One of the challenges of living in a country littered with the remnants of war is that you can inadvertently set off a landmine, lose a limb and possibly even your life. When students at the University of San Diego heard about the experience of one landmine survivor visiting from Uganda, they became determined to address the problems she and others face with East Africa’s pit-type toilets—a paved hole in the ground over which one squats.
Unfortunately that approach to doing one’s business is not an option for many with one leg. That’s why Mei-Li Hey, a mechanical engineering student, some of her classmates and a professor came up with a solution called Simple Seat, Better Lives. It will not only affordably solve the physical limitation, but it also will create income-generating work for the locals who manufacture the seats. ABILITY’s Chet Cooper spoke with Hey about her work.
Chet Cooper: How did you get involved in Simple Seat, Better Lives?
Mei-Li Hey: Through Margaret Orech. She was honored as a peacemaker at our school in the fall of 2014. During an interview, somebody asked her what was the hardest part of adapting to life with a disability after she lost her leg to a landmine. She said using the pit latrines because after she came out of the hospital and went back to her hometown in Uganda, she had to wait four days to use the bathroom. The problem was that she couldn’t access the pit latrine. She couldn’t walk there, and she couldn’t stand up and use it because one of her legs was gone. So her dad came four days later and drove her two hours away to the nearest toilet.
When she shared that story, I got interested. So did another professor. We found another student and said, “This shouldn’t be so hard. We should make something that people like Margaret Orech can use, a latrine aid.” It’s a technology that already exists, but it’s inaccessible for a developing country. Our goal is to make it accessible.
Cooper: Tell me about your visit to Uganda.
Hey: We went there to see what would be the best, sustainable system. We didn’t want to just make a few and send them over, and that’s the end of it. We wanted it to be something that could grow by itself and help the landmine survivors not only with this physical obstacle, but also with the stigma surrounding being disabled there. They can’t get jobs and a lot of times face poverty. We thought we could create a system around this where they could be the ones producing them, which would give them a source of income.
When we were there, we met with vocational schools and peace initiative groups like the Uganda Landmine Survivors Association (ULSA) and microfinance institutions to try to find a way landmine survivors themselves could produce the seats.
Cooper: With an investment loan from a microfinancier?
Hey: Yes. But we found it would be hard to go through a lot of the microfinance institutions because they want to keep a lot of the profit for themselves.
Cooper: We ran into a problem with one of the investors. We tried to partner with him on dealing with disability and microfinance, but we felt like he was charging the women too much in interest.
Hey: Yeah, we met with a couple of microfinance institutions over there, and it wasn’t a fit. Our mission was to make sure these landmine survivors were the ones profiting.
Cooper: I got very involved in trying to create a system to help people get financing in developing countries. But every time I’d say “disability,” their eyes would glaze over, which is what you’ve run into.
Hey: Yeah, after meeting with a couple of the investors, we ditched that idea.
Cooper: What were you thinking when you said just now that people with disabilities could sell them? Who would be buying them?
Hey: Our system right now is that the ULSA is going to buy them back from the landmine survivors, because they already have a whole network and know where the people who need them are.
Cooper: So it’ll be a nonprofit that has to find funding itself, and it would also be the client?
Hey: Here is how it works now: The ULSA puts out what they call a “livelihood stipend” to those whom they believe are serious about improving their situation. They don’t want to just give handouts because there are a lot of non-governmental organizations (NGOs); Uganda is one of the most over-NGOed countries. They’re giving handout after handout, and it’s creating a cycle in which people stop wanting to work.
So the ULSA already has a process they go through to make sure people want to improve their situation before they give them a livelihood stipend, which is about 1 million Ugandan shillings—about $300—to start a business. They usually give it to them in the form of craft materials, livestock, grains to start a farm or materials to start a carpentry business. That’s the route we’re taking; they’ll receive a livelihood stipend in the form of carpentry materials and the chance to go to vocational school.
Cooper: I like the school element a lot. Very good. Who are they selling the devices to? I’m missing that part.
Hey: They create the Simple Seats, and then sell them to the ULSA at a profit, and they then sell the product to their connections. They could sell them to the local disability community, but if they want—
Cooper: But if people with disabilities, landmine survivors, or those who have a mobility issue are already having a problem financially, who has the money to buy them? It’s really hard to market a product, let alone have enough profit built into it. Have you worked that out with the network you’re talking about?
Hey: That’s one of the biggest challenges and the biggest design limitations: making it as low-cost as possible so everybody can afford it.
Cooper: The problem is, if you make it too low-cost, then the people making it don’t have enough profit to be an entrepreneur.
Hey: Right. There’s a give and take, and the mediator is going to be the ULSA. They’re making sure the survivors have what they need, but are also getting as much as they can for the system.
Cooper: Sell it on a sliding scale, then?
Cooper: What I like is, if you’re teaching them a trade, maybe there are other products they could think about manufacturing to sell to a broader market.
