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!

As men step into their 50s and beyond, prostate health becomes an essential part of overall wellbeing. The gland naturally undergoes changes with age, many of which are not cancerous but can still cause discomfort, disrupt daily routines, and affect long-term health. Awareness, early screening, and preventive habits play a crucial role in staying ahead of potential problems.

Why the Prostate Changes With Age

One of the most common age-related concerns is benign prostate hyperplasia (BPH), a non-cancerous enlargement of the prostate. This happens due to hormonal shifts that cause the gland to grow slowly over time.

“Most men assume urinary symptoms are just a normal part of aging, but that mindset often delays treatment,” says Dr. Vineet Malhotra, Director and Founder, VNA Hospital. “BPH itself is not dangerous, but if ignored, it can seriously affect quality of life and even lead to complications.”

A larger prostate can press against the urethra, causing symptoms such as:

• Frequent urination
• Weak or interrupted urine flow
• Difficulty starting to urinate
• A feeling of incomplete bladder emptying
• Waking up multiple times at night to urinate

These symptoms often creep up gradually, making them easy to dismiss until they start interfering with sleep, work, or general comfort.

The Importance of Screening for Prostate Cancer

While BPH is not cancer, men must remain vigilant about prostate cancer, especially because its risk rises with age.

“Prostate cancer in early stages is usually silent,” explains Dr. Malhotra. “That is exactly why screening becomes so important once men cross 50.”

Two common screening tools include:

• PSA (Prostate-Specific Antigen) test
• Digital Rectal Examination (DRE)

These tests help detect abnormalities long before symptoms appear. Early detection not only improves treatment outcomes but also prevents unnecessary anxiety or uncertainty.

Men should also stay alert for red-flag symptoms, including persistent pelvic pain, unexplained weight loss, blood in urine or semen, and sudden urinary changes.

Lifestyle Choices That Support Prostate Health

Beyond medical screening, everyday habits have a strong influence on prostate wellbeing.

Dr. Malhotra emphasizes the role of lifestyle:

“A balanced diet, regular exercise, and maintaining a healthy weight can significantly reduce inflammation and support better prostate function.”

Healthy habits that help include:

• A diet rich in antioxidants (tomatoes, berries, leafy greens)
• Omega-3 sources like fatty fish and walnuts
• Limiting alcohol and caffeine
• Staying well-hydrated
• Avoiding smoking
• Regular physical activity

These choices not only support the prostate but also improve urinary health and hormonal balance.

Since stress can worsen urinary symptoms, incorporating yoga, meditation, or deep-breathing practices also makes a noticeable difference.

Breaking the Silence Around Prostate Health

One of the biggest challenges is the reluctance many men feel when discussing urinary or sexual symptoms.

“Men often suffer quietly because these issues feel too personal,” says Dr. Malhotra. “But silence delays diagnosis and treatment. Open conversations can literally save lives.”

Families, caregivers, and partners can play a supportive role by encouraging early checkups and normalizing discussions around prostate health.

The Bottom Line: Proactive Care Matters

With rising life expectancy and a more active older population, prioritizing prostate health is no longer optional—it’s essential.

Early diagnosis, informed decision-making, and evidence-backed treatments give men the chance to maintain independence, comfort, and quality of life well into their later years.

As Dr. Malhotra puts it, “Prostate health is not just a medical concern—it’s a foundation for staying energetic, confident, and healthy as you age.”

Crossing 40 often brings subtle but noticeable changes in how your body feels and functions. Many people brush off early signs like morning stiffness, reduced flexibility, or frequent bathroom visits, not realizing these are part of natural age-related changes. These shifts primarily affect the bones, joints, and urinary system, areas that quietly define everyday comfort.

According to Dr. Aashish Chaudhry, Managing Director & Head, Orthopedics & Joint Replacement, Aakash Healthcare, these changes are expected but shouldn’t be ignored. “After 40, the body’s regenerative capacity slows down, particularly in bones and joints. Being aware of these changes helps in early prevention and better long-term outcomes,” he says.

Bone Health: Slower Regeneration and Higher Risk of Fractures

Bone density gradually declines with age due to hormonal changes. Women experience a drop in estrogen, and men see reduced testosterone levels—both crucial for supporting bone formation.

“Lower hormone levels weaken the natural bone-building cycle,” explains Dr. Chaudhry. “This increases the risk of fractures and even slows down healing when injuries occur.”

Key concerns include:

• Reduced bone density
• Higher risk of osteoporosis
• Slower fracture recovery

To counter this, weight-bearing exercises and strength training are crucial. A diet rich in calcium, vitamin D, and protein supports bone metabolism and maintains strength.

Joint Health: Wear, Tear, and Early Stiffness

Years of repetitive movements, combined with declining collagen production, make joints more vulnerable. Cartilage becomes less elastic, leading to stiffness, reduced mobility, and the early onset of osteoarthritis.

