Who Belongs? EP 0 - Reinventing the Wheelchair: Interview with Ralf Hotchkiss

September 19, 2018

Download an MP3 of this episode.

Back in March we interviewed Ralf Hotchkiss, a renowned disability rights activist, engineer, and co-founder of the Whirlwind Wheelchair project, based in Berkeley, CA. The non profit works with local wheelchair riders and mechanics around the world to design and construct durable chairs that bring riders back into society in ways that standard US and European chairs don’t allow, because of their poor designs which severely limit peoples’ mobility. 

Learn more about Ralf's work at Whirlwind Wheelchair here.

And read a profile about him here.

Soundtrack Credits:
Intro song: "Traction" by Chad Crouch
Outro song: "Wide Eyes" by Chad Crouch

Interview Transcript

Marc Abizeid: Hello. I'm Marc Abizeid from the Haas Institute for a Fair and Inclusive Society at UC Berkeley. Back in March we met with Ralf Hotchkiss, a renowned disability rights activist, engineer, and co-founder of the Whirlwind Wheelchair Project based here in Berkeley. The nonprofit works with local wheelchair riders and mechanics around the world to design and construct durable chairs that really bring riders back into society in ways that standard US and European chairs don't allow because of the poor design, which severely limit people's mobility.

Mr Hotchkiss himself began riding a wheelchair following a motorcycle accident in 1966 when he was 18. He very quickly discovered the common flaws and hazards built into standard wheelchairs such as weak frames prone to fractures, folding cross-braces that break in half, and front wheel bases that are too short causing the chairs to tip over forward commonly leading to bruises and broken bones. Mr. Hotchkiss began his work in late 1979 when he went to Nicaragua and met with four boys who shared an old wheelchair that they had reinforced so it could be ridden on rough cobblestone roads common in their country.
Since then he's traveled throughout Latin America, Asia, East Africa, the Near East and other regions observing how locals were repairing their substandard wheelchairs, sharing some of his own ideas, and spreading them to other wheelchair riders in the network. This is our conversation.

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Marc Abizeid: You first got started with this project in Nicaragua and you just got back from Nicaragua.

Ralf Hotchkiss: Yes.

Marc Abizeid: How did it start and what were you doing there most recently?

Ralf Hotchkiss: I was sent down by Ed Roberts, who was head of rehabilitation in the state of California and who was one of the first students here at UC Berkeley with a significant disability. He said I've got to get down there, there are a whole lot of people with broken wheelchairs. I gathered up all the parts and an assortment of tools and went down with a handful of other Berkeley wheelchair riders and sure enough, there were broken wheelchairs everywhere and those people who could get their wheelchairs up and running typically were sharing several people to one wheelchair.

Marc Abizeid: We're talking about 1979 right now.

Ralf Hotchkiss: Yes.

Marc Abizeid: Okay.

Ralf Hotchkiss: Yes, end of '79, early '80. We found very interesting people and kind of sad wheelchairs. The typical wheelchair was a throw away hospital chair from US or Europe and those chairs, while they might be fine on a flat, flat floor, take them out on a Nicaraguan auto [inaudible 00:02:46], the cobblestones that are throughout the country, and those chairs would last just a few weeks and they'd have a major failure, the kind of failure that the Americans would call "beyond repair", got to buy a new one.

But when they broke down, these hospital chairs, the mechanics there would not throw them away, they would fix them, they would reinforce them, they'd figure out why they broke. What was the stupid reason that they weren't anywhere near as strong as a bicycle of a hundred years ago? The reason primarily was that they were not engineered, they were not made by master mechanics like the ones in Nicaragua who were trying to fix them, so they would reinforce them and then fix the other side of the chair. Say one side of the chair broke, one front wheel broke clear off the chair, they would reinforce that one as they repaired it, make it much stronger than it had been, then they would reinforce the one that hadn't broken yet so it wouldn't break in the future.
One chair that four teenage boys were sharing had 20 major fractures in its frame and every one had been reinforced during its repair and the other side had been reinforced as well. The whole frame had been redesigned and taken over most of the errors that the American manufacturer had made in manufacturing it and designing it. If you could call that even design.

Marc Abizeid: So you went down there and you found that they themselves were reinforcing the chairs.

Ralf Hotchkiss: They were re-engineering the chairs completely so that they would actually last.

Marc Abizeid: What kind of ideas did that give you?

