Denver Frederick is the host of The Business of Giving, a podcast that focuses on solutions to today’s complex social problems, and the people who are bringing about systems change through their work. He regularly has deep and insightful conversations with Catalyst 2030 members.
Denver: Shonaquip is considered a model for many social enterprises all over the world. Founded in 1992, they improve the lives of people with severe disabilities by addressing mobility barriers through supplying appropriate devices, custom-made wheelchairs, related services, and training. And here with us to discuss their extraordinary work is Shona McDonald, the Founder and Executive Director of Shonaquip.
Welcome to the Business of Giving, Shona!
Shona: Thanks so much, Denver.
Denver: So, the organization started in 1992. Share with us the founding story and what brought you to this work.
Shona: It started many years ago, even before 1992, when one of my daughters was born with severe disabilities, and I was told to put her in a home and have another baby, which obviously as a mother, made me really angry. That’s where it started, and I then was on a mission to prove everybody wrong and started designing equipment for her that would help her learn how to communicate because she couldn’t speak. And then I realized that wouldn’t work if she wasn’t sitting upright, so I started designing equipment to assist her with her mobility and her posture. And that eventually, obviously, turned into my starting to do the same sort of work for other parents.
Denver: And if I recall correctly, this was during the anti-apartheid movement. So, there were barriers and boycotts so you really couldn’t import anything; you really had to create everything yourself.
Shona: Yes. Everything was starting from scratch. At the time, in South Africa, the only type of wheelchair you could get was like a hospital folding-frame wheelchair for adults. There was nothing for children at all, and so we really started looking at not only what children need, but what other parents need.
And then I designed around the children’s needs…so really what one would call now, client-centered design, which sort of evolved out of not only the individual client’s needs, but also the environments in which they were living. Because most of the children I work with really live in rural or peri-urban areas where the ground they need to travel over is really rough, or sandy and rocky, and so European-style wheelchairs aren’t appropriate here anyway.
Denver: Why don’t we dig a little bit deeper on that, and tell me what is an appropriate wheelchair?
Shona: An appropriate wheelchair is a device that provides adequate body support that enables you to function to your best ability and prevents the development of secondary health complications like contractures and spinal deformities and aspirating pneumonias, but it also needs to be appropriate for the environment in which you’re going to use it, for instance, either in school, in society, going to church, the shops, or crossing really rugged ground. Like shoes, the wheelchairs should really be suited for the type of activity that you’re going to take part in. It also needs to be affordable, and it needs to be available close to where you live so it can be repaired and maintained.
And most of all important, you should actually benefit from using it. It shouldn’t cause any harm to you. As we see here, many children in Africa get donated chairs that cause serious secondary health complications, and that’s a really sad affair.
“So many times we see children with severe deformities, which I think the general public just consider are a result of being disabled, but actually are a result of being mismanaged… not having the right equipment, not having the right intervention.”
Denver: Now, when a young child shows signs of struggling to sit up and maybe is not moving around like their peers, there can be a tendency on the part of parents to say, “Let’s see if this works itself out; wait a little bit longer.” But you do not suggest that course of action. What should parents be doing when they see that?
Shona: I suppose the mantra is… early intervention. The sooner you can provide a child with 24-hour posture management, the more opportunity they have to reach their potential.
So many times we see children with severe deformities, which I think the general public just consider are a result of being disabled, but actually are a result of being mismanaged…not having the right equipment, not having the right intervention, that’s what causes children to become so deformed and more disabled than they need to. It is the barriers to getting the right equipment that often prevent the children from reaching their potential.
Denver: So, assessment is really important at that stage, I gather.
Shona: Hugely important. We start with positioning children even in lying or sitting from as early as one year old. A child’s back is pliable. It hasn’t developed to its normal curves yet, so if they sit incorrectly, they will develop a scoliosis, and that scoliosis then obviously affects not just their ability to function and use their hands appropriately, but ends up affecting their breathing and their swallowing and all other aspects of their lives.
