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!

Many working women who are pregnant tend to dismiss signs such as headaches, swelling, or vision changes, thinking that they are common during pregnancy. However, these issues can be caused by preeclampsia, a serious condition that requires timely attention, especially among busy working women.

What is preeclampsia?

Dr Prachi Sarin Sethi, Senior Consultant – Obstetrician, Gynaecologist & Laparoscopic Surgeon, Motherhood Hospitals, Gurgaon, said, "Pregnancy comes with many physical changes, and it is common for women to experience discomfort such as swelling, fatigue, or headaches. However, sometimes these symptoms may point to something more serious, namely preeclampsia, a pregnancy-related condition that can affect both the mother and baby. Working women tend to ignore the signs of this condition and struggle in silence. Preeclampsia is a condition that usually develops after the 20th week of pregnancy. It is mainly characterised by high blood pressure and can affect organs such as the liver and kidneys. If not managed in time, it can lead to serious complications for both mother and baby."

What are the causes of preeclampsia?

The exact cause of preeclampsia is not known. Certain factors increase the risk, including:

1. High blood pressure before pregnancy
2. First pregnancy
3. Multiple pregnancies (twins or more)
4. Obesity or diabetes
5. High stress levels and lack of rest

What are the symptoms of preeclampsia?

Many symptoms of preeclampsia are mistaken for normal pregnancy changes. These include:

1. Persistent headaches
2. Swelling in the face, hands, or feet
3. Blurred vision or light sensitivity
4. Sudden weight gain
5. Pain in the upper abdomen

Consequences of untreated preeclampsia

Working women may ignore these signs due to work pressure, long hours, or frequent travel, assuming they are just tired or stressed. If left untreated, preeclampsia can lead to serious complications such as:

1. Preterm delivery
2. Low birth weight of the baby
3. Organ damage in the mother
4. Seizures (a severe condition called eclampsia)

Early detection and proper care can help manage the condition and reduce risks.

This is why working women miss the signs

In today’s fast-paced lifestyle, many women continue working through pregnancy without slowing down. Long working hours, stress, irregular meals, and lack of rest tend to worsen symptoms. Many women delay check-ups or ignore warning signs, thinking they are minor issues.

What can women do?

Report any signs and symptoms, such as headaches and vision changes, to a doctor. De-stress by practising yoga and meditation. Monitor blood pressure regularly, avoid overexertion, and maintain a balanced diet consisting of fresh fruits, vegetables, whole grains, and pulses. Avoid junk, oily, and canned foods. It is also necessary to stay hydrated, attend regular health check-ups, and follow-up appointments.

Osteoarthritis (OA), long considered a “wear-and-tear” disease of old age, is increasingly being diagnosed in people as young as 30, according to new research.

The review by researchers at Indraprastha Apollo Hospitals suggests OA should be viewed as a heterogeneous syndrome rather than a single disease. The condition is driven by a combination of biological, biomechanical, metabolic, genetic, and molecular factors, but in youth obesity and poor lifestyle is surging the cases.

“Osteoarthritis is no longer confined to the elderly — we are now seeing patients as young as 30, often driven by obesity and sedentary lifestyles. This research makes clear that osteoarthritis is not a single disease but a spectrum of conditions,” said Dr. (Prof.) Raju Vaishya, Senior Consultant Orthopaedic and Joint Replacement Surgeon, Indraprastha Apollo Hospitals.

Noting that a one-size-fits-all approach may not help, the expert stressed the need for personalized treatment that recognizes the specific phenotype in each patient.

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Six Disease Subtypes Identified

The review, published in International Orthopaedics, identifies six disease subtypes, including inflammatory, metabolic, and pain-sensitization variants. Researchers recommend MRI-based tools and biomarker panels to guide treatment decisions.

Emerging technologies such as AI-assisted MRI scoring and PET-MRI with 18F-NaF may also enable earlier detection and better patient classification, although wider clinical adoption will require standardized protocols and large-scale validation studies.

Osteoarthritis Burden Rising Worldwide

More than 500 million people worldwide live with osteoarthritis, accounting for 7.6 per cent of the global population. According to Global Burden of Disease estimates, prevalence has increased by 132 per cent over the past 30 years and is projected to rise by another 60 per cent by 2050.

Women, people with obesity, and those with previous joint injuries are disproportionately affected.