Ralf Hotchkiss: There were numerous better reinforcements. I had been doing the same thing on my chair at that point for 13 years. I'd been riding since '66 and my first chair lasted half a block in the streets of Chicago. Hit a crack in the sidewalk, smashed one of the front wheels, it was beyond repair said the manufacturer. It had to be dragged back to the hospital. From that point on I was repairing, reinforcing, re-engineering the chair so that it would actually more or less work as well as my bicycle that I had ridden for many years over railroad tracks every single day with virtually no problem.
The chair that these four teenagers had was so nicely reinforced that I could absorb some of the understanding of the flow of the forces through the chair when you ram into a curb or go over miles and miles of very large rounded cobblestones at top speed, which they did every day because how else are the going to get to school or work? How else are they going to pick up their kids? All those things. They were doing it.

By the time I went to Nicaragua in '79 I was way beyond the first chair that I got in Chicago in '66. At that point I was riding a homemade, four-wheel drive, manually propelled, folding wheelchair. The front wheels were omnidirectional. They were powered by bicycle chains from the rear wheels. It would go backwards through snow and up high curbs. These Nicaraguan kids were very interested in my chair because I could go through stuff that they could not even dream of going through. One of them looked my chair up and down and said, "Very interesting, but it's going to break there, there, and there."

Marc Abizeid: Did it?

Ralf Hotchkiss: It already had and I had fixed it but not well enough.

Marc Abizeid: How much of a part did the monopoly over the manufacturing of the chairs play in them being held back as far as technology? I know during that period it was Everest and Jennings that really controlled the lion's share of wheelchairs.

Ralf Hotchkiss: That was true from about 1950 through the middle '80s. Its control was broken in 1979 by a Justice Department anti-trust suit in which their anti-competitive activities in keeping foreign competition out of the US were exposed, challenged, and through a consent where they swore that they never done anything wrong, but promised never to do it again, within a couple of years there were dozens of new manufacturers in the US. Money poured into the field. People were very insistent to make chairs that were lighter, better, and stronger all at the same time and did very well.

Marc Abizeid: Yeah. It's unbelievable how a company whose purpose is to be able to help people who require wheelchairs, but through its monopoly it was doing the exact opposite by-

Ralf Hotchkiss: The problem is the "help people" part of it. It's the custom of pity and fear of disability that keeps people from dealing with it in a serious way. Helping people is cool, but it doesn't necessarily solve really hard problems. Being nice to them and patting them on the head is cool too, but doesn't solve the problems. People are just kind of given a wheelchair and forgotten about or maybe allowed to have a little bit of mobility, but not encouraged to get out, go to school, get a job, fight for political office, demonstrate, all those things. How many disabled people were there in the 1900s in the US doing that? Some. Some. Toward the end, a lot, but at the beginning, very, very few.

Thus, wheelchairs were kind of accepted as they became as they had been say in the 1940s. They're still accepted today in that form. The most common wheelchair is what we call the hospital box. Very short wheelbase, folding frame so it doesn't take much space when you're not using it, but it's not an outdoor capable chair, not even close. If people had been working really seriously on that, progress would have happened sooner.

The monopoly kept small manufacturers out of the business from, again, 1950 to the '80s, and that definitely slowed things down but I think that the core of the slow motion of the development of the wheelchair is that there was a shortage of people who really understood getting out and living independently and being a competitive worker. I wouldn't say in spite of, but I would say especially because of your disability. If you had a disability, you better get out there and do well or you're really going to be stuck.

Marc Abizeid: Right. There's an extra motivation there.

Ralf Hotchkiss: Extra motivation.

Marc Abizeid: Right. Exactly. That's what I'm saying about the corporation not really seeing people who ride wheelchairs as full human beings, as people who belong in society.

Ralf Hotchkiss: Now, the beginning of that company, Everest was a wheelchair rider, injured in 1918 in a mining cave-in, paraplegic, spinal cord injury. He wanted to make a major step forward from the few very heavy steel chairs that were there at the time and the more common big wooden chairs with large front wheels and a single or double rear castor that were the more popular chairs until the '50s. He wanted to make real progress and he did. Then their chair was what became the standard hospital chair but for the 1930s it was a great advance.

The sons of Jennings appear from what they did with their designs during the '50s and '60s to have been at least as interested in just cutting costs as in making significant usability or mobility advances. They did several things that weakened the chair significantly. My failure in '66 was due to their 1958 cheapening of the front fork.

Marc Abizeid: So, in 1979, 1980 you went to Nicaragua, you saw how they reinforced the chair, you got some ideas, and over the years you've built a network all across the world and Latin America.

