A report by Swachh Bharat Mission says that 74.5 per cent of public places are equipped with toilets. Another report by the Ministry of Jal Shakti states that there are 2.23 lakh Community Sanitary Complexes built across all States and UTs under the Swachh Bharat Mission (SBM) since October 2014. Over 92 lakh toilets have been constructed since the launch of SBM Gramin (SBM (G)) in April 2020.

While toilets are there, are they accessible? This is the question one should ask. The National Family Health Survey (NFHS) focuses on 131 health indicators, but not until the NFHS 5 survey did they include the question of accessibility of toilets in the survey. This happened after the inputs from the Department of Drinking Water and Sanitation (DDWS) and the Ministry of Health & Family Welfare questioned the accessibility.

One might ask, why is the question of accessibility so important? The answer is quite simple. Access to water, sanitation and hygiene is the most basic human need and is also included under the Sustainable Development Goals by the UN.

Are These Numbers Real?

This thought crossed my mind because back in 2021, I went on a solo trip, on a bus to Udaipur from Delhi. There, the bus made two stoppages. This was done so people could get a quick dinner and freshen up, relieve themselves and be prepared for the rest of the journey. This was a nightmare. The bus only stopped for 10 minutes. While some men used the washroom, others went to the bushes.

For the women, there were three cubicles. One of them was broken, and the other one did not have a light bulb, which meant only one was usable. There was a long queue for that cubicle, and time was short. There was no point in trying to find an isolated corner, because it was past midnight, in an unknown area.

I waited anxiously. When finally, my turn came, I saw an overused, dirty washroom. The toilet seat is in a horrible condition. I wanted to touch nothing there. But I had to pee. So, I used my mask to cover my nose from the odour, folded my pants so they did not touch the floor and squatted. It was quite a task to balance.

On my way back to Delhi, I made sure to not drink any water for over a 13-hour bus journey. I dehydrated myself so I did not have to use the washroom. When I did reach, I was severely dehydrated and was sick for three days.

I shared my experience with my friends only to realise that many women have faced the same. There are no washrooms for women.

A friend of mine told me that it is because these roads and dhabas are mainly designed to serve men. They are the ones who travel at night or are on the roads most of the time. As a result, the few women who do travel or are on the road suffer.

Health Risks Women Are Prone To

Well, it is true, but partially. While holding your pee for too long can lead to health risks, peeing on a dirty toilet seat cannot lead to infections unless your urethra is in contact with the bacteria present on that toilet seat. However, nobody wants to sit on a dirty toilet seat, even if you do not get an infection. A safe and hygienic toilet is a basic need.

One of the regular saleswomen, Usha, who visits my house shared her experience with me. “Being on the road constantly means I must use the dirty public washrooms. But I do not want to use them. So, sometimes I ask my regular customers to let me use their washrooms. Some say yes, and some say no. I understand they are also concerned about their safety and privacy,” she says. As a result, Usha spends most of her day not drinking enough water and holding her pee when she is at work. Due to this, she also suffered from a Urinary Tract Infection (UTI).

Her friend, Halima too faced similar problems and due to increased levels of uric acid in her body, she suffered from Hyperuricemia.

Other health risks are kidney stones and other kidney problems, headaches, dull skin, xerostomia or dry mouth, fatigue, and urinary incontinence, which means losing control over your pelvic floor muscles leading to uncontrolled leakage of urine, seizures and weakness.

What Can You Do?

Wear comfortable clothes and capris. Capri pants are comfortable and are short in length, which means this won’t touch the toilet floor when you squat or sit.

Carry Essentials

Even though you cannot get a UTI alone from sitting on a toilet seat, it is always safe to carry a toilet seat sanitiser. If nothing, it can help you get rid of the bad odour so you can use your stand and pee device inside the toilet. You can also use disposable toilet seat covers if your knees are weak, and you cannot squat. Always flush with your seat down.

Always keep disposable gloves, a portable bidet (fill it with water before use), a pocket liquid handwash, wet wipes, tissues and sanitiser handy. Do not forget to keep extra sanitary pads. It might sound a lot, but I promise that it all fits in one pouch. Use this travel-friendly pouch every time you are on the road, or using a public washroom.