Denver: That’s incredible. What role in the ecosystem does community-based outreach seating play? Tell us a little bit about that.
Shona: Many of the parents we work with, and there are hundreds of thousands of children across Southern Africa who need wheelchairs cannot live near hospital services and cannot access hospital services. So even though wheelchair services might be available at a central hospital in a town or a city, the travel ability to get to that city or get to that hospital is too great– even the cost of transport, and also the fact that transport is not accessible in South Africa. So, we have designed a way of providing services, working together with government, and government hospital services all working with private funders and individuals, to take these services into the community.
So, we have vans; we have teams of therapists, seating practitioners, and technicians, who actually hop in a van, go on a trip, might be out in the field for a week or two, going village to village or clinic to clinic, providing wheelchair seating services, and at the same time, upskilling government therapists, private therapists, and repair maintenance technicians, and sharing information with parents on how best to use the devices that their children then get.
These devices are often provided through government services, but our outreach actually connects the device with the end-user.
Denver: Shona, this is quite an ecosystem and continuum that you have really built. It is extraordinary, and another piece of that would be your blue line projects. What is that?
Shona: That’s something I’m quite passionate about because I really believe in the circular economy and we waste too much.
What we’re doing is we’re collecting abandoned and broken equipment from hospitals and private clients. We bring that into our production facility and train wheelchair technicians on how to maintain and repair that or refurbish it. And in that process, we are turning all those products blue. So instead of the black-powdered coating here, they blue-powder coat it, and those products are then available to be reissued into the market as completely refurbished, upgraded, and ready for the next child.
And through this process, we can get equipment to turn around many times to help many children in different circumstances. Obviously, the refurbished product is cheaper than the new one and is attractive to international funders who want to send a large volume of chairs into other countries.
Denver: Fantastic. Shonaquip could be fairly described as a hybrid social enterprise. Tell us about those elements and how they all work together.
Shona: Shonaquip started, as you said, out of my garage in my house as a small CC, the close corporation, that was specifically designed as a social enterprise to reinvest its profits back in systems change and changing people’s lives for the better, but we very soon realized that the problem was far greater than we could ever address just through a very small profit margin on selling equipment.
And so we launched a not-for-profit, or the Uhambo Foundation, and later, Champions of Change Trust. So these three organizations function as one. We have one delivery team, but we have three boards, and we have three financial reportings; we have three impact reportings, and then our board sits collectively, and we bring all our impact and all our finances together in terms of measuring our success.
Where we have all these different entities, we really are addressing one issue, which is to make sure that with an appropriate assistive device and the knowledge to make informed choices.. together with the agency of people to be able to act on this knowledge, that a family of a child with a disability will never need to experience that their child is less valued as I did.
And I think that’s collectively what all three entities work towards, but the entities do it separately. We do it, obviously… Shonaquip focuses on design and manufacture and provision of devices, whereas Uhambos look very much at the social support services, early childhood development, anti-bias, and stigma work and empowering parents to really become those knowledge-holders of information for their child.
Denver: Do you see this as a business model that other organizations might adopt? If so, what are some of the challenges? I mean, I can get your advantages here, but again, when you have three different entities and you’re, again, trying to have collective impact with them. I know it’s not as smooth as it probably appears on the written page, but tell us about some of the dynamics of all that.
Shona: I really hope the space for social enterprise will start pushing and attracting business into a new way of delivering its services that is focused on really business for good, because it is really powerful to be able to have a purpose that is more than just breaking a profit or driving a profit. Driving of our impact is equally as important as our profit margins because the more profit we make, the more sustainable we are, and the more impact we can make.
But if we make a really bad choice and decide to sell something that adds to the problem, then we’re undermining our own initiative. So every decision we make has to be really deeply considered in terms of: Does it add value? Does it address our purpose? And is it profitable or at least breakeven, and are we able to do it?