Ralf Hotchkiss: As best we could, yeah. We found people in 40 countries who were ready, willing, and willing to build their own chairs. There was, in 1981, the beginning of the Disabled People International, the worldwide organization of disabled activists of all disabilities together from blind people to wheelchair riders and everything in between and they were a goldmine of good ideas. People would come in with their own inventions to their conventions and of people who just wanted to get started or already had gotten started on their own. So it wasn't that we started it either.

We just went around. I was a gringo lucky enough to be able to get airplane tickets and visas. A lot of it was because I had a US passport. Many of these people basically were prohibited from making the visits that I made across boundaries or from segments of the world to other segments of the world.

Marc Abizeid: Right. You worked kind of as a messenger or organizer to bring the ideas.

Ralf Hotchkiss: Right. Stealing good ideas and passing them on. Testing them here.

Marc Abizeid: You said something interesting earlier about how in the market-based culture in the US, something breaks, you throw it away. That's usually what you see around is when something goes bad, people don't really try to fix stuff anymore. Things are inexpensive, they throw them away. In a lot of other countries, they don't have the luxury of just being able to throw something away if it breaks and get a new one. They're forced really to be more creative.

Ralf Hotchkiss: And thus they learn as well, a lot more from the old technology than they would if they threw it away.

Marc Abizeid: Right.

Ralf Hotchkiss: Taking it apart and fixing it, that's how I learned most of what I know.

Marc Abizeid: We were talking a little bit earlier before we were recording about how these old standard wheelchair has that problem where it tips over forward, where you fall over forward, and then came the solution of extending the front wheelbase.

Ralf Hotchkiss: And that required completely redesigning the footrest to get the feet out of the way of the swiveling of the front wheels.

Marc Abizeid: Right. It was that design, but it was also the wheels themselves that you found a solution. You discovered the solution actually in Zimbabwe. Can you talk about that?

Ralf Hotchkiss: Here it is. Here's the Zimbabwe wheel. There's nothing in the sides. If you cut the tire in half, cut one side in half and open it up, it looks like an hourglass of rubber. That makes the middle nice and solid. It will roll easily on your perfect flat floor here, but once you're in sand, the soft edges contact the ground and keep you from sinking.

Marc Abizeid: And so now these are used all over the world.

Ralf Hotchkiss: I wish they were. They're used in certain segments all around the world, in certain locations.

Marc Abizeid: But you've introduced these ideas to different places.

Ralf Hotchkiss: We've done our best to spread the Zimbabwe technology and there are a dozen countries where they are widely used now and a few others where there are several.

Marc Abizeid: What are some of the other ideas in some of the other countries that you've shared with the network?

Ralf Hotchkiss: This brake is derived from German technology. It's a handle that actuates a lever that digs well into the pneumatic tire. This is a standard bicycle mountain bike tire. You get more clearance between the lever and the tire. When the brake is off, if the lever isn't far from the tire, you can hurt your fingers when you're pushing on the tire itself because there's not room under the brake. Everyone's ripped a whole thumbnail off, for example, on an Everest and Jennings because they only gave about a half an inch or 5/8, 3/4 inch of clearance, less than 3/4, between the tire and the brake actuator. It didn't move far enough away.

Marc Abizeid: How long did that make that model for before they-

Ralf Hotchkiss: They still do.

Marc Abizeid: Are you kidding?

Ralf Hotchkiss: That's the standard brake on virtually all hospital chairs worldwide because they set the ... That's what you get by just caring for people, not working for them.

Marc Abizeid: That's unbelievable with that safety flaw, that hazard.

Ralf Hotchkiss: That's a disastrous safety flaw. Not as disastrous as falling forward because it doesn't break your femur and give you a fractured skull, but never the less, it drives us crazy every time there's another injury. We have footrest issues that we'd like to make better. Our footrest is already way ahead of most of the western ones. I lost a toe to a western footrest.

Marc Abizeid: You're kidding.

Ralf Hotchkiss: 15 years ago, yeah.

Marc Abizeid: How did that happen?

Ralf Hotchkiss: I just nudged against a door jam, a doorframe rather.

Marc Abizeid: And it was exposed?

Ralf Hotchkiss: My toe was my front bumper and that's true with almost every chair on the US market.

Marc Abizeid: Oh, so your toe just hangs over the edge of it.

Ralf Hotchkiss: Right. And so it just chopped off my toe. I found a doctor who sewed it back on. It's just fine. And I kept in the refrigerator for four hours until I found that doctor.

