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 shocking case highlighting delayed diagnosis, a UK-based man visited doctors 24 times in a year for persistent back and leg pain but was repeatedly dismissed. He died just 12 days after being diagnosed with cancer.

The symptoms of 61-year-old Nigel began with lower back and leg pain. As the cancer spread across his body, he suffered from indigestion and severe weight loss. His doctors ignored his symptoms and could not even pinpoint the exact cancer till his death.

It was only a week after his death that the doctors were able to find that Nigel had pancreatic cancer — a type of cancer that often goes undiagnosed due to a lack of early detection tests, said his wife, Liv Williams, writing in an essay for Metro.co.uk.

“Nigel saw a healthcare professional 24 times, and even then, we didn't know it was pancreatic cancer. If something like the breath test had been available, maybe Nigel could have had treatment to give him more time with us,” Liv explained.

Also read: Former US Senator Ben Sasse Opens Up About Battle With Terminal Stage 4 Pancreatic Cancer

Nigel, a father of three, began experiencing lower back and leg pain in early 2023. Liv said that his primary care doctor referred him to a physiotherapist, but the wait took months and his condition worsened. He also developed serious indigestion.

“From March to June, Nigel sought medical advice, and each time he was sent away, either empty-handed or with medication for pain or indigestion,” she said.

Thinking the pain must be related to a spinal issue, the family paid out-of-pocket for an MRI. The lumbar spine MRI scan revealed nothing.

"But what is it then?, we asked in frustration numerous times; always to be told it would get better on its own," Liv wrote in the essay.

By July, Nigel could not stand the pain, and Liv was forced to take him to the Emergency Room (ER).

“His painful leg was getting thinner and thinner, like it was wasting away, and the pain was unbearable,” she said. Nigel lost significant weight, struggled to eat, relied on crutches, and could not sleep due to constant pain.

“Just before Christmas, I demanded a blood test from his GP – but three weeks later, a few days before the scheduled tests, Nigel couldn't urinate, which left him in agony,” she added. A visit to the ER was unfruitful as they had to rush back due to his pain.

The next time they visited the hospital, Nigel "screamed with pain", and seeing this, "a nurse promptly set him up on a bed with an IV".

The next day, the doctors informed Liv that Nigel had cancer. But as it had metastasized so much that his doctors could not pinpoint the exact cancer.

In just 12 days on February 9, 2024, Nigel died surrounded by his family.

Also read: Benjamin Netanyahu Undergoes Treatment For Early-stage Prostate Cancer: Symptoms You Should Not Ignore

What Is Pancreatic Cancer? Know The Warning Signs

Pancreatic cancer has long been one of the toughest challenges in oncology. With a five-year survival rate hovering around 13 percent and recurrence rates approaching 80 percent after treatment, the odds have historically been stacked against patients.

The prevention and early detection remain vital.

Experts warn that pancreatic cancer often masquerades as common ailments, delaying diagnosis. Here are some early symptoms that should never be ignored:

• Abdominal or back pain that worsens over time or eases when leaning forward.
• Unexplained weight loss without changes in diet or exercise.
• Jaundice, including yellowing of the eyes and skin, sometimes with intense itching.
• Changes to urine or stool, such as dark urine or pale, greasy stools.
• New-onset diabetes without obvious risk factors.
• Persistent fatigue unrelated to poor sleep or lifestyle

Kidneys are extraordinary organs that perform critical tasks on a continual basis, e.g., filtering out waste, keeping electrolytes balanced, controlling blood pressure, and providing metabolic stability.

However, many people don’t pay enough attention to keeping their kidneys healthy until they discover that substantial damage has already happened.

Some of the most prevalent and underestimated threats to kidney functioning include uncontrolled blood pressure, chronic anxiety, and unhealthy living.

The Effect Of Hypertension On Kidney Function

Hypertension (high blood pressure) is considered one of the most prevalent causes of CKD (chronic kidney disease) worldwide.

The kidneys need the support of a complicated design of tiny blood vessels to carry out their task of removing waste from the bloodstream. An ongoing and increased blood pressure level will slowly harm these small blood vessels by reducing their ability to function normally. As time passes, this injury will result in scar formation of the kidney tissue, causing a continual decline in the kidney’s ability to filter.

Hypertension is known as a silent killer because it frequently has no symptoms for many years. By the time someone experiences symptoms of high blood pressure, their kidneys may have already been damaged for a considerable period.

Chronic stress is often overlooked as an indirect cause of kidney damage. When we are under chronic stress, our sympathetic nervous system is activated, and the amount of stress hormones (cortisol and adrenaline) in our bodies increases.

These physiological changes lead to prolonged increases in blood pressure and blood glucose; both of these risk factors are bad for our kidneys. Chronic stress may cause people to engage in unhealthy coping strategies like poor diet, smoking, consuming alcohol, or not being physically active, which also increases their risk of kidney damage.