Hey: Absolutely. When they go to vocational school and learn how to build the latrine aids, they’ll go through six months of carpentry training and metal working and come out of it with skills they can use to start a business. And then when the ULSA comes to them and says, “We know of 10 people who want to buy these,” they can produce 10 Simple Seats.
Cooper: Or something else?
Hey: Yes. The seat can be customizable, too. The ULSA is about 10 volunteers, but that makes it very personable, because they’re going to these places throughout Uganda and meeting with the actual people who need the devices.
Cooper: Is there training at a given site? Do they go to a certain village or region and say, “We’re going to open up and provide X number of days of training?”
Hey: Right now we’re starting with a pilot program, which is 10 landmine survivors. That’ll be at a private school called Ave Maria Vocational Training and Youth Development Centre. If it scales and is successful, we’re thinking about creating workshops. Ave Maria is slightly north and slightly east, which is far away from most of the population, because the capital is southwest and at quite a distance. But this private school will serve that community for now. It is backed by a lot of church funding, so it charges very little, or maybe nothing at all, for people with disabilities to attend, which is very, very uncommon and why we’re trying to start there. They seem equipped to handle everything, and they had the same mindset of inclusion for those in the disability community. We would visit other schools, and they would say, “Oh, yeah, we have a few disabled kids,” and we’d ask, “Okay, how are they able to use the pit latrines?” and they were like, “We don’t have anything.”
On the other hand, this school has its own private latrines, including a lawn chair with a hole in it placed over the latrine “for our disabled students.” But that’s one of the only places we’ve seen that, which demonstrates they’re already trying to be inclusive.
Cooper: Scaling and using that as a test site makes some sense.
Hey: Some sense? What do you mean?
Cooper: One of your challenges is that that is a unique environment, as you just said. You found a unique school. So, in a way, you’ve gone there and picked the low-hanging fruit. How are you going to duplicate this model in other parts of the country or world? The brilliance of this idea is not so much the product, but the training. If you can give these people a skill set, that’s sustainability right there. Since you’re engineers, you should be able to start thinking around this issue. What else can they produce beyond the chair, something the general population wants but costs too much right now? Or maybe they don’t even know they need it.
We talked to some students at MIT who were doing something similar with wheelchairs. They created a really cool design that allows a chair to gear up and go over rough terrain. They wanted them to build it on-site, so they looked around and found that they could integrate bicycle tires, which made sense. They made this thing out of bicycle parts. It’s a wheelchair but most of the components are from bikes.
Hey: That’s really cool.
Cooper: How did you determine the need?
Hey: The first prototype we built, we showed to Margaret Orech over Skype and asked her what she thought. She said, “Well, it folds up and that’s great, but there’s no way they’re going to get to the latrine holding that.” It’s kind of heavy—
So then we started thinking about different mobility devices. She told us very few people have wheelchairs. Some people make their own walkers or crutches, but that’s dependent on their situation and what they can get their hands on. So we started thinking about a device that incorporates either a walker or a crutch, and we brought a walker designed for the terrain in Uganda. That was one of our three prototypes we took to Uganda in January. We thought, Okay, we have these three prototypes, and we’ll ask everybody that we show them to, “Which one would you use?” We thought there would be a unanimous favorite: Everybody says this one, or 80 percent of people like this one.
That was not the case. It was almost even between the three prototypes. It was dependent on what disability they had and also what technologies were available to them at the time. One woman who had a wheelchair really liked the one that wasn’t a mobility device, because she could just put it on her lap and get there. Other people who had a crutch were like, “I would want the crutch.” Lots of people had prosthetics that couldn’t bend. They were more like balancers or just made it look like they had another leg. They weren’t very functional. Here a prosthetic helps you walk, but those not as much.
Cooper: So it was more for appearances?
Hey: It would seem so. One woman had to take off her entire prosthetic before she even tried to get to the pit latrine because she wouldn’t be able to hold it and squat. She would take it off before she left her house to go to the pit latrine, which made it really hard for her to get there. She would usually crawl.
Cooper: When you say, “pit latrine,” are they going to a communal one or their own family pit latrine?
Hey: Communal, usually. They have a clan system. You live around the same area as the rest of your clan. Some of them are family members, some are not. It basically makes up a village. In a village, depending on the size, a clan will have a communal pit latrine.
Cooper: Wow. Why couldn’t you leave your seat there, at the latrine? Why would you have to take it back and forth?
Hey: Because it would get stolen.
Cooper: How do you know, have you tested that?
Hey: Well, if they leave their soap at the latrine, it gets stolen.
Cooper: Is there water at the latrines?
Hey: It’s like going to a campsite where they have a well right next to the latrines.
Cooper: Are these similar to outhouses?
Hey: Yes. We saw one that didn’t have any structure around it. It was just tucked away.
Cooper: For those people who are having a problem commuting back and forth, couldn’t there be a way for them to lock it there so there’s some security, so they don’t have to carry it each time? If it’s a clan, I don’t see why somebody’s stealing it anyway. Why would they do that?