Marc Abizeid: So what are some of the other flaws of the standard models?

Ralf Hotchkiss: Where do I start? The folding cross frames breaks in half. How about that? They need a certain level of strength in their cross-braces and a lot of them don't have it. It's much better than it was 20, 30 years ago and most of them didn't have the strength to bounce down high curbs repeatedly every day without bending and/or fracturing that X blade brace under the seat. The whole chair would fall in half.

Marc Abizeid: Wow.

Ralf Hotchkiss: Yeah. I had that happen. Many of my friends have had that happen. There are wheelchair standards now that many of us have worked together to fight for and some of the industry has been good fighting for them too, the stronger new little parts of the industry, they came in after the anti-trust settlement broke up the monopoly. There was some good mechanics who jumped in to the field and wheelchair riders who started these new companies. We have new standards. The chairs are required to run over 200,000 bumps with 100 kilogram, 220 pound dummy or 250 pound dummy in the chair, but also it doesn't necessarily cover most of the cheaper chairs, the hospital style chairs. Those are the ones that get thrown away and donated to the south.
If you're an American and you buy an inexpensive chair for granny and then granny, after a while, becomes rehabilitated or passes on, then you have a choice. You can either give the garbage man an extra 5 or 10 bucks to haul it away or you can donate it to somebody who gives it away south of the border and take a $400 deduction on your income tax. What do you think people do? A whole lot of broken chairs get sent south. They're not an appropriate chair for off-road, for living independently in a small town in 80% of the world where they don't have much pavement.

Marc Abizeid: Tell me about some of the shops that you have in different regions.

Ralf Hotchkiss: First was Nicaragua, Mexico, eventually most of Central America. Later on, late '80s it was South America. East Africa mostly. First introduction was Zimbabwe then Kenya, Uganda, Tanzania. Philippines was early, they were our teachers really. Tritan, Fiji did a thorough training, had a really strong local group, but it was kind of shut down by a pre-existing manufacturer of wheelchairs made out of rebar. The most incredibly unridable chairs I've ever encountered in my life, but they were being manufactured in Fiji by the Red Cross and the Red Cross had all the political power. Then southeast Asia, we found some good places to build. Vietnam, Cambodia. China was difficult and then a little bit in the New East. Palestine. Palestine was very active in the last half of the '90s.

Marc Abizeid: Tell me about the one in Palestine.

Ralf Hotchkiss: It was an organization of disabled folks. Palestine was probably the best-off country of which I've worked as far as, they were well-developed, they were technologically far advanced, but they still needed lower cost chairs and there was an organization of disabled folks who also wanted very strong chairs. They were wrecking the chairs that they had. So it was organized initially in Ramallah, not far from Jerusalem, and their local chapters in Gaza and Nablus joined in and we ended up having three factories, each one specializing in certain parts of the chair and all three of them assembling independently.
That worked quite well for a while, though there were occasional delays getting through the checkpoints to carry stuff, especially from Gaza to the other two shops or vice versa.

Marc Abizeid: This was during the '90s?

Ralf Hotchkiss: The '90s, yeah. Late in the '90s, early in the 2000s, things ground to a halt because they were having so much trouble bringing ... We had Israeli sources of many of the materials, which meant that our drivers had to go through the checkpoints back and forth and there was a very strong organization of disabled folks in Israel that was making the connections for us to get our parts, some of which were unavailable. Certain bearing sizes and tubing diameters and so on, unavailable in Palestine. So things kind of fell apart. Too bad, it was a pretty active group and a vibrant group I would say and they also were providing us with a string of very, very good ideas.

Marc Abizeid: As far as the number of people who require wheelchairs but don't have access to them, what's your estimate globally?

Ralf Hotchkiss: The current accepted number is 50 million.

Marc Abizeid: Okay. 50 million people, maybe 20 years ago or so it used to be about 20 million?

Ralf Hotchkiss: That's right.

Marc Abizeid: Okay. Why has it risen so dramatically and is it just because of ...

Ralf Hotchkiss: People are recognizing more need. For example, in the US there's one wheelchair, roughly, for every 200 people. In England, there's one wheelchair for every 100 people. Why is that? Because they have socialized medicine and people that need them get them because they recognize the part-time use of a wheelchair as a valid, for example, if you're an amputee and you walk on prosthesis and you have injury trouble with the end of your missing limb either acting with the prosthesis, for example, it's great to have a wheelchair as backup. In fact, many amputees keep a spare wheelchair for their whole lives just for whenever they might happen to hurt themselves.

