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!

A simple five-factor risk score may help identify people at high risk of dementia, particularly in low- and middle-income countries (LMICs), where around 60% of the world's dementia cases now occur.

Developed and validated by researchers at Northumbria University, the risk score uses five everyday factors to identify older adults at higher risk of dementia. It aims to address a gap in dementia research, as existing prediction tools have largely been developed using data from high-income countries and may not work as well in lower-income settings.

The research team developed the model using data from more than 11,000 older adults across seven countries and three continents.

“We know the burden of dementia is shifting towards lower-income parts of the world, yet the prediction models clinicians and researchers rely on were designed with wealthier populations in mind. This model is a step towards changing that. It is simple, it is built for the settings where it is needed most, and it gives researchers a practical way to find the people who should be the focus of future studies and trials,” said Dr Eduwin Pakpahan, from Northumbria University's Applied Statistics and Data Science Research Group. The study is published in the American Journal of Epidemiology.

What Are The Five Factors Used To Predict Dementia Risk?

Also read: WHO's New Dementia Guidelines Prioritize Healthy Habits, Warn Against Supplements

The model can be applied using information gathered through a straightforward conversation with an older adult and, where relevant, a family member or carer. It does not require blood tests, brain scans or specialist equipment.

The five factors included in the risk score are:

• Age: The strongest single predictor. Dementia risk rises meaningfully from age 70 and more steeply from 80 onwards.
• Social engagement: This includes whether a person is married or living with others, how often they meet friends or family, and whether they participate in community or religious groups.
• Physical activity: The model considers how active a person is in daily life, across both work and leisure. Everyday movement, such as farming, walking to the market or doing household tasks, also counts.
• High blood pressure: Uncontrolled hypertension can damage the blood vessels supplying the brain over time. It is common, often undiagnosed in lower-income settings, and inexpensive to manage.
• Difficulty managing money: A family member or carer is asked whether the person has experienced a noticeable change in their ability to handle finances. This can be one of the early everyday signs of cognitive change.

How Does The Dementia Risk Score Work?

Each factor contributes points towards a total score ranging from 0 to 9. A person scoring 0 has around a 1% chance of developing dementia within three years, while someone scoring 9 has a nearly 19% chance.

The researchers built and tested the model across seven sites in China, Cuba, the Dominican Republic, Puerto Rico, Venezuela, Mexico and Peru. It achieved a performance score of 0.75, above the 0.70 threshold generally regarded as clinically useful.

However, the researchers emphasise that the tool is primarily intended for research rather than routine screening of the general population. It could give researchers and clinical trial teams a practical, low-cost way to identify and recruit people at higher risk of dementia.

The team has also called for the model to be validated in regions not covered by the study, particularly South Asia, the Middle East and North Africa, and Sub-Saharan Africa.

Read More: Dementia Is More Than Forgotten Birthdays, Lost Keys: Doctors Explain Early Signs Before Memory Loss

Why Is A Dementia Risk Prediction Tool Important?

Dementia affects more than 57 million people worldwide, with around 60% of cases occurring in LMICs across Latin America, the Caribbean, Asia and Africa.

Identifying people at higher risk could help researchers in these regions plan studies and clinical trials that better reflect their populations. A simple tool based on everyday information may also make risk assessment more accessible in settings where specialised diagnostic resources are limited.

From Independence Day and Janmashtami to Ganesh Chaturthi, Onam, Eid, Navratri, Dussehra, Diwali, Christmas and New Year, the period from August to January means celebrations across the country. However, some can also suffer from stress, loneliness and worsening of pre-existing mental health symptoms.

In India, festivals can provide connection, cultural continuity and family bonding. However, celebration is not positive for everyone. For some, the period can lead to issues such as social pressure, loneliness, grief, financial concerns and even interpersonal conflict. Festive periods can be challenging for the general population, while people with pre-existing mental health conditions may be vulnerable to worsening symptoms, increased sensitivities or relapse.

