Take back the wheel

Driving is not something you have to give up because of a disability. MARISKA MORRIS speaks to experts about the requirements to allow people with adequate mobility to drive

For many people with an SCI or a mobility impairment, it is still possible to drive. The main criterion is adequate control over the vehicle. However, you may need a few modifications to your vehicle. Because each individual and their injury or disability is unique, it is best to consult a specialist – but getting started is easy!

Not sure whether you want to get your driver’s licence and adapt your car? Aside from the independence it gives you, it makes you more employable, says occupational therapist and disability driving consultant Caroline Rule.

Depending on the injury or disability, obtaining a driver’s licence can in fact be a simple process. The individual will require a medical letter stating that they are fit to drive an adapted vehicle and might have to be retested, but there are a number of companies that can assist with this.

QASA offers driving lessons for people with disabilities in its adapted vehicles through the Driving Ambitions programme. Rule can also provide a driving assessment.

“If there is any doubt about the individual’s capacity to drive, a driving assessment is required,” she says. “For example, when there is concern about whether or not they have adequate strength to turn the steering wheel or manage the hand controls, or about their cognitive, perceptual or visual function.

“Safe driving requires an efficient interaction between a number of sensory systems and cognitive processing. Should there be any limitation in any of these systems, it is advisable to undergo a driving assessment before starting to learn to drive,” Rule says. If the individual fails the driving assessment, they are unlikely to pass the K53 test.

Most commonly, former drivers will need to have a driving assessment done when returning to the road after an injury or being diagnosed with a medical condition. Once the individual has been medically cleared and obtained their driver’s licence, they will require an adapted vehicle. The modifications to a vehicle can be as simple as fitting hand controls or moving the accelerator pedal.

While some might be tempted to do a “quick fix”, Rule cautions against this. An amputee, for example, might be tempted to reach across with their leg rather than move the accelerator, but Rule warns that this will lead to lower back pain very quickly.

Instead, she encourages people to consider the seating principles, which includes a stabile spine, pelvis and tilt in space.

“I always aim to get people driving as ‘normally’ as possible. Cars are currently designed to be driven with two hands and two feet. Therefore, I will always first try to achieve that option by, for example, fitting a left foot accelerator pedal rather than hand controls,” Rule explains.

“Being correctly aligned when driving is very important to optimise performance. For drivers who have limited balance, it is essential to get their body as stable as possible as this enables them to use the strength in their arms. Bucket seats provide excellent stabilisation, while ‘wedging’ the pelvis, slightly reclining the backrest and using a chest or pelvic strap are other techniques that can be used to stabilise the pelvis and trunk.”

In addition, she notes that a driver using hand controls should always be positioned closer to the steering wheel than someone who relies on pedals. Fatigue in the shoulders can also be reduced if they are seated slightly higher than the steering wheel. Ideally, a driver should consult a seating specialist to ensure they are not at risk of developing injuries from their driving posture.

Ensuring that the equipment in the vehicle is safe is just as crucial as seating. Some drivers have used brooms or sticks to control the vehicle, but this is very dangerous!

“People are often so desperate to get their independence back that they don’t think through the risks to which they are exposing themselves and others by getting behind the wheel,” Rule says.

“I have seen many people driving with inadequate sensation in their legs and therefore they are unable to feel what their feet are doing on the pedals.

“People with spinal injuries need to ensure their feet are away from the pedals as it is so easy for a foot to slide under the brake pedal. They won’t feel it and then the brake doesn’t work when they need it to.” A steel plate fitment over the pedals could be a good solution.

Another extremely dangerous driving habit is holding a cellphone while using hand controls. Rather invest in a good Bluetooth or voice answering system and keep both hands on the controls.

If a driver with a disability can’t afford the correct hand controls, there are organisations that can help them secure the necessary suitable equipment.

Nicky’s Drive assists with vehicle adaptation and hand control funding of up to R15 000. South African citizens with an automatic vehicle can apply to be considered for funding.

“We aim to support at least four projects per year,” says Nicky’s Drive founder Nicky Abdinor. “Preference is given to applicants who need their vehicle adapted for studies and/or employment. As Nicky’s Drive is a small organisation, the organisation cannot fund the car itself, only the hand controls within their budget.”

The organisation is solely funded by Abdinor, a clinical psychologist and inspirational speaker from Cape Town. The application process includes a driving assessment by an occupational therapist.

Abdinor explains why driving independently is so important: “One of the greatest challenges for people with disabilities in South Africa is access to transport for employment, education and participating in society. Most public transportation is inaccessible and Nicky’s Drive hears of many applicants who are paying private taxis and drivers to get them to work, university or general day-to-day activities like shopping and doctor’s appointments.

“This is very expensive. Until public transportation is accessible to all, driving an adapted car becomes a gateway to independence and mobility.” To apply for funding through Nicky’s Drive, visit www.nickysdrive.com.

If purchasing an automatic vehicle and fitting it with the correct equipment is too expensive, investing in an already modified vehicle could be an alternative. Cape Mobility imports vehicles from the United Kingdom (UK).

Because people with disabilities in the UK receive a government-funded adapted vehicle every five years, there is a surplus of vehicles. These vehicles are then imported at an affordable cost to South Africa.

Geoff Dear from Cape Mobility explains: “The majority of the vehicles are supplied to order. I have access to approximately 300 wheelchair-accessible vehicles [WAVs] a month that were on three- to five-year leases at Motability in the UK. All the vehicles come with a full service history and the majority has very low mileage.”

The customer’s needs will determine which vehicle is suitable, and it will take between ten and 12 weeks to have it delivered to Cape Town, a process that includes finalising permits and other documentation, packaging, shipping and customs procedures. Because the vehicles are imported, their initial cost is paid in foreign currency, whereas the fees and VAT is paid in rands when the vehicle arrives in South Africa.

As an example, Dean estimates that the cost of a five-year-old Peugeot Partner 1.6-litre diesel car with about 56 000 km on the clock would cost £10 000 (R178 222), excluding VAT but including all the required permits, delivery fees and a three-month warranty. Registration for the vehicle can also be organised.

“I’ve been supplying these adapted vehicles now for nearly ten years and some early customers are only now purchasing a replacement vehicle for their original one,” Dear says. “Owning a WAV is life changing for most people. It makes trips such a simple process – it takes two minutes to secure the wheelchair user safely into the vehicle.”

Cape Mobility also supplies vehicles that have been adapted to allow wheelchair users to drive while seated in their wheelchair.

Purchasing or adapting a suitable vehicle is only one part of the process. It is also important to know how to maintain an adapted vehicle.

Des Harmse, a driving instructor at Driving Ambitions, shares some advice: “Never remove the original pedals. The car may have to be used by a person driving with their feet and who is not familiar with the hand controls. These controls are not easy to drive with if you are not familiar with them. Your natural instinct will be to use your feet to brake. Realising there are no brakes and that you need to use hand controls may make all the difference in stopping in time or not.”

Hand controls can also be a once-off investment. Harmse notes that these last for a long time and can usually be transferred to a new vehicle. Although there is little maintenance required, it is important to ensure that only qualified professionals work on the vehicle.

“Please do not allow anybody, even service and maintenance professionals, who is not familiar with the hand controls, to try to operate the vehicle. If you can, you should let the above people sign an understanding that they will be held accountable for any damage to the vehicle if they should try and operate the vehicle with the hand controls,” Harmse concludes.

With a few easy adaptations and some knowledge on proper seating, most people with mobility impairments can get back behind the wheel with little effort! What are you waiting for?

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