Marc Abizeid: How many of these people, if you look globally, are people who require wheelchairs because of an illness versus, for example, an accident versus a war?

Ralf Hotchkiss: I don't know. Even in war, the injuries are probably still most often not from the war itself. One of the biggest sources of spinal cord injury, for example, is being a pedestrian or a rider in a car, being a pedestrian who is hit by a car. I don't really know what the breakdown is that way. I've seen various numbers, but they're not very consistent.

Marc Abizeid: Right. But is it hard for example, before we were recording this we talked about your friend Saddam from Iraq who came here a little after 2003 and he's very creative in his designs.

Ralf Hotchkiss: Very creative.

Marc Abizeid: To go back to him, you told me a little bit about how he wanted to start one of these centers back in Iraq, but something unfortunate happened with his brother who was going to be his partner and it didn't work out. How much would that have contributed-

Ralf Hotchkiss: Something related to the war happened to his brother.

Marc Abizeid: Okay. That's just compounding how war is really making the situation even more tragic. But how much does a war, or if we use the example in Palestine I was reminded about, after all those protests started happening in Palestine, Gaza, and the West Bank after the Jerusalem announcement late last year, one of the protesters who was in Gaza, he was a man who uses a wheelchair, he didn't have any legs because he lost his legs during one of the previous Israeli invasions in the Gaza and he was going to plant a flag near the fence. You know how Gaza's kind of caged off and he was climbing.

Ralf Hotchkiss: I know that is probably the North Gate. I know it all too well having passed it many times.

Marc Abizeid: Yeah and he was shot dead there. He was shot dead by the Israelis, a man who already couldn't walk because he was ...

Ralf Hotchkiss: Yeah, right. What kind of threat was he?

Marc Abizeid: Right, exactly. But the point is-

Ralf Hotchkiss: Unless he was really heavily armed.

Marc Abizeid: In these regions that are constantly subjected to war and aggression, how much does that also contribute to people having disabilities?

Ralf Hotchkiss: It contributes a lot, but probably not as much from the injuries in war as from the destruction of the the medical care systems that comes with war and increase in automobile injuries that comes with lack of law and order on the streets or people having to drive crazy because they're at great risk.

Marc Abizeid: So with everything associated with the panic and the falling apart or the collapse of infrastructure.

Ralf Hotchkiss: The infrastructure, the health infrastructure. Because for example, spinal cord injury, when I was injured, something like 3/4 of the quadriplegics in the US would be dead soon and some significant percentage of the paraplegics as well. Quadriplegic being neck and up and paraplegic being all below neck. Now they're about three times as many quadriplegics as there were then, but the injury rate is the same, hasn't changed much. In fact, it's down a little bit because we have seat belts now. But it's much higher because the quadriplegics are surviving now in the States at a much much higher rate.

So, medical care is critical to the survival of a lot of people with significant potential disabilities. Especially certain kinds of injuries, spinal cord injury is a classic one. People with complete spinal cord injury pretty much didn't survive before the second world war. That was when the antibiotics became available and that made the difference. They could survive their early pressure sores, bed sores they call them, that came from having limited or no sensation in parts of their body and not being moved enough to keep the blood flow from being blocked off just by the pressure of the bed against their skin.

Marc Abizeid: Let's say you were a mega lobbyist and you could control Congress, and have them do whatever you wanted to do, what would you do as far as trying to get them to make life more inclusive for people with disabilities or wheelchairs in particular?

Ralf Hotchkiss: Integration into public schools is the beginning of next generation's inclusion. We've had some inclusion into grade schools, for example, of kids with significant disabilities. That's given us an incredible advance in attitudes of kids now in college and beyond. We did that with only 5 or 10% of real integration into grade schools? Not a whole lot. Most of it was where my kids went to school in Oakland. They had a separate classroom in a different building next to the kindergarten that they called their special ed center and most of the kids spent most of their time there and were integrated just a little bit.
It's gotten better and it's getting better but with just a little bit of integration, you've got an incredible attitude shift. There are a lot of other things like historical changes, progress.

Marc Abizeid: Let's finish up the first question about Nicaragua, where you got started, and you just came back from Nicaragua. What were you doing there most recently? Then the last thing I'll ask you is about your next initiative.