Festivals carry an expectation that everyone should be happy. People are expected to participate, dress up, attend gatherings and appear enthusiastic. Though some may experience anxiety, burnout, depression or emotional exhaustion, maintaining this expected level of participation can become another source of stress. Emotional wellbeing does not automatically change because it is a festival. Recognising this can reduce guilt and self-criticism.

Family Gatherings And Emotional Sensitivities

Festivals frequently bring extended families together. While this can strengthen relationships, it can also reactivate longstanding interpersonal dynamics. Questions about marriage, children, career, finances, appearance or personal choices can become uncomfortable, particularly when they touch existing vulnerabilities.

For someone who has experienced criticism or comparison within the family, a seemingly casual festive comment may carry considerably more emotional weight because of the history attached to it. The festive setting can therefore bring individuals into closer contact with relationships or unresolved issues that they may otherwise have greater distance from.

Also read: Excessive Screen Time & Mental Health: Expert Urges Parents To Limit Children's Screen Time At Times Health Summit 2026

Why Clinical Populations May Be More Vulnerable

For individuals already living with a mental health condition, the festive season can introduce several stressors simultaneously. Travel, disrupted sleep, irregular meals, increased social stimulation, financial pressure, family conflict and interruptions to established treatment routines can place additional demands on psychological functioning.

People with conditions such as depression, anxiety disorders, bipolar disorder, trauma-related conditions, obsessive-compulsive symptoms, eating disorders or other psychiatric difficulties may be more sensitive to these changes.

In individuals with a history of recurrent episodes, significant disruption may also contribute to relapse. Festivals themselves do not necessarily cause relapse. Rather, the accumulation of environmental, interpersonal and behavioural stressors can increase vulnerability in someone already at risk.

Changes from an individual's usual baseline such as significant alterations in sleep, appetite, mood, anxiety, irritability, impulsivity, social withdrawal or functioning can therefore be important early warning signs.

Grief Can Become More Visible

Many traditions are built around shared experiences: preparing food, decorating homes, travelling to family members, exchanging gifts or gathering for meals. When someone important is no longer present, familiar rituals can make their absence more noticeable.

This can occur during religious festivals as well as occasions such as Independence Day or New Year, when people naturally reflect on their lives and relationships. Participating in a celebration does not mean grief has disappeared, just as sadness during a celebration does not eliminate the capacity for joy.

The festive season can also place pressure on household finances. Clothing, gifts, travel, home decoration and social events can increase expenditure over several months. For those already experiencing financial uncertainty, this can create considerable stress.

People living alone, those estranged from family, individuals experiencing relationship difficulties, older adults and people who have recently relocated may become more conscious of social isolation during this period. New Year can be particularly challenging because social expectations around parties, relationships and celebration become highly visible.

Also read: Can Mental Health Improvement Help Lower High Blood Pressure? Study Points Towards 3 Habits

Indians Living Abroad: Culture, Belonging and Homesickness

Celebrating Diwali, Eid, Navratri, Onam, Christmas or Gurpurab away from India can provide an important connection with cultural identity and family traditions. At the same time, it can highlight physical distance from parents, siblings and extended family.

A person may attend a community celebration abroad while still missing the food, sounds, neighbourhood atmosphere and family rituals associated with celebrations in India. Those unable to travel home may experience increased homesickness, particularly when several major occasions occur within a short period.

Festivals Can Be Difficult For General Population Too

Feeling tired, overwhelmed, irritated, lonely or emotionally sensitive during a demanding period does not automatically indicate a psychiatric disorder.

Even psychologically healthy individuals can experience festive stress because of travel, social obligations, financial commitments or difficult family interactions.

Making The Festive Season Psychologically Sustainable

• Set boundaries around intrusive questions: “I’d rather not discuss that today” or “We’re comfortable with where things are right now” can end conversations about marriage, children or finances without confrontation.
• Decline invitations without over-explaining.
• A smaller number of meaningful gatherings may be preferable to trying to attend every event.
• Decide spending limits for gifts, travel and celebrations in advance rather than responding to social pressure.

For those receiving mental health care, prescribed medication, therapy and established support systems should not be casually disrupted during the festive period.

