Stopping people in wheelchairs getting pushed around

Shona McDonald, founder of Shonaquip

In 1982, Shona McDonald’s daughter Shelly was born with cerebral palsy. The doctor told Shona that the best thing to do was to put Shelly in a home and have another baby. But Shona vehemently disagreed. During the 28 years since then, Shona has been developing innovative solutions to improve the lives of people affected by disability. Far from a burden, Shelly has been Shona’s guiding light and still plays an important role in her social business – Shonaquip.

As we sat drinking mugs of tea at Shona’s large kitchen table, we were introduced to Shelly. Driving an electric wheelchair, she carefully positioned herself to be right at her mum’s side and refused to do anything but smile. “This is Shelly,” Shona said, “the reason all of this came about.” When Shelly was born Shona refused point-blank to accept that Shelly should have anything other than a life just the same as her sisters.  Through her own research and a bit of support from friends, Shona built a wheelchair for Shelly that far surpassed what the doctor had given her. “I just like making things!” Shona laughed and described how one of the mechanisms for this first chair was a windscreen wiper part from their old Land Rover.

Without any decent state provision, Shona was determined to create DIY solutions to help Shelly take control of her own life. She designed ways for Shelly to communicate using simple techniques such as putting pictures up on the fridge and on her wardrobe doors. Shelly would then stare at the picture of what she wanted to eat or the clothes she wanted to wear. And it was out of this – one mum’s determination to help her own child – that Shona’s mission grew.

In 1984, working with the therapists who helped to look after Shelly, Shona registered her first charity called Interface. Their purpose was to build alternative communications equipment for children who couldn’t speak, an entirely new concept for South Africa at that time. Like all small organisations, they had to be incredibly resourceful. As a mum of three, this was a skill which Shona has perfected. “I’m very good at asking people to do things; a great case of someone who knows how to use my friends, and abuse them, too.”

Leading the life of a privileged white South African during apartheid, Shona’s work with Interface quickly exposed her to the plight of other families caring for disabled relatives; families she wasn’t used to mixing with. “Through my communications work I became exposed to all the other parents in desperate situations – hugely disempowered parents, especially in black communities who’d been brought up to do what the doctor said, simply because he wore a white coat.”

The more Shona learnt, the more fired up she became. The stories were shocking and the stats were, too. For example, according to the World Health Organisation (WHO), an estimated 1% of the world’s population, or just over 65 million people, need a wheelchair. [1] Despite still classifying herself as a ‘home mum’ at this point in her career, Shona’s next venture was another new charity called Empowerment Through Partnership Trust (ETPT). This was an expansion of Interface and carried out work in a much broader range of areas including the provision of parent support, information resources and free equipment to families who couldn’t afford it.

ETPT also ventured into the world of political lobbying where Shona learnt that any real change to the system would take time. During apartheid the white ruling parties saw little merit in equality and though they were primarily concerned with maintaining the racial divide, disability was still a huge taboo. ETPT pushed for a change in the segregated school system, trying to convince the government that education should be provided no matter the colour of a person’s skin, their religion, language or ability. Thanks to Shona’s growing reputation and the fact that she is white, her voice was heard. But the government was still not persuadable and the matter of disability in educational reform remained overlooked.

Although Shona was unable to sway the politicians, her own opinions had never been more clear. ETPT’s work was broad but there was one issue on which Shona became transfixed: the poor quality of basic provisions for all people living with disabilities – most critically, their chairs. “If you can’t be mobile or sit upright then what’s the chair for? It’s just a convenience for the people who push you around,” she told us with a mixture of passion and resentment.

Shona shared with us a story which explained her preoccupation with the wheelchair.  During her time running ETPT, Shona was invited to run clinics in hospitals where she met a young boy who had been put through numerous rounds of surgery to try and correct his spinal deformities. After every operation he was placed back in the same basic wheelchair which was entirely inappropriate for his needs. Over the years this caused his whole body to mould itself into the same shape as the chair and,  given his poor access to appropriate equipment, he eventually lost his life.

Ever since Shona built Shelly’s first wheelchair, she has been tinkering with her wheelchair designs and supplying them to others through her start-up charities. Determined to address the issue of ineffectual wheelchairs on a much larger scale, and confident that her products were now tried and tested, Shona decided to morph one of the projects from ETPT into a for-profit social business known as Shonaquip. Operating out of Shona’s home in Cape Town, Shonaquip sells modular disability equipment which can be tailored to an individual’s needs and specially designed to tackle tough African terrain.

Before Shelly’s birth took her life off at a tangent, Shona had been an artist and her eccentric home is a demonstration of her creativity. Step inside and you’re greeted by rows of jam jars, giant photo montages, hand crafted sculptures and a pack of golden retrievers. In between all that, there is also an army of staff, every bit as warm as the homely environment they work in. Shonaquip employs 70 people, at least 30% of whom are disabled themselves.