What Can We Learn From Others?

However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!

Step into a busy OPD, and you will see it: people coughing but not paying much attention. Tuberculosis is still around, just quietly spreading. By 2024, one out of every four global TB infections was recorded in India.

More than a number, each case hints at missed chances, tiny failures in spotting or stopping the disease that swell into widespread strain.

In earlier times, TB was common and very hard to recover from. Crowded homes, lack of fresh air, and low income open doors for germs to move fast. When hunger weakens people too, their bodies fail to hold back hidden sickness. But that is only part of what happens now. Conditions like smoking, drinking, high blood sugar, or HIV have slipped into view, tying daily habits closely to how often TB strikes.

After that, finding the right treatment can feel like a struggle. Some people start by visiting private clinics, shifting between different doctors until they finally learn what is wrong. Every wait means more time lost, moments when illness keeps growing without check.

Tuberculosis: What Takes The Biggest Toll?

Adults in their prime work phase feel it most. Males, particularly over the age of fifteen, carry heavier loads - a pattern the World Health Organization keeps pointing out. Yet biology alone doesn’t explain it.

Who shows up for treatment, who waits too long, who gets missed entirely, it's all written into the pattern. Older people, men, and anyone struggling with poor nutrition, using tobacco, or living with diabetes, show up more often in India’s national health data. The numbers tell a consistent story.

Tuberculosis: Late Symptoms

Here’s what happens. Tuberculosis usually shows up too late. Close to 60 percent of those feeling sick skip early help. Ongoing cough, body heat, weight loss, and night sweats are early signs. Some self-treat. For many, money becomes a barrier. Then comes the expected outcome - severe illness, tougher treatments, more time healing.

Still, false beliefs hang on. Air carries TB, not hands. Passing a meal does not pass the disease, yet shame can hold someone back from care. Cough that won’t quit, rising heat in the body, pounds slipping away, sweat at night - these hints show up early but get ignored till chances shrink.

Fighting TB in India isn’t only about medicine; it lives in habits, choices, and how people see illness. If getting help fast stays rare instead of routine, the disease keeps moving quietly through packed houses, buzzing health rooms.

Dr. Harish Bhatia is Senior Consultant in Pulmonary Medicine at Yatharth Hospital, New Delhi.

Today, the fitness scene has gained much traction among the Gen Z population. With more and more young people spending time in the gym and working out, it is important for fitness enthusiasts to remember the importance of leg stiffness and its impact on spine health. Leg stiffness has the potential to cause unnecessary strain on the spine and back during workouts.

From a neurosurgical point of view, we see that the spine is not just a mechanical support structure but a sensitive pathway through which the spinal cord and nerve roots run. Repeated micro-strain caused by poor flexibility can cause young patients to suffer early degenerative changes that may cause nerve irritation.

We also see that strengthening the abdominal muscles is essential in stabilizing the spine, thereby preventing disc injuries. Early intervention in minor complaints, such as back stiffness or nerve pain, is essential in preventing more serious problems that may need surgical intervention.

The Link Between Leg Stiffness And Spine Health

The muscles in your legs are important for your spine's health. The hamstring, hip flexor, and calf muscles are all significant players in the movement and positioning of your spine. Leg stiffness has the potential to cause unnecessary strain on the spine and back. Leg stiffness limits the movement and positioning of the hips and the spine.

When these muscle groups are tight, they alter pelvic alignment and increase load on the lumbar spine. Over time, this abnormal biomechanics can lead to disc stress and facet joint overload.

In neurosurgical practice, we often see young patients presenting with early symptoms of nerve compression where underlying muscle imbalance and stiffness play a contributory role.

Common Gym Mistakes That Increase The Risk

For young people, the main focus in the gym is on strength training, while flexibility and rest are ignored. This makes the condition of the legs stiffer. Another common error is improper posture while performing certain exercises in the gym. When the legs and hips are inflexible, proper posture is difficult, which causes pressure on the spine.

Sitting for a long time, studying, playing games on gadgets, etc., causes the hip flexors and the hamstring muscles in the legs to become stiffer, which causes pressure on the spine.

From a clinical standpoint, improper lifting techniques combined with stiffness can increase the risk of lumbar disc prolapse and nerve root irritation, conditions frequently encountered in spine clinics.