Curated festive content represents selected moments, not the entirety of another person's life.

Professional support becomes particularly important when festive stress is accompanied by persistent hopelessness, severe anxiety, substantial social withdrawal, changes in sleep or appetite, increased substance use, impaired functioning or other marked behavioural changes.

The goal is not to remove complexity from celebration, but to make space for it. Allowing people to experience the festive season without the pressure to feel festive can itself be an important form of psychological care.

By Ms Dhara Ghuntla, Psychologist/Psychotherapist, Sujay Hospital, 7 Hills Hospital & Criticare Hospital

As Delhi wakes up to another spell of deteriorating air quality just days ahead of Diwali, ophthalmologists warn that dust, smoke, particulate matter, and toxic gases can affect children's eyes, triggering redness, itching, burning, excessive watering, and dryness.

On Tuesday, India's national capital's average Air Quality Index (AQI) climbed to 331 at 7 am, entering the ‘very poor’ category. At the same time, eight monitoring stations recorded readings above 400, falling in the ‘severe’ zone, according to the Central Pollution Control Board (CPCB).

As per data from the CPCB, 33 of the city's 58 monitoring stations recorded AQI levels in the ‘very poor’ category. Meanwhile, the India Meteorological Department (IMD) and the Indian Institute of Tropical Meteorology have forecast that air quality is likely to remain in the ‘very poor’ category over the coming days.

“Children’s eyes are more sensitive to irritants in the environment, and exposure to pollutants, particulate matter and toxic gases can irritate the surface of the eye,” Dr Shibal Bhartiya, Clinical Director – Ophthalmology and Program Director – Community Outreach and Wellness at Marengo Asia International Institute of Neuro and Spine (MAIINS), told HealthandMe.

Also read: Supreme Court Allows Green Crackers In Delhi-NCR Ahead Of Diwali: Are They Really Safe For Your Health?

How Does Air Pollution Affect Children's Eyes?

The experts warned that exposure to pollutants and particulate matter can irritate the surface of children's eyes, causing redness, itching, burning, excessive tearing and dryness.

Dr Neepa Thacker Dave, Senior Consultant in Paediatric Ophthalmology at SRCC Children's Hospital, told HealthandMe that the eye’s surface is protected by a delicate tear film that provides lubrication, maintains clear vision and helps defend against environmental irritants. Exposure to airborne pollutants can disturb this protective layer and contribute to ocular surface irritation and inflammation.

"Excessive watering does not necessarily mean that the eyes are adequately lubricated. Irritation can trigger reflex tearing even when the tear film is unstable. Consequently, children may experience watering alongside dryness or discomfort," she said.

Further, children with existing allergies or sensitive eyes may notice their symptoms worsening during periods of high pollution.

“Long-term exposure to poor air quality may also worsen pre-existing ocular surface conditions,” Dr Bhartiya said.

How Can Parents Protect Children's Eyes From Air Pollution?

Read More: Rising AQI In Delhi-NCR: Doctors Warn Of Lung And Heart Risks As Pollution Builds

Reducing children's exposure to pollution is important, particularly on days when air quality is poor.

Dr Bhartiya advised parents to:

• Avoid outdoor activities when pollution levels are high.
• Keep windows closed during periods of severe pollution.
• Encourage children to avoid rubbing their eyes.
• Ensure children wash their faces after coming indoors.

Dr Dave also highlighted the importance of greater awareness, reduced exposure and timely medical care in protecting children from pollution-related eye irritation and discomfort.

When Should Children See an Eye Specialist?

Dr Dave said children may not always have the vocabulary to describe eye discomfort. Parents and teachers should watch for frequent eye rubbing, excessive blinking, squinting, watering or reluctance to participate in reading and outdoor activities.

Parents should not dismiss eye irritation in children, particularly when pollution levels are high.

Although mild irritation may improve when exposure is reduced, recurring or persistent symptoms warrant an eye examination. Eye pain, significant sensitivity to light, blurred or reduced vision, marked redness or difficulty opening the eye require prompt medical attention.