Our long-term kidney function is largely determined by lifestyle choices, including our dietary habits. Diets high in sodium, processed foods, and unhealthy fats increase the probability that you will develop hypertension, metabolic disorders, or some combination of both of these, which puts even more strain on your kidneys.

The sedentary lifestyle associated with obesity, insulin resistance, and cardiovascular disease are all significant contributors to chronic kidney disease. Dehydration, taking large amounts of over-the-counter medications (especially NSAIDs), and using tobacco products are all additional risk factors for progressive loss of kidney function.

Preventative Interventions For Kidney Health

Many of these risk factors can be addressed through prevention.

Regular monitoring of blood pressure, using mindfulness and other methods to manage stress levels, and maintaining a healthy diet full of fruits, vegetables, and whole grains will all help to reduce the strain on your kidneys.

Regular health screenings for people who have some of the above-mentioned risk factors (e.g., diabetes, high blood pressure, etc.) will give people an opportunity to identify problems early, giving them time to adjust their lifestyle or possibly seek some other type of treatment (e.g., taking medication).

The Importance of Early Awareness and Intervention

Gaining and maintaining awareness of what contributes to the health of the kidneys can help protect the kidneys.

Gaining awareness of and taking action against hidden risks, such as high blood pressure or chronic stress, and making positive changes to your lifestyle will help maintain kidney function and minimize the likelihood of developing long-term complications in the future.

Early intervention is the most effective method for protecting the health of your kidneys.

In my early years of clinical practice, it was not uncommon to see children admitted with severe measles, struggling with complications that could turn fatal.

Polio was not a chapter in textbooks—it was visible in outpatient clinics, in children who came in with permanent disabilities, and in families learning to cope with lifelong consequences.

Vaccines Save Lives: From Polio To COVID

Diarrheal diseases filled pediatric wards, often pushing already fragile children to the brink. These were not isolated cases; they were a pattern we saw far too often. What changed this reality was not a coincidence. It was vaccines.

Over the years, I have witnessed firsthand how immunization has transformed pediatric care in India. The introduction of the measles vaccine in 1985, followed by the second dose in 2010, has brought us to a point where a disease once feared by every parent is now on the verge of elimination.

Similarly, the impact of the Pulse Polio Immunization campaign has been extraordinary. From routinely seeing children affected by polio, we moved to a historic milestone—India being declared polio-free on March 17, 2014. For clinicians who have seen both sides, this shift is nothing short of remarkable.

The change has been equally significant in other areas. There was a time when severe diarrhea dominated pediatric admissions. Today, with better sanitation and the introduction of the rotavirus vaccine in 2016, we see far fewer cases of severe rotavirus-related illness. This is not just a statistic—it is reflected in fewer hospital admissions, less distress for families, and better outcomes for children.

More recently, during the COVID-19 pandemic, the importance of vaccines became evident on an unprecedented scale. As healthcare providers, we experienced the strain of the pandemic firsthand. The introduction of vaccines in January 2021 marked a turning point. It not only reduced the severity of illness but also brought a sense of control in an otherwise uncertain situation. The ability to protect lives at such a scale reaffirmed what medicine has known for decades—vaccines are among the most powerful tools we have.

Across diseases, across decades, and across generations, one truth remains consistent: vaccines save lives. However, despite these clear gains, we are now witnessing a concerning shift.

Vaccine Hesitancy And Emerging Diseases

In recent years, vaccine hesitancy has started to emerge—even among well-informed populations. As a clinician, this is deeply concerning. When diseases become less visible, people begin to underestimate their impact. Questions arise, doubts increase, and misinformation often fills the gap.

The consequences of this are already visible globally. The re-emergence of measles in countries with strong healthcare systems is a clear warning.

As per CDC data from March 18, 2026, the United States has reported 1,362 confirmed measles cases across 20 states, with multiple outbreaks—after more than two decades of control. This is not due to a lack of availability of vaccines, but due to reduced uptake.

From a medical standpoint, this is both predictable and preventable. Vaccination is not just about protecting one individual—it is about safeguarding entire communities. In my practice, I often remind families that immunization protects not only their child but also those who are more vulnerable—newborns, pregnant women, and individuals with weakened immunity. When vaccination rates decline, this collective protection weakens, and diseases find their way back.

History has shown us that progress in public health is not permanent unless it is sustained. The absence of disease does not mean the absence of risk—it often reflects the success of prevention.

Timely Immunization Is Key

The way forward is clear. We must continue to ensure timely immunization, strengthen awareness, and address concerns with clarity and empathy. As healthcare providers, it is our responsibility to build trust and provide evidence-based guidance. As a community, it is equally important to rely on science and not misinformation.

Vaccines have already proven their value—both in data and in daily clinical practice. The science is robust, the outcomes are visible, and the impact is undeniable. The question is no longer whether vaccines work. The question is whether we will continue to trust and use them.

Because the cost of inaction is not theoretical—it is seen in preventable illness, avoidable hospitalizations, and lives that could have been saved. For every generation, vaccines have worked. It is now our responsibility to ensure they continue to.