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!

White sugar is widely known for its harmful effects on health. As a result, many people—especially those with Type 2 diabetes—turn to low- and no-calorie sweeteners such as aspartame, saccharin, and erythritol, believing they are a healthier alternative.

However, a new study published in Neurology, the medical journal of the American Academy of Neurology, has again suggested that higher consumption of certain artificial sweeteners may be associated with faster declines in memory and thinking skills over time.

The researchers stressed that the findings do not prove these sweeteners cause cognitive decline. Instead, they show an association, meaning other factors could also contribute to the observed pattern.

"Low- and no-calorie sweeteners are often seen as a healthy alternative to sugar. However, our findings suggest certain sweeteners may have negative effects on brain health over time," said study author Claudia Kimie Suemoto from the University of São Paulo, Brazil.

What Did the Study Find?

The study followed 12,772 adults in Brazil, with an average age of 52 years, for approximately eight years. Researchers examined the intake of seven commonly used low- and no-calorie sweeteners:

• Aspartame
• Saccharin
• Acesulfame K
• Erythritol
• Xylitol
• Sorbitol
• Tagatose

These sweeteners are commonly found in ultra-processed foods and beverages, including flavored water, soft drinks, energy drinks, yoghurt, desserts, and products marketed as low-calorie. Many are also sold separately for use in coffee, tea, cooking, and baking.

The researchers found that people with the highest total intake of sweeteners experienced a 62% faster decline in overall thinking and memory abilities than those with the lowest intake. This difference was estimated to be comparable to about 1.6 additional years of brain ageing.

Participants in the middle consumption group also showed a 35% faster decline, equivalent to approximately 1.3 additional years of ageing.

The association was especially strong among people with diabetes, who are more likely to use artificial sweeteners as sugar substitutes.

Stronger Link in Adults Under 60

Age also appeared to influence the findings. Among participants younger than 60, those who consumed the highest amounts of sweeteners experienced faster declines in verbal fluency and overall cognitive performance than those with the lowest intake.

Researchers did not observe the same association among participants aged 60 years and older. The study found that aspartame, saccharin, acesulfame K, erythritol, sorbitol, and xylitol were associated with faster declines in overall cognition, particularly memory. Tagatose was the only sweetener not linked to cognitive decline.

"While we found links to cognitive decline for middle-aged people both with and without diabetes, people with diabetes are more likely to use artificial sweeteners as sugar substitutes," Suemoto said. "More research is needed to confirm our findings and to investigate if other refined sugar alternatives, such as applesauce, honey, maple syrup or coconut sugar, may be effective alternatives."

Are There Any Limitations?

The researchers also acknowledged several limitations in study :

• It did not evaluate every artificial sweetener currently used in foods and beverages, so the findings cannot be applied to all sugar substitutes.
• Dietary intake was self-reported, meaning participants may have inaccurately remembered or estimated what they consumed.
• The study was observational, meaning it identified an association but cannot establish that artificial sweeteners directly caused cognitive decline.

Brain disorders are becoming one of India's fastest-growing public health challenges, said health experts ahead of Brain Day on July 22.

The experts highlighted that an ageing population, rising lifestyle diseases and limited access to specialist care are contributing to an increasing burden of conditions such as stroke, epilepsy, Parkinson's disease, dementia and multiple sclerosis.

Access Gap Delays Diagnosis, Treatment

Dr. Madhukar Bhardwaj, Director & Head of Department, Neurology, Aakash Healthcare, said neurological disorders have become one of India's most urgent healthcare concerns.

"Neurological disorders are no longer a concern of a small section of the population—they are one of the most pressing emerging healthcare challenges of our time. In a country as vast and diverse as India, with a rapidly ageing population, this is a matter of urgency. What makes the situation even more worrying is the lack of equitable access to care," he said.

According to the World Health Organization's Global Status Report on Neurological Disorders (2025), India faces a severe shortage of neurologists, with the neurologist-to-patient ratio nearly 80 times worse than in high-income countries, leaving specialist care concentrated in major cities.

Stroke Increasingly Affects Younger Adults

Experts also highlighted a worrying shift in disease patterns, with strokes increasingly affecting younger people. Dr. Bhardwaj said strokes, once considered a disease of older adults, are now being seen more frequently among people in their 30s and 40s, underscoring the need for greater awareness and prevention.

Lifestyle Diseases Driving Brain Disorders

Doctors identified uncontrolled hypertension, diabetes, obesity, smoking, chronic stress, physical inactivity and poor sleep as major contributors to the rising burden of neurological diseases.

Dr. Rajas Deshpande, Consultant and Head of Neurology, Jupiter Hospital, Pune, said many neurological conditions share common lifestyle-related risk factors.

"Controlling hypertension, diabetes, obesity, smoking and physical inactivity can significantly reduce the risk of stroke and vascular dementia. Prevention deserves as much attention as treatment because many neurological disorders share common modifiable risk factors," he said.

