“Yeh kaise aaye hai?”
This first comment followed us through the wooden doors of the theater, accompanied by snickering from the group of young boys who had said it. Inside, the lobby was flooded with bright fluorescent light, movie posters stretched from floor to ceiling, and the overpowering smell of buttered popcorn and samosas. My family waded through it, working my grandmother’s wheelchair through the clusters of people. I was ten then, and my family and I were there to see Rocky Aur Rani Kii Prem Kahaani, a love story full of dramatic romance, colorful sets, and feuding families. Her chair was bulky and high-backed, wide enough to support her body, with two footrests that jutted several inches beyond her feet. She had progressive supranuclear palsy, a neurodegenerative disease that had taken away her ability to walk and weakened her muscles, requiring a wheelchair specially adjusted to accommodate her needs.
The same group of boys called after us again, their voices mocking. “Isko movie dekhna hai?”
They laughed, looking from my grandmother to one another, as if the very idea of her wanting to see a movie were a joke itself. We kept pushing, leaving their laughter to dissolve into the crowd.
At the entrance to the screening room, the smooth tiles gave way to a ramp. It was short and sharply inclined, a steep slab of concrete wedged between two levels. As we approached it, the wheelchair tipped forward. Going down face-first would shift my grandmother’s weight toward the footrests, making the chair difficult to control and putting her at risk of falling. So my family did what we had learned to do from adapting to spaces that had not adapted to her: We turned the chair around. I watched as the wheels caught against the incline and my grandmother’s body tensed while gravity pulled her backward down the ramp.
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By then, my grandmother’s illness had taken away her ability to walk independently. But before we even reached our seats, it became clear that the wheelchair itself was not the problem; the problem was the space around it. Like many public spaces, ramps were built at the wrong angle, so steep that if any wheelchair user went down it facing forward, they could tip out. My family learned to roll my grandmother backwards instead, easing her down while strangers stared as if her presence were the strange thing, not the fact that a public space had no safe way for her to enter or move through it.
Health care innovation is often discussed as though access can be engineered into a device: a better wheelchair, a smarter monitor, or an AI-powered communication system. Many of these technologies work extraordinarily well for the people and environments they are designed to serve. But those same solutions do not necessarily accommodate everyone, particularly when differences in bodies, infrastructure, and geography are treated as secondary design considerations or not considered at all. My grandmother’s experience taught me that a device cannot be separated from the world in which someone must use it.
This problem affects an enormous population. The World Health Organization estimates that about 1.3 billion people, or roughly one in six people worldwide, live with a significant disability. Those numbers should have made accessibility central to how we design care. Instead, disability is still too often treated as an afterthought.
When my grandmother’s disease weakened the muscles in her neck, she needed a wheelchair with sufficient head and lateral support to keep her body safely positioned. My family searched tirelessly for one in India. We called suppliers, compared models, and contacted different vendors, but none of the available chairs could provide a configuration her condition required. So we resorted to jerry-rigging our own solution: a mountain of pillows carefully arranged around her neck, family members repeatedly adjusting my grandmother’s posture, and constant attention to whether her head was falling forward.
The technology existed, but getting it from Utah to Kolkata was nearly impossible.
The same pattern appeared with smaller devices. My family once tried to use a glucometer from the United Kingdom designed to connect to a phone so that readings could be monitored remotely. Unfortunately, it would not connect to an Indian phone. A feature advertised as “remote” still depended on a local ecosystem: compatible phones, supported software, regional app availability, and reliable connection. The monitor might have been able to cross international waters in a carry-on, but its infrastructure could not.
Disability scholar Rosemarie Garland-Thomson offers a useful word for this problem: “misfit.” A fit occurs when a person’s body and its environment work together to support the person’s needs; a misfit occurs when the environment fails to accommodate the body. This distinction relocates where the problem truly lies. Inaccessibility is produced at the moment wheels meet a ramp too steep to descend safely. The inherent properties of a wheelchair are irrelevant to whether a building is encountered as inaccessible. The incompatibility truly emerges when a public space’s architecture and occupants have exceptionalized the presence of a disabled body.
Seen this way, accessibility exists as an ecology: a network of relationships among bodies, devices, buildings, software, caregivers, transportation systems, manufacturers, and social expectations. Each depends on the others. After all, a perfect communication device cannot provide independence if replacement parts and trained technicians are continents apart.
Designing for disability therefore requires designing for the local environments in which technologies will actually be used. Manufacturers could test medical devices across regional phone systems and electrical standards. Mobility equipment could be modular, built from interchangeable parts that can be individually replaced or adapted, so repairs can happen locally, allowing headrests, lateral supports, and special controls to all be accounted for. Accessibility standards should account for not merely whether a ramp exists, but whether a wheelchair user can actually navigate it safely.
Eventually, we got my grandmother down the theater ramp. We hurried down the hallway, found our seats, and maneuvered her chair into place. The lights had already fallen, and Rocky Aur Rani Kii Prem Kahaani had begun. While Rocky and Rani were already busy falling in love onscreen, my grandmother had been outside, being rolled backwards down a ramp just to get there.
The boys had wondered how she had gotten there and whether she really wanted to see a movie. By the time we reached our seats, the irony of their questions was clear: Getting there had been difficult; wanting to be there never was.
The goal is a world where there is no reason to ask either question, a world in which my grandmother could have entered through the same doors, moved smoothly through the same hallways, and watched Rocky and Rani fall in love from the very beginning, instead of us struggling while trying to figure out how to get her into the room.
Roshni Nair is a high school student. Roshan Agarwal is an oncologist.