What Is Osteoarthritis And Its Symptoms?

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Osteoarthritis occurs when the cartilage that cushions the ends of bones gradually wears down, causing joints to become stiff, painful, and less mobile.

The disease commonly affects the knees, hips, and small joints of the hands, although it can occur in almost any joint.

Common symptoms include:

• Joint pain
• Joint stiffness
• Difficulty moving affected joints
• Swelling
• Joint tenderness
• A grating or crackling sensation during movement
• Pain and stiffness after periods of inactivity
• Enlarged or knobbly joints
• Reduced range of movement
• Muscle weakness or muscle loss

How To Prevent Osteoarthritis

Experts say maintaining a healthy weight, staying physically active, avoiding prolonged sedentary behaviour, and preventing joint injuries can help lower the risk of osteoarthritis.

One of the biggest challenges in osteoarthritis treatment is the “care gap.” Many patients are too young or not yet severe enough for surgery but may spend years relying on medications that relieve symptoms without addressing the underlying mechanics of joint stress.

Research suggest gait retraining — adjusting the way a person walks — could help bridge this gap. Unlike medication or surgery, gait retraining is non-invasive and may offer a sustainable long-term solution.

Currently, gait retraining often requires specialized tools such as motion-capture systems and pressure-sensitive treadmills. However, newer approaches, including smartphone-based video analysis and sensor-equipped “smart shoes,” are being developed to make the technique more accessible.

Experts caution against making major changes to walking patterns without professional guidance, as improper adjustments may place additional strain on other parts of the body.

After the COVID-19 pandemic, a large number of young adults returned to social life with unhealthy coping habits such as smoking, vaping, alcohol consumption, late-night eating, and excessive spicy or junk food intake. These are now causing a worrisome surge in cases of mouth cancer in people below 40. Youngsters fail to pay attention to the early warning signs, such as unhealed mouth ulcers, a burning sensation, white patches, difficulty swallowing, or persistent mouth pain, leading to delayed diagnosis. Hence, it is the need of the hour to seek timely treatment, which can save lives.

What is mouth cancer?

Mouth cancer, also known as oral cancer, refers to the abnormal growth of malignant cells in the gums, lips, tongue, or the inner lining of the cheeks and floor of the mouth. Early detection of this disease can help improve survival rates. The symptoms of mouth cancer are:

1. Sore or blister inside the mouth that lasts for two to three weeks
2. Bleeding
3. Numbness
4. Lump or swelling or thickening of the mouth, lip or neck
5. Persistent pain in the mouth
6. Persistent white or red patches in the mouth
7. Difficulty in swallowing or speaking

What are the risk factors for mouth cancer?

According to doctors, mouth cancer can happen to anyone. But there are some risk factors that can make you more prone to developing the tumour:

1. Smoking
2. Tobacco use or chewing tobacco
3. Using betel nut or paan
4. HPV
5. Frequent or heavy alcohol use
6. Excessive exposure to the sun
7. Poor oral hygiene

For timely detection, it is important to go for regular check-ups. If any of the symptoms appear, a biopsy can help with cancer detection.

Why are mouth cancer cases rising among people in their 40s?

Dr Prathamesh Pai, Senior Consultant Head and Neck Surgical Oncologist, Gleneagles Hospital, Parel, Mumbai, said, “There is a spike in cases of mouth cancer among younger individuals aged 25–40. The causes can be smoking, vaping, alcohol intake, poor dietary habits, and spicy junk food. Many youngsters believe mouth ulcers are common and harmless, but any ulcer that does not heal within two weeks should never be ignored. Early symptoms may include mouth pain, white or red patches, bleeding, difficulty chewing, bad breath, or swelling inside the mouth. Also, there is a lack of dental hygiene, and almost no one visits the dentist on a regular basis. In a week, three out of five patients visiting our clinic come with signs of unhealed mouth ulcers, white and red patches, difficulty opening the mouth, or altered speech and swallowing, and are often diagnosed with mouth cancer.”

Tobacco in any form, including vaping, can damage the body from the oral cavity to the lungs, as well as the heart, urinary bladder, and brain. Combined with alcohol, the incidence of cancer rises threefold. Maintaining good oral hygiene, avoiding tobacco and alcohol, reducing spicy processed food intake, and undergoing regular dental or oral check-ups are key to preventing mouth cancer, and early detection can lead to a cure.