Early Diagnosis Can Improve Outcomes

Dr. Bhardwaj stressed that many neurological disorders progress silently, making early diagnosis critical.

"Whether it is stroke, epilepsy, Parkinson's disease or memory disorders, early diagnosis can significantly improve outcomes. Unfortunately, many patients seek specialist care only after the disease has advanced, either because symptoms are ignored or because neurological services are not easily accessible. Greater public awareness and timely referrals are essential," he said.

Brain Health Linked to Women's Reproductive Health

Experts also emphasized that brain health extends beyond cognition. Dr. Hrishikesh Pai, Consultant Gynecologist & IVF Specialist, Lilavati Hospital Mumbai and Fortis Hospitals Delhi & Chandigarh, said the brain plays a central role in regulating women's reproductive health.

"Brain health plays a critical role in women's reproductive health. The hypothalamus and pituitary gland in the brain regulate the hormonal signals that control menstruation, ovulation, and pregnancy," he said.

He added that chronic stress, neurological disorders, pituitary diseases and certain medications can disrupt hormonal balance, leading to irregular menstrual cycles, infertility and pregnancy-related complications.

As wildfire smoke continues to affect communities across North America and Europe, fertility experts are recommending people undergoing vitro fertilization (IVF) to pay attention to an overlooked factor before embryo implant: air quality.

A new study suggests that exposure to unhealthy levels of air pollution, particularly from wildfire smoke, could significantly reduce the chances of a successful pregnancy after IVF.

Researchers, therefore, recommend discussing the timing of embryo transfer with a fertility specialist when air quality deteriorates.

Wildfire Smoke May Interfere With Embryo Implantation

The study, published in the journal Human Fertility, indicates that air pollution may affect reproductive health.

Between June and July 2023, researchers from Northwell Fertility in New York examined 190 fresh and frozen embryo transfers, when smoke from massive Canadian wildfires caused hazardous air quality across the northeastern United States.

They then compared the rate of successful pregnancies based on the Air Quality Index (AQI) on the day of embryo transfer.

Clinical pregnancy rates were approximately 62% on days with good air quality and 65% on days with moderate air quality.

But when the AQI rose above 100, a level considered unhealthy for sensitive groups; the pregnancy rate dropped to just 27%.

Although only 11 embryo transfers took place on days with unhealthy air quality, the researchers say the findings raise concerns about whether temporary exposure to wildfire smoke could affect one of the most critical stages of IVF.

Also read: Miles Apart, But Planning A Family Together: The Fertility Reality Of Long-Distance Marriages In India

How Can Air Pollution Affect Fertility And IVF Success Chances?

IVF embryos are created and stored in strictly controlled laboratories, meaning they are protected from polluted air and other contaminants in the environment.

Instead of damaging the embryo, researchers believe that wildfire smoke can affect the woman's body by increasing inflammation and oxidative stress. This could create a less favourable environment for the embryo to implant in the uterus.

Air pollution contaminant, PM2.5, a fine particulate matter, is one of the main pollutants in wildfire smoke. It is minute enough to enter the lungs, bloodstream, and trigger inflammatory responses throughout the body.

Previous studies have already indicated that PM2.5 exposure could cause pregnancy complications and harm fertility.

Dr. Randi Goldman, Program Director at Northwell Fertility and co-author of the study, said the research suggests patients and physicians should consider environmental conditions when planning embryo transfer.

Also read: Global Female Infertility Could Affect 80 Million Women Aged 35+ by 2036: Lancet Study

"The embryo is safely protected inside the laboratory. The effect we're seeing is more likely related to how air pollution influences the body before and after embryo transfer rather than the embryo itself," Goldman said.

She opines that patients experiencing severe wildfire smoke or hazardous air quality should discuss whether delaying embryo transfer by a few days could improve the chances of success.

"Patients invest enormous emotional, physical and financial resources into IVF. Delaying treatment is difficult, but when air quality reaches unhealthy levels, it may be worth discussing timing with your fertility specialist," Goldman said.

Expert-Recommended Tips To Improve IVF Success

Adopt a Fertility-Boosting Lifestyle: Eat a balanced diet, exercise daily, and enjoy a healthy BMI. Reduce alcohol intake, do not smoke, and avoid recreational drugs.

Take Key Supplements: Folic acid, CoQ10, and vitamin D can improve egg quality and overall fertility.

Stress Management Is Key: Elevated cortisol levels can affect reproductive hormones. Practice mindfulness, yoga, or acupuncture.

Sleep Well: Aim for at least 7–8 hours of restful sleep to support hormonal balance.

Address Underlying Health Conditions: Conditions such as PCOS, thyroid issues, and endometriosis can interfere with fertility outcomes if left unmanaged.

Start Early, If Possible: The earlier IVF is initiated—especially for women over 35—the better the chances.