And that gets us into this really difficult space that social enterprise holds, where you sometimes have to turn down doing something that’s profitable because it undermines your social agenda, and I think that’s where the tension comes. The guys that run the sort of the financial direction of the organization are constantly pulling in one direction, but the impact is pulling in the other. And the art or the magic happens when you get the financial and the impact agenda lining up and delivering really meaningful change for many, many people at scale.
And we’ve seen it’s possible. We’ve experienced it. We live it. And yes, it has huge challenges, but if you continually stay true to your purpose, you can maneuver your way through this minefield and end up being able to really make systemic change in a sector, and that’s why I think business could be really attracted by this model.
Denver: It’s a very interesting model. It’s a dynamic model. Listening to you, I can hear how important your values must be to guide those decisions. So when you have the financial people over here and the impact people, you take a look at those values, and that hopefully provides the clarity to determine which way you’re going to go.
Shona: And to support that way of working, we took a decision a number of years ago to create distributed leadership in the organization. So we don’t have one CEO running the organization because it would be very easy for that person to either take the financial agenda or take the impact agenda and run with it.
So, our CEO is a collective CEO with three people, one heading up impact, one heading up finance, and the other one driving the opportunities. And in this way, we stay as balanced as possible. We do swing, but we are able to hold each other accountable to the common purpose.
Denver: And how much have you grown? I know you started with two people in your garage, I think, back in 1992. Thirty years later, how has the organization grown and flourished?
Shona: We have grown significantly, We are about 80 on the team. We work with approximately 21,000 clients a year, individual sort of impacts, and because of our training and capacity-building work, we’re working with about a quarter of a million family members and therapists and other stakeholders. So, the work has expanded significantly. We’re in seven countries and have just secured our FDA and CE so that we can start exporting, from south to north.
Denver: Great. In addition to all that, you also play a political role with organizations such as the World Health Organization. Tell us what you do there.
Shona: I got involved in the World Health Organization in 2006, when they asked me to take part in the design and writing of the World Health guidelines on wheelchair provision in under-resourced countries. And since then, I’ve stayed really well-connected with World Health and now sit on the board of ISWP, the International Society of Wheelchair Professionals, and have also started working in some respects with UNICEF and partners working with World Health to drive the agenda on wheelchair and assistive technology provision globally.
A lot of our work gathers data and is able to inform policy, and I think our work and our model in South Africa is an important example of how one can design around need in a different way from what has been happening in the past. And this obviously is of interest, not only within South Africa, but in answering or addressing the challenges in other countries.
“We evolve as people’s needs evolve, as policies, as financial systems change. I think innovation is born out of need, just addressing need in the most effective way.”
Denver: There has been so much innovation in and around all you do, Shona. I’m absolutely blown away by this because you’re really designing for complex social challenges. Is there a system or a process or a philosophy that you follow that spurs so much innovation in your organization?
Shona: I suppose the fact that the philosophy is just grounded in what do people need rather than: What do I want to do? So the whole team is constantly looking at what is needed, evolving and changing that constantly. I would say that one of the things we do the most is change. I know a number of people joining the team have really found that difficult, and that we never stay consistent for more than a year or two in what we’re doing.
We evolve as people’s needs evolve, as policies, as financial systems change. I think innovation is born out of need, just addressing need in the most effective way. So, it’s not just product need, but it’s how that product gets to people. And whether it is an early childhood development program, training on inclusive education… or whether it is an outreach clinic, or just a back support system for a wheelchair, that has to be the best it can be possible for the person at that time. And in doing that and getting feedback from people, we’re constantly learning. So, as a learning organization, our focus has to be on changing because as we learn, we need to change.
Denver: What is your major focus at the moment? What are you really excited about today?
Shona: I’m really excited about so many things, but I would say that the one thing that really, is getting me fired up every day is a project that we launched during COVID, where we realized that parents were completely isolated from access to health services, access to education support, scared of not being able to do the right thing for their children because the knowledge and the skills have historically been tied up with professionals in these sectors. And many parents have not been exposed to the information that they actually need as parents to interact and add benefit to their children.
