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!

Amid India's growing burden of high blood pressure among the youth, Prataprao Jadhav, Union Minister of State (I/C), Ministry of Ayush and Minister of State for Health and Family Welfare, said hypertension is emerging as a major public health concern due to worsening lifestyle habits.

High blood pressure is a “silent killer” that is rapidly increasing among India’s youth because of unhealthy lifestyle changes, the minister said.

Hypertension Rising Rapidly Among Young Indians

Ahead of World Hypertension Day 2026, Jadhav noted that the condition often progresses without visible symptoms and can eventually lead to severe complications such as heart attacks and strokes.

“In today’s time, it is essential that we make our communities more sensitive and aware and strengthen awareness about hypertension. Due to changing lifestyles and reduced attention to physical and mental health, hypertension is rapidly increasing even among the youth,” Jadhav said in a video message during the ‘Illness to Wellness Conference on Transforming Hypertension Care: Prevention to Wellness’ organized in the national capital.

He highlighted that the Government of India, under the National Program for Prevention and Control of Non-Communicable Diseases (NPCDCS), is actively promoting population-based screening, early detection, and management through Health and Wellness Centers across the country.

Modern Lifestyle Habits Increasing Hypertension Risk

Prof. Rakesh Yadav, Cardiologist and head of the Department of Emergency Medicine at AIIMS, New Delhi, stated that once known to be the disease of the elderly, hypertension is now more common among the youth. The reason — lifestyle changes, the experts said.

“The biggest problem is that despite increasing awareness, people still do not monitor their blood pressure regularly or continue treatment consistently. Hypertension is no longer limited to the affluent or elderly; it is now affecting all sections of society, including children and young adults,” said Prof. Rakesh Yadav, Cardiologist and head of the Department of Emergency Medicine, AIIMS, New Delhi.

“Obesity remains one of the major underlying causes, and regular monitoring of blood pressure and sugar levels, affordable lifelong medication, healthy dietary practices, and weight management are essential to reducing mortality associated with hypertension and related diseases,” he added.

In India, more than 1 in 4 people have hypertension, and cumulatively, more than 90% of adults with hypertension are either undiagnosed, untreated, or treated but live with uncontrolled hypertension.

Experts at the conference also pointed out that modern lifestyles marked by long working hours, constant connectivity, poor sleep, sedentary habits, and rising stress levels are significantly contributing to the growing burden of hypertension and other lifestyle disorders.

Another major concern, they said, is that many people tend to ignore early symptoms until complications arise, negatively affecting treatment outcomes.

“Hypertension is one of the biggest public health challenges today because most people do not take it seriously until complications arise. Nearly one in four adults is affected by hypertension, yet awareness and blood pressure control remain very low,” said Dr. Ripen Gupta, Vice Chairman & Unit Head - Cardiology, Max Smart Super Speciality Hospital, Saket.

Rajesh Bhushan, Former Secretary, Ministry of Health & Family Welfare, said high blood pressure is not limited to urban populations and is increasingly affecting youth in rural India as well.

“The problem of hypertension is as prevalent in rural India as it is in urban India, but because we live in metro cities, we often believe it is only an urban problem. Early detection is extremely important because without early detection, early treatment becomes difficult,” Bhushan said.

Experts Stress Early Detection And Preventive Care

Bushan stated that non-communicable diseases impact GDP significantly across countries, and therefore, prevention and timely intervention are critical.

Hypertension should never be taken lightly, said Dr. Sanjeev Singh, Chairperson, FICCI Medical Education Task Force and Medical Director, Amrita Institute of Medical Sciences & Research Centre. He urged people to follow medical advice seriously to avoid long-term complications.

The doctors called for critical lifestyle interventions for prevention and management. This included:

• annual BP screening,
• aerobic exercise,
• resistance training,
• reduced desk time,
• proper sleep,
• yoga,
• meditation,
• monitoring BMI and waist circumference.

High blood pressure, or hypertension, is often called a “silent killer” because it may cause no symptoms, but serious damage to multiple organs can occur. Most people associate hypertension only with heart attacks, but its ill effects extend far beyond the heart. Persistent high blood pressure can gradually damage the brain, kidneys, eyes, and blood vessels, reducing both quality and length of life.

The heart pumps blood through blood vessels, which carry blood to every organ. When hypertension is not properly treated, blood pressure remains high for years, and these blood vessels become stiff, narrow, and damaged. This affects blood flow to vital organs that these blood vessels supply and triggers multiple health problems.

Hypertension: Stroke And Dementia Risk

One of the most serious consequences is damage to the brain. Hypertension is the leading cause of stroke. A blood vessel in the brain may either get blocked or burst due to excessive pressure, resulting in paralysis, speech difficulty, or even death.

Repeated uncontrolled hypertension can also impair memory and thinking ability over time, increasing the risk of vascular dementia in older age. Many patients are surprised to learn that controlling blood pressure today may help preserve brain function years later.

Hypertension: The Silent Effect On Kidneys

The kidneys are another major target. High blood pressure damages the delicate blood vessels inside the kidneys, gradually reducing their ability to function.