Just around the corner from Shona’s HQ there is a vibrant workshop where the wheelchairs are made. People in wheelchairs making wheelchairs. Why not? From here all the chairs are transported out to hospitals, schools and children’s homes across South Africa, where Shonaquip’s therapists then work with their clients and carers to, in Shona’s words, “fit them, train them and maintain them.”

Much more the average mum than the hard-nosed business woman, Shona remarked, “It was never a formal thing, we just did it. We just started finding ways to deliver on what we knew we needed to deliver on.” For an ‘informal thing’ their impact isn’t bad. Since its beginning in 1992, Shonaquip has become the service provider of choice for South Africa’s Department of Health and has increased the number of chair types on the government tender list from four to 40. As a result Shonaquip conservatively estimates to have directly impacted over 65,000 lives.

To achieve this kind of impact, Shona has had to educate and encourage. She and her team have demonstrated their equipment to families, therapists and medical professionals, trying to make them aware of how much better life could be if they introduced a different seating solution for people with physical disabilities. And whenever they win people over, the transformation is quick to observe. As Shona herself explained, “We’ve been into centres where the kids are doing nothing but lying on mattresses and being baby sat by the staff. When we leave they are able to interact and are instantly seen by their carers in a totally different way.”

Shonaquip has big plans for the future. Already working in Namibia, they want to grow their work to pan-African scale. But taking Shonaquip to these new heights requires new investment and a shakeup of their business model. In 1992 Shona decided to move Shonaquip away from the NGO model at ETPT towards a more pure business model because the funding was so unreliable. “I grew sick of being messed around by trust funds. They never wanted to support what you do for more than a year because then they’d think it was time to try something else and share the money out,” she said with frustration. Interestingly, however, the purer business model comes with its difficulties too.

Shonaquip’s success has opened up a market for competitors wanting a share of government money, the most threatening of which are the Chinese and Indian companies who sell their standard folding wheelchairs for a much lower cost. Though competition is a basic principle of market economics, the ethics involved in this scenario are tough. New providers market themselves as ‘seating experts’ but Shona doesn’t think their products are built to last in rural conditions or designed to meet each individual’s needs. Shona argues that: “Their costing structure makes them attractive contenders for ill-informed funders and short-sighted politicians but they are responsible for ‘wheelchair graveyards’ stacking up all over the world”.[2]

Owing to their scrupulous reputation, Shonaquip are yet to be squeezed out the market but they’re very honest about the challenges that lie ahead. Shona is closely following the ongoing debate surrounding ‘impact investing’ whereby investors are looking to lend money to socially driven organisations, comfortable to sacrifice a higher return for a much greater social impact. Shonaquip would love to find an investor willing to help them grow their operation so they could achieve economies of scale and produce their equipment at a more competitive price, but Shona is sceptical about this ever happening, asking, “Who really wants to invest money in something if they’re not going to make lots of money? Can they really console themselves with just knowing they have made a difference and be happy to get nothing more than their money back. That’s philanthropy.”

Despite running the business sustainably for over 20 years and believing that a business-focused approach is still the best way forward, Shona has had to compromise and go back to seeking donor funding for some of her activities. Previously, Shonaquip used the profits made from the disability equipment to fund policy, advocacy and research work, but now margins are so tight that this simply isn’t feasible. Instead of scrapping these complementary activities, Shona has set up a separate charitable foundation to manage this aspect of their work which seeks funding from external sources and is topped up by equity from the core business. This approach, known as a ‘hybrid non-profit venture’[3], is becoming increasingly popular across the third sector, and whilst it wouldn’t have been Shona’s first choice, it means she is able to keep the business afloat whilst continuing to sustain her not-for-profit activities.

As Shona’s story teaches us, running a business with a social purpose creates all kinds of conflicting priorities. The rise of philanthrocapitalist funders like Bill & Melinda Gates can prompt people to think that business principles can be lifted and shifted into the world of social enterprise.[4] But we would argue that whatever way you look at it, it’s a totally different rulebook. As Shona points out, “A social enterprise is about running a business for people, not for profit. Of course you still need the profit, but it’s for the needs of the people first.”

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[1] The World Health Organisation, Guidelines on the provision of Manual Wheelchairs in less resourced settings (2008)

[3] John Elkington and Pamela Hartigan, The Power of Unreasonable People: How Social Entrepreneurs Create Markets that Change the World (Harvard Business Review Press, 2008) p.37-42

[4] Matthew Bishop and Michael Green, Philanthrocapitalism: How Giving can Save the World (A & C Black, 2008)


Copyright © Nikki and Rob Wilson 2011