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!

In a country where diseases have become a daily topic of discussion, hypertension is gradually increasing behind closed doors. Also referred to as “the silent killer”, this ailment is notorious for making its presence known without symptoms, unlike many health conditions. By the time it is discovered, it may have already begun to affect vital organs.

Diabetes: A Comorbidity Giving Rise to This Vicious Cycle

One of the most prevalent comorbidities of hypertension is diabetes; together, the two create a difficult combination of chronic conditions affecting a patient's overall health. Diabetes causes high blood glucose (sugar) levels that, over time, damage blood vessels by reducing their ability to stretch or expand. When combined with the pressure caused by hypertension, these already compromised blood vessels can deteriorate rapidly, resulting in further damage.

The combined effects of diabetes and hypertension significantly increase the risk of heart-related complications, such as enlargement of the heart muscle, a reduced ability of the heart to pump blood effectively, and heart failure. Thus, the two conditions create a vicious cycle and emphasise the need for prompt diagnosis and treatment.

According to Dr Ameet Soni, AVP Medical Affairs, CORONA Remedies, “Hypertension and diabetes mellitus (DM) are two of the most common cardiometabolic disorders, often occurring together, and each exacerbates the impact of the other. When combined, these conditions significantly increase the risk of complications such as cardiovascular, cerebrovascular, and renal damage, particularly when symptoms are not identified early or when treatment adherence is inadequate. Minimising the risk of these complications depends on early identification, proactive risk assessment before diagnosis, and long-term adherence to treatment regimens for controlling blood glucose levels and blood pressure.”

According to Dr Manoj Chawla, Diabetologist, P.D. Hinduja Hospital and MRC, Khar, Mumbai, “These diseases are also termed ‘silent partners’, indicative of both their association and the silent damage they cause to bodily functions. The connection between these diseases in India is quite common owing to several factors, including a sedentary lifestyle, poor nutrition, obesity, excessive stress, and a lack of proper diagnosis. Individuals suffering from diabetes have twice the risk of developing hypertension compared with healthy individuals. Since both diseases are asymptomatic in many cases, patients may only discover them when complications arise. Early diagnosis of hypertension and diabetes is therefore vital. Tests such as blood pressure and blood glucose monitoring, weight management, proper nutrition, exercise, adequate sleep, and stress management all help to prevent these risks.”

Here are five alarming signs that your hypertension might be linked to diabetes.

1. Frequent Urination and Thirst: One of the earliest signs that hypertension may be associated with diabetes is frequent urination, accompanied by an abnormal increase in thirst. When blood sugar levels are high, the kidneys work overtime to filter and absorb excess sugar, leading to increased urine production. This, in turn, causes dehydration, prompting an increased thirst response.
2. Fatigue and Weakness: If you are experiencing unexplained fatigue or weakness, this could be a sign that your hypertension is coupled with diabetes. High blood sugar levels prevent glucose from entering the cells efficiently, leaving the body depleted of energy. Hypertension, in turn, places additional strain on the heart and circulatory system, leading to a further decline in overall energy levels.
3. Blurred Vision: The eyes are particularly vulnerable to the effects of both high blood pressure and diabetes. High blood sugar levels can damage the blood vessels in the retina, leading to diabetic retinopathy, which can cause blurred vision. Additionally, hypertension can further exacerbate this damage by increasing pressure within the blood vessels, resulting in worsening vision problems.
4. Numbness or Tingling in the Extremities: Diabetic neuropathy, a common complication of diabetes, causes nerve damage, particularly in the hands, feet, and legs. This nerve damage can lead to symptoms such as numbness, tingling or even a burning sensation in the extremities. When hypertension is present alongside diabetes, the blood vessels supplying the nerves may become compromised, exacerbating the symptoms of neuropathy.
5. Elevated Blood Sugar with Uncontrolled Hypertension: If your blood pressure is consistently high despite treatment or lifestyle changes, it could indicate an underlying issue, such as uncontrolled diabetes. Insulin resistance, which is common in type 2 diabetes, can worsen hypertension by increasing blood pressure due to factors such as weight gain and metabolic imbalances. When blood sugar levels are poorly managed, they can interfere with blood pressure regulation.

Early detection and intervention are key to managing both conditions and reducing the risk of complications. If you are experiencing any of the symptoms mentioned above or have a family history of either condition, it is vital to consult your healthcare provider. Regular screenings, lifestyle modifications and adherence to prescribed treatments can help control both hypertension and diabetes, improving your quality of life and preventing long-term complications.

Parkinson’s disease is characterized by slowness of daily activities, rigidity, and tremors with gait issues, commonly seen after the age of 45-50 years.

It is two times more common in men than women, though clinical features, response to the treatment, and prognosis are different in women as compared to men. From subtle early signs to how the condition develops over time, gender can shape the Parkinson’s journey in important ways.