In fact, hypertension is one of the important causes of renal failure leading to dialysis. Unfortunately, kidney damage develops silently and may remain unnoticed until advanced stages. Regular monitoring of blood pressure and kidney function is therefore essential.

Hypertension And Eyesight

The eyes, too, can suffer from uncontrolled hypertension. The tiny blood vessels of the retina may narrow, leak, or bleed, leading to blurred vision or even permanent visual loss.

Eye specialists can often detect signs of long-standing hypertension during routine retinal examination. Sometimes, the eyes provide the first warning that blood pressure has been poorly controlled for years.

Hypertension Weakens Blood Vessels

High blood pressure also weakens arteries throughout the body. It accelerates hardening of blood vessels, increases the risk of peripheral artery disease, and can contribute to aneurysms — dangerous ballooning of arteries that may rupture unexpectedly. In some patients, hypertension is linked to sexual dysfunction, sleep disturbances, and reduced exercise capacity.

Hypertension: How To Curb

The good news is that hypertension is both detectable and treatable. Lifestyle measures remain the foundation of prevention and control.

Maintaining a healthy body weight, exercising regularly, avoiding tobacco, limiting alcohol, and managing stress can significantly lower blood pressure.

Adequate sleep is equally important. However, many patients also require medicines, and these should be taken regularly even when one feels perfectly well.

Adults should check their blood pressure periodically, especially after the age of 30 or earlier if there is obesity, diabetes, or a family history of hypertension. Early diagnosis and proper treatment can prevent devastating complications later.

Hypertension is not merely a “heart problem.” It is a whole-body disease that silently injures multiple organs. Recognizing this reality is the first step toward prevention, timely treatment, and healthier living.

The risk of hantavirus spreading is generally considered low, as repeatedly stated by the World Health Organization (WHO) and other global health agencies, after the recent outbreak on the MV Hondius cruise ship. However, a shocking peer-reviewed study has found that the Andes strain of the rat-borne virus can persist in human semen for up to six years.

More concerning is the possibility that the virus could potentially be transmitted sexually even after a person has recovered, according to the 2023 study published in the journal Viruses.

The research, conducted by Swiss scientists at Spiez Laboratory, suggests that hantavirus may survive in the male reproductive tract like viruses such as Ebola.

What Did The Study Find?

The research team, which included scientists from the University of Bern and the University of Lausanne, investigated a 55-year-old man who had contracted the Andes strain of hantavirus in South America six years earlier.

The researchers discovered that although the virus was no longer detectable in the man’s blood, urine, or respiratory tract, it was still present in his semen 71 months later.

"Viral RNA remained primarily detectable intracellularly in semen samples throughout the complete study period of almost six years," the 2023 study stated,

“Taken together, our results show that the Andes virus has the potential for sexual transmission,” it added. However, so far no confirmed case of such transmission has yet been documented.

Also read: Hantavirus Outbreak: Critically Ill French Patient On Artificial Lung Support

Andes Virus: Male Testes Hidden ‘Reservoirs’?

Hantavirus is not the first virus found to persist in the male reproductive system. According to the study, viruses such as Ebola and Zika are also known to evade the immune system by remaining hidden in the testes for extended periods.

A 2021 Ebola outbreak in Guinea, which resulted in 23 cases and 12 deaths, was later linked to a survivor of the 2014–2016 West Africa epidemic who reportedly transmitted the virus sexually years after recovery.

The testes are considered a biological “safe harbour” for at least 27 infectious diseases, enabling certain pathogens to remain hidden in the body and potentially spread years after a patient has recovered.

Because sperm cells are essential for reproduction, they are shielded from the body’s immune response. However, this immune protection can also create an environment where viruses are able to survive and persist for long periods.

Safe-Sex Guidance For Hantavirus-Infected Individuals

Analysts at Airfinity, a company that tracks global health risks, recommend that male patients should receive “extensive safe-sex guidance beyond the [42-day] quarantine”, the Telegraph reported

The guidance should be “analogous to the World Health Organization’s (WHO) Ebola survivor semen-monitoring protocols,” it added.

The WHO protocols recommend that the semen of male Ebola survivors should be tested every three months and should not be considered virus-free until two consecutive negative test results are obtained.

Until cleared, they should “abstain from all types of sex” or “use condoms consistently and correctly.”

They should also wash themselves “thoroughly” with soap and water after any contact with semen – including after masturbation, according to the guidance.

Hantavirus on MV Hondius

According to the World Health Organization (WHO), 11 people have been affected by the rat-borne virus so far, of whom three have died.

A Dutch couple is believed to have been first exposed to the virus while visiting a birdwatching site in Argentina.

The WHO has confirmed that the Andes strain of hantavirus — the only strain known to spread from person to person — is behind the outbreak.

While all passengers onboard the cruise have been taken care of by health authorities, the virus' long incubation period is a serious risk factor. Which means that even those asymptomatic can turn infectious 6-8 weeks later.