in preparation for using the PECs communication system) and the school was kind enough to allow us to use them for this purpose. The (free) result is below:



The 8 year old child learned to self feed within a few minutes, his smile was ear to ear, and the staff are able to duplicate this tool (free) for anyone who needs it in the future.

1 comment:

  1. Very very cool and way to go thinking outside of the box!!!!
    ----Jessica, Chloes mom

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