Tips to Prevent Spine Problems In The Gym

• Warm-ups: It is important to warm up the body before performing weightlifting exercises in the gym. It is recommended that the warm-up process take at least 5–10 minutes.

• Flexibility: It is important to include flexibility exercises in the gym routine, as they help in the proper movement of the legs, which in turn helps in preventing spine problems.

• Proper Posture: It is important to maintain proper posture while performing certain exercises in the gym, like squats, deadlifts, etc.

• Stretching After Workouts: This will help in the release of tension in the muscles and prevent the buildup of stiffness.

• Balance of Training and Recovery: This will help in maintaining the flexibility of the muscles and the spine.

Additionally, from a neurosurgical perspective, core strengthening plays a crucial role in stabilizing the spine and reducing the risk of disc-related injuries. Early attention to minor symptoms like back stiffness or radiating pain can prevent progression to more serious conditions requiring intervention.

Common Spine Problems To Avoid

Common spine problems to avoid during gym workouts include Herniated Disc, Sciatica, Spondylolisthesis, and Muscle Strain. These can occur from poor form, heavy lifting, or lack of warm-up.

In advanced cases, such conditions may lead to nerve compression requiring specialized evaluation and, rarely, surgical management. However, most of these issues are preventable with correct technique and conditioning.

Fitness enthusiasts in the Gen Z generation need to understand that it is very important to develop strength in the body while at the same time maintaining flexibility. The solution to the problem of a stiff leg is the foundation of protecting the spine and improving workout performance. This is achievable through the right warm-up, correct workout, and correct lifting.

Dr. Gaurav Batra is a Consultant - Neurosurgeon (Brain & Spine) at Max Hospital, Vaishali.

A recent meningitis outbreak in Kent University has led to many people wandering about the MenB vaccine and whether they should be getting it. The UK Health Security Agency (UKHSA) with NHS England and the government is already coordinating a targeted vaccination programme against Meningitis B- the strain identified to cause the outbreak.

Who Is Eligible for MenB Vaccine?

As per UKHSA, anyone in the following group has been offered preventative antibiotics which is also known as prophylaxis, is being offered the MenB vaccine. As of now, this includes:

• close contacts of those who are confirmed or suspected to have meningococcal disease
• students at the University of Kent who are normally resident on the Canterbury Campus, including those who may have now travelled home. Some staff living or working in these Halls of Residence have also been offered preventative antibiotics and are eligible for vaccination
• students who attend other universities in Canterbury, living in halls of residence or off-campus locations where there has been a case, and have been advised to take an antibiotic due to a close contact by UKHSA
• sixth form students (years 12 and 13) attending a secondary school or sixth form college in Kent where there has been a confirmed or probable case of meningococcal disease informed by local risk assessment
• anyone who visited or was working at Club Chemistry in Canterbury between 5 March and 15 March, when the venue closed voluntarily

Read: Fact Check: Did Keir Starmer Say UK ‘May Need To Go Into Lockdown’ If Meningitis Cases Keep Rising?

Is there Any Risk To The Public?

As of now, notes UKHSA that the risk of infection to the wider public remains low. This is because transmission of MenB requires close and prolonged contact to spread. This could only happen when people are living in the same household and with intimate contact such as kissing or sharing drinks or vapes.

The bacteria, notes UKHSA, are not as contagious as the other infections like measles and COVID 19.

Why Are Antibiotics Being Prescribed?

Antibiotics play an important role, and almost an immediate one when it comes to responding to an outbreak. For anyone who has been in close contact with a confirmed or suspected case, preventative antibiotics are being offered to them to clear any meningococcal bacteria they may be carrying. This will reduce the risk of them becoming ill or passing the bacteria on to others.

Most Commonly Asked Question: I've Had The MenACWY Vaccine, Do I Still Need MenB Vaccine?

The simple answer is a yes. UKHSA notes that if you are eligible for the MenB vaccine despite the fact that you have taken MenACWY vaccine, you should come forward and take the MenB vaccine. This is because the MenACWY vaccine does not protect you against the MenB strains, as they are both different strain. MenB has been identified as the primary cause of meningitis outbreak in Kent University.