So, we created an online training app to be able to link parents together in a network across South Africa. And we’ve up-skilled those parents to actually be the champions of their own child’s information. And together with that, we launched an app for them to be able to monitor the policies that affect them on a daily basis. There’s a white paper in South Africa on the rights of children with disabilities, and now parents can get onto that app at any time of the day and report a barrier that they’re facing.
It’s a live data that constantly comes through and we’re able to use that information to design training to upskill parents further and also to take that information and inform policy with it. So, parents have really, through this process, become the knowledge-holders of their own child’s disability, and they have created for themselves a significant network of support, which I think and I’m really hoping, will change the face of disability in South Africa.
Denver: You’ve created an army of advocates in doing this. So I guess if there’s a silver lining that’s come from COVID, that would be one of those silver linings.
Shona, tell us about that breakthrough collaborative Catalyst 2030, the impact it has had, maybe the impact it’s had on you, and an update on its progress.
Shona: I first got involved with Catalyst right at the beginning when we were dreaming about: How can we, as social entrepreneurs, collaborate more effectively to really see systemic change take place in our lifetime? And we have through this process– which I think when we first started we were dreaming might happen, and already two, three years later, we’re seeing– significant collaborations happening.
People who we never guessed would talk to each other are now partnering and people are taking note. I mean, funders, we’ve been able to put together statements that we’ve come together to design– to help inform… and identify and inform better ways of funding, better ways of working together, better ways, really, of coordinating our work.
And although it’s still in its infancy, we are seeing a significant shift. I know that I’m now part of the South African chapter: we’re busy building a plan of how we’re going to catalyze the work further within this region and bring more social entrepreneurs together so that we don’t work in these silos. We’re not chasing our single agendas, but are really aware of each other’s work and find the touch points that create that magic space where you can say, “I’m doing this; you’re doing that; how can we do more together?”
“Our work is really focused on ensuring that disability becomes a common discussion in every aspect of life, whether it’s architecture, transport, financial planning, or disability services. All those conversations need to be driven through a growing awareness around the bias and stigma we carry ourselves around what disability means.”
Denver: Finally, Shona, Shonaquip Social Enterprise goes beyond wheelchairs, as you’ve alluded to, and is working to build sustainable ecosystems that support inclusion. Tell us about that work and the future vision that you see around inclusion.
Shona: Inclusion of people with disabilities has historically been siloed in a space around charity and pity and often poverty. And even the disability sector itself has kept its own areas separate from each other so that you would have the sector for the visually impaired, the sector for intellectual disability, people with physical disabilities, and each of those sectors has, in a way, been forced through the management of relying on donor funding to not really collaborate or share because there’s always this fear that you’re going to lose an opportunity for funding; and so even within the disability sector, there is very little inclusion.
Then you start looking at the much broader society, where you look at: How are people with disabilities included in education– historically again in special schools… separate, and then look at: How are people included in work?– sheltered workshops. So, our work is really focused on ensuring that disability becomes a common discussion in every aspect of life, whether it’s architecture, transport, financial planning, or disability services.
All those conversations need to be driven through a growing awareness around the bias and stigma we carry ourselves around what disability means and exploring that through our tools– which we correlate to disability– so that we start entering any discussion with inclusion top of mind and not as something that is separate.
Denver: I hear exactly what you’re saying. Often, it’s an add-on to what somebody else is doing, but it’s really got to be the start of the conversation and the center of the conversation.
For listeners who want to learn more about Shonaquip, or maybe financially support your foundation, tell us about your website and what people will find there.
Shona: Our website is shonaquipse.org.za;( it stands for social enterprise), and you can hop on there and find all our work under one site, both our business work– which is the wheelchair provision, our impact and social development work, and our Champions of Change work.
Denver: Great. Thanks, Shona, for being here today. It was such a pleasure to have you on the show.
Shona: Thank you so much, Denver.