Hey: Clans are pretty large. You don’t always know everybody in your clan. And a lot of them are built on roads and people pass by on those roads, and a lot of times those are the people who take their stuff.
Cooper: It’s open to anybody?
Hey: Yes. In the village of Margaret’s clan, there was one set of pit latrines close to the road and another that was far away. She said, “I like to go to the ones that are farther away, because the ones close to the road that people can see and stop to use get gross.”
Cooper: Don’t they all smell no matter where they are located?
Hey: Many do. I don’t know if it’s anybody’s job to take care of the latrines, but they definitely weren’t clean by our standards. Using them in a sanitary manner is a whole other issue.
We actually asked if we could make something that folds down from the wall, and that stays there so people who don’t want to use it don’t have to, and people who do need to can, but they didn’t seem as interested in the idea.
Cooper: In your picture, you had what looked like a plastic seat connected to bamboo. Why couldn’t you just give them the plastic seat and they put the seat on that fold-down, so it’s their private seat but the fold-down is permanent?
Hey: Like hinge it from the wall?
Cooper: Right. Did you ask them about that?
Hey: Yeah, we brought that up, but they wanted something that was theirs. Also, there aren’t standard dimensions. But we were still thinking that wouldn’t be too hard—you’d just take a couple planks of wood. And yet, when we presented it as an option, they didn’t choose it.
Cooper: I bet if you build it, they will poop.
Hey: I’m sure it’s better than nothing.
Cooper: You were saying there are some latrines that are just open and out there, but if there’s X amount of these latrines, you could create a team that has gone through your class, learned carpentry, and charges a certain amount to the village to come and build the accessibility portion. They could build something that’s part of the universal design.
Hey: I definitely think we should at least include it as an option. What we did see in a couple of the nicer areas were pit latrines made with a cement hole, like a cylinder upwards and a hole that went all the way through to the pit latrine, which was handicapped-accessible. That is something we could totally train people to do, just create a little cement box or a little wood box, pour cement in there, dig out a hole, and you’re good.
Cooper: And then you have to create some rails, something they can hold onto. When you talk about governments and all the committee meetings, sometimes dictators are actually a good thing. “We’re just gonna do this,” and they do it. And then they will say, “Oh, okay, this actually kind of works. It’s not the best, but it’s absolutely better than what we had.” Especially if you have a good idea, you’re not trying to do something to charge people for, like, “Every time you sit on this thing it’s gonna cost you”—
If you just go ahead and decide, “Everyone’s going to this latrine area, we’re gonna build one.” You’ll probably find that more people—even in the States—would prefer using the accessible bathroom because it’s usually less used and typically cleaner than the other ones.
Hey: Yeah, more room! But I think the other reason that it’s portable is because—
Cooper: I’m not saying not to do the portable. You’re teaching the skills for them to build that accessible location.
Hey: It connects to your visitability or your ability to take it somewhere and go off for maybe a longer period of time, because you don’t have to go home to go to the bathroom.
Cooper: There’s a need for it, I agree. It’s simple. But it looks like there’s some part you could get hurt on.
Hey: That bamboo prototype is no more. It was made out of rattan, a solid form of bamboo, but it was very porous. This is a funny story. We did a bunch of research on what sorts of materials are used over there for carpentry, and we came up with rattan, and we asked Margaret and she said, “Oh, yeah, there’s rattan here.” So we went to Huntington Beach, the closest place to the school we could find that sells rattan, and bought a bunch of it to build the seats.
We built our prototypes out of it and brought them there, and they were like, “What is that? We’ve never seen it before.” We were like, “What? Rattan!” Margaret translated and they were like, “Oh, yeah!” They use the outside part of rattan for furniture, but not the porous inside.
It was a miscommunication. So then we were like, “What do you use?,” and they said 2x4s.”
Cooper: As in we usually just go to Home Depot.
Hey: Right. So now we’re making a lot of the prototypes out of 2x4s. And there’s a possibility we can use metal, too. There’s a metalworking class, and we visited a carpentry shop too. All the carpenters come to one place so they can share tools. That’s a way to make them more stable; they looked a little rickety.
Cooper: I look at that as another option of building out. I don’t know what they teach. If there’s a way you could talk to them about building the actual unit as a class assignment.
Hey: Yeah, that’s cool. We’re making pictorial manuals, like idea manuals. We want the seat to be easy to build and very user-friendly. They can tell by the pictures where everything goes.
Cooper: You also want the people coming out of the class to have the knowledge and skill set the village might not have.
Hey: Right, but we’re not carpenters. I’ve learned a lot about how to build from this project, but when we were there and I met carpenters, my professor at first was saying, “Then you can teach these carpenters how to build the seat.” I think I would have felt silly. These are people who have been doing carpentry their whole life. They saw the seat, and they almost immediately knew how they were going to build it. But for landmine survivors who aren’t carpenters, they would need the training so when they see the seats, they say, “Okay, I know how to do that. I can build that.”
Cooper: And not get splinters.
Hey: Right. In a safe way.