“Many people notice joint pain but assume it's just fatigue,” says Dr. Chaudhry. “In reality, early joint wear can be detected and managed much earlier with the right interventions.”

What contributes to joint discomfort after 40?

• Natural wear and tear
• Reduced cartilage elasticity
• Slower lubrication of joint spaces
• Early degenerative changes

Flexibility-focused exercises like yoga or stretching, along with anti-inflammatory foods such as leafy greens, berries, nuts, and omega-3 sources, can ease stiffness and protect long-term mobility.

Urinary Changes: More Common Than You Think

While both men and women experience changes in urinary patterns, men often notice symptoms more prominently due to prostate enlargement. A bigger prostate narrows the urinary passage, causing:

• Frequent urination
• Weak urinary stream
• Urgency or incomplete emptying
• Night-time urination

Women, on the other hand, may struggle with pelvic floor weakness, leading to leakage or urgency.

Dr. Chaudhry notes, “These symptoms are common after 40, but they shouldn’t be normalized. Early evaluation can prevent chronic discomfort.”

Hydration remains essential. Cutting back on caffeine, alcohol, and salty foods can also lighten urinary symptoms and prevent kidney irritation.

Lifestyle Adaptations That Make a Real Difference

Shifting from reactive to preventive care is key after 40. The goal isn’t to stop ageing—it's to age comfortably and confidently.

What helps:

• Strength and mobility exercises
• Pelvic floor training
• Maintaining a healthy weight
• Regular health screenings (bone density, kidney tests, prostate evaluation)
• Stress management through yoga, meditation, or deep breathing
• Consistent sleep routines to support tissue repair

“Think of this stage as preparing your body for the next decades,” says Dr. Chaudhry. “With the right lifestyle adjustments, most people can maintain excellent mobility and function well into older age.”

After the Thanksgiving, on Friday, the Food and Drug Administration (FDA)'s top vaccine regulator, Vinay Prasad made a clam that shocked the public-health established. "For the first time, the US FDA will acknowledge that COVID-19 vaccines have killed American children," he wrote in a leaked email to his staff, as reported by The Atlantic and The Washington Post.

The agency has identified that at least 10 children died after getting COVID shots.

The email has been perceived by physicians as a "threat". A response from 12 former FDA commissioners, published in The New England Journal of Medicine on Wednesday, called Prasad's memo "a threat to evidence-based vaccine policy and public health security". All of the potential vaccine related deaths reported to government were already reviewed by the agency's staff, and had reached "different conclusions", wrote the former commissioners.

Elsewhere, doctors and scientists have declared that there are no evidence that links COVID-19 vaccines to deaths in children. The commissioners have claimed that in an attempt to deliberately bring evidence, Prasad and his colleagues had engaged in an "evidence-manufacturing mission", a "dumpster dive" for shoddy data, or worse, a campaign of lying.

Prasad is one of several public health officials who, under Robert F. Kennedy Jr.’s leadership, have been steadily chipping away at public trust in vaccines. So far, he has not provided evidence to back his claims, and his estimate of vaccine-related deaths may be exaggerated. The memo’s intense language and focus on political complaints also cast doubt on his assertions.

However, something that cannot be ignored is that fact that his memo may have provoked people to deny even the possibility of COVID-vaccine-related deaths. The Atlantic notes that "the idea that mRNA-based shots have, tragically, killed a very small number of children is not far-fetched." The article written by Benjamin Mazer, a physician who specializes in pathology and laboratory, notes that the this does not imply a "catastrophic threat to public health" as tens of millions of doses of the same vaccines have saved young people.

Understanding the Debate Of Vaccine-Linked Deaths

Public-health experts agree that COVID vaccines, like all medical treatments, can cause side effects. Myocarditis, a rare heart inflammation seen mostly in adolescent boys and young men after mRNA shots, remains the most discussed risk. Although usually mild and far less severe than virus-induced myocarditis, a few deaths have been documented worldwide, including isolated cases in the U.S., South Korea, and two American teenagers described in a peer-reviewed report.

These findings fuel ongoing debate about whether extremely rare vaccine-related deaths are being overlooked. Some scientists, including Paul Offit and Michael Osterholm, say the evidence does not prove the vaccines caused these deaths, noting that population-level studies show no rise in mortality after vaccination. Others argue that well-investigated autopsy-confirmed cases should be taken seriously rather than dismissed outright.

Experts such as Krutika Kuppalli, as cited by Mazer, emphasize that even if deaths occur, they are so uncommon they do not appear statistically, while the benefits, significantly reduced COVID mortality, are unmistakable. However, individual cases still raise questions on health authorities and the stricter standards of proofs they have applied when vaccines were involved to create a room for skepticism.

The concern is that rare side effects of vaccines could go undiscovered and not that vaccinations are inherently harmful.