Women usually experience Parkinson’s disease at a later age, but with faster progression of symptoms as compared to men. There is a need for more research in this space; however, we will try to shed light on these differences in Parkinson's trajectories in men and women based on available evidence.

Why Is Parkinson’s Less Common In Women?

Estrogen, a group of primary female sex hormones, is neuroprotective and protects dopaminergic neurons in women; women also have a higher baseline reserve of dopaminergic neurons. Hence, Parkinsonism is less common in women.

In the post-menopausal period, once this estrogen-related neuroprotective effect disappears, Parkinson’s symptoms progress rapidly. Motor symptoms emerge later in women with tremors, rigidity, and gait disturbances being more common and severe. Freezing of gait and postural instability with falls are more common in women.

Differences In Motor vs Non-Motor Symptoms

Non-motor symptoms like pain, fatigue, autonomic disturbances, sleep disorders, constipation, and mood disorders, including depression and anxiety, are more common and severe in women. Men with Parkinson’s disease have worse general cognitive abilities; however, women have worse visuospatial abilities.

Women with Parkinson’s receive less social support, lower quality care, attend medical appointments alone, and report more psychological stress. Women have a lower body mass index and higher bioavailability of levodopa, which makes them more susceptible to the side effects of levodopa, such as motor fluctuations and dyskinesia, which entail involuntary movements like fidgeting and writhing.

Why Personalized Treatment Matters

There is a clear need for personalized and tailored treatment. The different and distinctive clinical features in women, like later onset, higher tremors and rigidity, higher dyskinesia and motor fluctuations from drugs, and worse non-motor symptoms, require tailored, sex-specific treatment strategies rather than a “one-size-fits-all” approach.

Clinicians must give importance to the screening and management of non-motor symptoms in women, which are the main factors of their decreased quality of life. Women with this ailment go through longer delays in diagnosis and less access to specialists, highlighting a need for better healthcare access for women.

While HPV vaccines are most known for preventing cervical cancer, a top US doctor says they can also help curb the rising incidence of head and neck cancers.

According to Mikkael A. Sekeres, Chief of the Division of Hematology and Professor of Medicine at the Sylvester Comprehensive Cancer Center at the University of Miami, Human papillomavirus (HPV) — the same sexually transmitted virus that can infect the genital area and lead to cervical cancer — is now the greatest risk factor for head and neck cancer.

Writing in The Washington Post, Sekeres noted that HPV accounts for about 30 per cent of oropharyngeal cancer worldwide.

HPV is believed to be responsible for the recent rise in head and neck cancers, which include malignancies affecting the mouth and throat (oral cavity and pharynx), voice box (larynx), sinuses and nasal cavities, and salivary glands.

Sekeres said the US records about 60,000 new cases of head and neck cancers each year, while the global incidence is expected to rise by 30 per cent by 2030.

What Are The Risk Factors?

The expert noted that men develop oral cavity and pharynx cancers at approximately 2.5 times the rate of women.

Major risk factors include:

• Tobacco use, including smoking, secondhand smoke and smokeless tobacco
• Chewing areca nut, also known as betel quid
• Heavy alcohol consumption
• HPV infection

Also read: PM Modi Launches Nationwide Free HPV Vaccination Drive; A Landmark Step, Says WHO

The Centers for Disease Control and Prevention (CDC) estimates that the high-risk HPV subtypes most associated with head and neck cancers are detectable in the mouths of 4 per cent of adults aged 18 to 69.

While a pap test detects early-stage cervical cancer in women, no such test exists for penile, anal, or head and neck cancers in men, which can worsen their survival rate.

HPV Vaccination Best Prevention Strategy

Thus, Sekeres said: “The best way to prevent the most common types of HPV is through vaccination, with two doses of the vaccine recommended for children at age 11 or 12, or starting as early as 9 years and up to age 26 for those who missed it as a child".

He noted that although the vaccine is approved for use up to age 45, it is generally less beneficial after age 26 because many individuals may have already been exposed to HPV. However, doctors can help determine whether vaccination may still be beneficial for adults.

Earlier this year, the European Cancer Organization also urged broader HPV vaccination regardless of gender.

“HPV affects everyone, regardless of gender. It can lead to cancers of the cervix, mouth and throat, anus and penis. This is why universal protection is so important,” the organization said in a social media post.

Read More: Who Needs HPV Vaccine? Guide For Every Parent, Teen And Adult

HPV Vaccine Can Boost Cancer Risk

A 2026 study published in JAMA Oncology found that boys and men who received the HPV vaccine between the ages of 9 and 26 were nearly 50 per cent less likely to develop cancers of the head and neck, esophagus, anus, or penis.

The findings, based on data of more than 510,000 boys and men, highlight the importance of vaccinating all children and adolescents against HPV, said Taito Kitano, first author of the study and a researcher at Nara Prefecture General Medical Center in Japan.

“Children, adolescents, parents and health care workers should be more informed about the expected benefits of the HPV vaccine, not just cervical cancer,” Kitano said.