Contrary to what Hamlet claims, "to be or not to be" is not the question, as far as I'm concerned. The choice which has preoccupied me frequently during my life is - manual or electric? As I'm paralysed from the neck down, I cannot propel myself in a manual wheelchair. To drive a chair on my own, I need to use a battery-powered one and control it using my left foot - the only one of my limbs with enough movement. So I face a choice between being pushed in a manual chair or driving myself in an electric.
From my perspective, there are two distinct advantages to using a battery-powered wheelchair. If you want to go on a long, outdoor trek, an electric wheelchair generally has more stamina and endurance than most carers do. I remember a few years ago a disabled friend telling me an amusing anecdote about one of her holiday sightseeing 'walks'. She set out in her electric wheelchair and was still going strong three hours later. But early on, her carer struggled to keep up and by the end of the excursion she was trailing a long distance behind, hot, aching and out of breath.
Apart from a brief foray into a Swedish pine forest, I'm not someone who usually relishes the "great outdoors". However, an electric wheelchair is also very useful when attending parties or drinks receptions. It's much harder to 'mingle' in a room full of people when you're being pushed by a carer.
Obviously, my carers don't know all my acquaintances by name, so if I'm in a manual chair and I spot someone in a room I'd like to chat to, I have to describe to my carer which person I want to approach. Not only do I feel selfconscious doing this (I'm always worried that someone will overhear my description and laugh or, even worse, be offended) but there's also the possibility that my carer might mishear or misunderstand me and push me up to the wrong person.
It's rather embarrassing to find oneself advancing towards a perfect stranger or someone you don't particularly want to talk to, and suddenly having to make conversation with them. You can't exactly be honest and say to them, "Actually, I had no intention of talking to you. My carer just pushed me over here by mistake". Similarly, people I would prefer to avoid may come up to me, and if I'm in a manual chair it's easy to get stuck talking to them. You are, in a manner of speaking, a sitting target.
During most of my school and university career I used an electric wheelchair more than half the time. Yet, since moving to London 10 years ago, I've only ever used a manual chair. These days I rely on carers, relatives and friends to push me wherever I need to go. You might think this strange. After all, doesn't this mean I have less independence and freedom than in the past? However, the truth is that, with my current lifestyle, I find a manual chair far more practical.
For a start, a manual wheelchair enables me to access more places. Now and again I visit friends' homes which have steps up to their front door or I'm invited to private functions held in upstairs floors of restaurants and pubs that don't have a lift. Friends are usually very willing to carry me but this simply wouldn't be possible with a heavy electric wheelchair. Over the years I've lost count of the number of times I've been lifted up and down flights of stairs by friends who've consumed a few alcoholic drinks during the evening. It breaks every health and safety rule in the book but I don't need to fill in a risk assessment form for activities in my social life.
My manual wheelchair is also easier to manoeuvre. Most battery-powered chairs can only climb up a step under four inches which means particularly high kerbs pose a barrier. In a manual chair, if my carer agrees, I can get in and out of some taxis and trains without having to wait for a ramp, simply by someone tilting the chair onto the back wheels.
Usually I find I can reach my destination more quickly in a manual chair than in my electric one. Although the movement in my left foot is stronger and more reliable than in my hands, it's still not perfect. In the days when I regularly used my battery-powered chair, I used to find that the keener I was to travel quickly, the more inaccurate my foot movement would become. This would annoy me and as I grew more frustrated, inevitably my foot movement would become even less precise. And so a vicious circle would develop. I can easily imagine such a scenario occurring at work if I was trying to get to the studio in a hurry or was running late for a meeting.
Another advantage of my manual chair is that it's considerably smaller than my electric wheelchair. In tight offices, busy restaurants and crowded pubs, a small chair is a tremendous help. I've also come across a number of buildings with lifts and corridors which are only just big enough for my manual chair to squeeze into. There are many situations when a "Sherman tank", as my friends nicknamed my electric wheelchair, would be a distinct liability.
Finally, a manual wheelchair doesn't require any physical effort on my part. Operating my electric wheelchair with my foot used to be quite tiring, especially if I drove it for long periods. (I know some people use a suck and blow switch but I've never fancied that). These days I prefer to devote the energy I do have to my job and other commitments.
Some disabled people probably think I'm crazy for preferring to use a manual chair. I once heard a prominent disabled person assert that every wheelchair user should be able to move their chair themselves in order to be independent. But I'm adamant that a manual chair is the option that works best for me. Even if I used an electric chair I would still need carers around me most of the time to help with all the other tasks I can't do myself, so I wouldn't be any more self-sufficient.
What's clear to me is that I'm lucky to have a choice over what type of wheelchair to use. It's estimated that 65 million people worldwide require a wheelchair but more than 20 million of them do not own one. This is despite the fact that personal mobility has been recognized by the UN as a fundamental human right. According to article 20 of the UN Convention on the Rights of Persons with Disabilities, governments must ensure disabled people can obtain quality mobility aids at an affordable price. In many developing countries, however, access to wheelchairs is severely limited. Even when people do acquire a wheelchair, it may not be suitable for them and cause medical complications.
Without mobility, it's impossible for a disabled person to take part fully in the life of their community. No wheelchair means people can't go to school, to work, to market or participate in local decision-making. But the lack of a wheelchair can also kill someone. Gladys Charowa, a member of a disabled women's support group in Zimbabwe, says: "I was one of 19 disabled people being rehabilitated in 2001. Now I am the only person alive. The rest have died because of pressure sores. If someone can't afford a wheelchair and is using a wheelbarrow and doesn't have a cushion, what do you expect?".
Last year the World Health Organisation published new guidelines on the provision of manual wheelchairs in developing countries. These guidelines aim not only to increase the supply of wheelchairs but also to ensure they are fitted properly and that disabled people are trained on how to use them. It is vital that these new guidelines are implemented effectively. In the coming years, the need for wheelchairs is likely to increase due to population growth, more people living longer and a higher survival rate from serious injuries.
One of the leading charities in this field is Motivation, which has helped more than 40,000 people in 30 developing countries since it was founded in 1991.
Motivation helps to set up workshops in developing countries to produce wheelchairs for local people.
They also mass produce a range of appropriately-designed low-cost wheelchairs which can be assembled and fitted on site by local services and are suitable for rural terrains.
For example, they have devised a three-wheel chair ideal for conditions in Cambodia that can be distributed as a flatpack in rice bags. The charity also trains local therapists on how to assess an individual's wheelchair needs and advise users on wheelchair maintenance.
Last month the American government bailed out Wall Street with a $700 billion rescue package. Meanwhile, Chancellor Alistair Darling was forced to inject £50 billion into British banks to stabilise the financial system on this side of the Atlantic. It's a sobering thought that just £2.4 billion would be enough to provide a wheelchair for every person in the world who needs one, wheelchairs that can transform people's lives. In the words of one paraplegic person in Tanzania: "People treat me differently since I got my wheelchair and became more independent. I now have a wife, a child and a business, just like my friends. We are the same, we are equal now."