Ralf Hotchkiss: Just for a start, I'm happily remarried to the woman who was one of the three mechanics in the very first shop and who taught me to sew and I taught her to weld and so on and she's been building chairs, fixing chairs ever since.

Marc Abizeid: In Nicaragua?

Ralf Hotchkiss: Yeah. And she's probably my toughest critic of chair design. Not only can she break everything I do because she rides much faster over these cobblestones than I can, she's always having to stop every block to wait for me as I go as fast as I can, but she's also a very good analyst and critic of the ergonomics of wheelchair design changes as well as their strength. When I'm there I live with her and when she's here she lives with me.

Marc Abizeid: Okay.

Ralf Hotchkiss: So we always meet at her house. Every week there's a meeting of old disabled radicals, Nicaraguan Revolutionaries. Their organization, interestingly was originally funded in 1981 by USAID and their proposal said this is the Center for Independent Living in Managua, Nicaragua and they were funded steadily through 1984. Until it became known by the then Reagan, not Carter, connected staff at the Embassy that their real name was [foreign language 00:33:04] and they lost their funding, but the Swedes then were ready to take over and fund them through the rest of the century.

So she has a meeting of some of the remnants of that group every week in her house. All of them do their own repairs and all of them are very critical of everything we've ever come up with. We were working with them, we were trying out several new ideas for the brakes. A lot of good chair design is not in the whole chair, it's in the little details. Like the rear hub, we've been through at least 12 different kinds of rear hubs.

Marc Abizeid: So what is your next big initiative?

Ralf Hotchkiss: To try and bring back more small shops. In the year 2000, a huge initiative began in which philanthropists started buying chairs and giving them away in developing countries and that was a mixed blessing for us. Yes, it's great to have more chairs. We lack 50 million. We've only made 100,000 related to our project. We've influenced more, but that's all our groups have ever made. So great to have more chairs, but the chairs they were giving away were almost exclusively hospital style chairs designed in the '50s, '40s, which are the same chair that broke in half a block when I first received one in '66, which were made out of parts that could not be bought in developing countries, could not be bought, they were not available.

So unless you find a Nicaraguan blacksmith who can invent you a new footrest or front fork on the spot, when your chair breaks down there's nothing you can do. You can't get a replacement from the people that came once and gave away a thousand chairs and then disappeared for five years to return who knows when and who, when they gave away those thousand chairs, put the local wheelchair shop out of business because until the chairs all started breaking down, which might take a whole six months, there would be no business at all and by then the shop was belly up. Happened in numerous countries.

Due to this great improvement, a lot of our smaller shops or the ones that we knew of, are belly up and we would like to adapt our technology to be so damn cheap that we can compete with the Chinese prices, which are quite low and the efficiency and quality of Chinese manufacture. These are well-made chairs of not very good designs, but we would like to be able to make chairs locally. One, so there's more pride in the chairs and people take better care of them and they last longer. Two, so that the repair parts are all available right there in town and so the chairs are designed so that even if you can't get the spare parts, if the chair shop has gone belly up, you can go to the local blacksmith and, bingo, they'll make you one while you wait.

That's most important because that's the only way to get repairs. That's the only way people will have consistent, sustainable transportation and live independently for their whole lives. If you've got a wheelchair, it better last you one lifetime. If we can meet this challenge, then chairs will be significantly cheaper for the user. It doesn't matter what the chair costs nearly as much as what it costs to operate a chair for each year, depreciating the chair instead of over six months, over 15 years. Right there you've saved a fortune if you can find some way to pay for it up front. The availability and cost of any replacement part you might need, critical, critical.

We're looking at that bottom line to the user, not to the donor, but to the user and we've actually found a few users now. The US Mormons are the biggest buyers of wheelchairs in the world. They have people in almost every country trying to convert people and among those people is typically a retired couple that stays for two years in each country and those people are in charge of wheelchairs, among many other things. Some of them are dead serious and agree with us in so many ways and they've been pushing back home to really deal with that bottom line. They're the ones who see all the broken chairs. People come to them because they gave the chair away. What are they going to do when it doesn't work anymore?

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Marc Abizeid: And that concludes our conversation with Ralf Hotchkiss, the co-founder of Whirlwind Wheelchair based here in Berkeley, California. If you're interested in learning more about Ralf's work, visit the Whirlwind Wheelchair website at whirlwindwheelchair.org. You can also find a profile about Ralf on our website at haasinstitute.berkeley.edu or we'll also have links to these sites in the description field of the audio file page below at soundcloud.com/haasinstitute. Thank you for listening.