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!

For people who work, laptops and computers are something we use every day. Sitting in front of a screen for hours can be bad for your neck and spine. When you sit and use your laptop the way you position yourself can hurt your neck over time.

This is true even when you are just scrolling on your phone. Keeping your head bent for a long time can put stress on the muscles and joints in your neck.

How Looking Down At Screens Strains Your Neck

The problem is not the laptop itself but how we use it. Many people spend hours looking down at a screen without realizing it. This can cause muscle fatigue, stiffness, headaches and neck pain that will not go away.

Your neck is meant to support your head and let you move it around. When you keep your head tilted forward for hours the muscles in your neck have to work hard to keep it that way. Over time this can cause discomfort. Make it harder to move your neck.

If you sit with posture it can also affect the normal curve of your neck. Poor posture may not cause spinal problems on its own but it can cause wear and discomfort. This is especially true for people who already have neck or spine problems.

Also read: The Hidden Health Risk of Sitting for Long Hours: What Young Professionals Need to Know

Small Workspace Changes Can Reduce Neck Strain

One simple way to reduce strain on your neck is to make your workspace more comfortable. Your laptop or monitor should be at eye level so you do not have to look down all the time. Your back should be. Your arms should be comfortable too. Keep your feet flat on the floor. Do not sit still for too long.

It is also important to move regularly. Of sitting for hours get up and move every 30-40 minutes. Stand up walk around and move your neck and shoulders gently. This can help prevent stiffness and reduce strain on your neck. Your neck is meant to move not be stuck in one position for hours.

When Neck Pain Should Not Be Ignored?

If your neck is stiff after a day, it may feel better with rest and better posture. If the pain gets worse or does not go away, you should see a doctor. If you have pain in your arm or if your arm feels numb tingling or weak you should see a doctor too.

To protect your neck, you do not have to make changes. Just make small adjustments to how you sit and use your laptop and move around more during the day. This can make using your laptop more comfortable. Reduce strain, on your neck and spine.

By Dr. Zahir Abbas Merchant, Consultant Spine Surgeon, Saifee Hospital, Mumbai

Delhi has issued a public health advisory amid a sharp rise in H1N1, commonly known as swine flu, cases. Health authorities urging residents to follow respiratory hygiene, avoid crowded places and seek medical advice if flu-like symptoms develop.

The national capital has reported more than 1,777 H1N1 cases so far this year, including 114 new infections recorded on August 20 alone, according to the latest health department data. Overall, Delhi has reported more than 2,300 Influenza-A cases in 2026.

The sudden surge has prompted the Centre and Delhi authorities to step up surveillance and hospital preparedness. Health officials have also stressed that people should not panic but take necessary precautions to avoid getting sick.

Delhi Sees A Sharp Rise In H1N1 Cases

According to health department, Delhi had recorded 2,392 Influenza-A cases by August 21, of which 1,777 were H1N1. The tally also included H1 and H3 infections and other Influenza-A strains.

The current number is significantly higher than the corresponding period last year. Public health experts have also described some of the H1N1 cases being seen this season as relatively severe.

Dr Chandrakant Lahariya, a public health expert, said H1N1 is not a new subtype and has been known for years, but the current surge needs to be taken seriously.

Also read: Delhi H1N1 Cases Rise To 1,777: Patients Reporting Diarrhea, Muscle Pain, Drop In Oxygen Levels, Say Doctors

Humid Weather Could Be A Major Factor

Doctors have linked the increase to the seasonal pattern of respiratory infections during the monsoon, when humidity, changing temperatures and increased indoor contact can facilitate the spread of respiratory viruses.

Dr Neetu Jain, senior consultant in pulmonary, critical care and sleep medicine at PSRI Hospital, told PTI, “H1N1 cases are particularly high in Delhi-NCR this year.”

She also said the number of cases was reported to be around six times higher than previous years and noted that high temperatures and humidity may contribute to the increase in flu and other viral infections.

Common Symptoms

H1N1 infection can mimic other viral respiratory illnesses. Common symptoms include:

• Fever
• Cough
• Sore throat
• Runny or blocked nose
• Headache
• Body aches
• Chills
• Fatigue and weakness

Some people recover without complications, but influenza can become serious, particularly in young children, older adults, pregnant women and people with weak immune systems.

Difficulty in breathing, chest pain, drowsiness, low blood pressure, bluish discolouration or worsening of an existing medical condition are among warning signs that need urgent medical attention.

Also read: Human H1N2v Swine Flu Case Detected In China: Should You Worry?

Doctors Advise Against Self-Medication

With flu cases rising, doctors are also urging people not to assume that every fever or cough is H1N1 and start medicines without medical advice.

Dr Jain described H1N1 as a “fairly treatable illness”, while noting that it can become serious in vulnerable people. Antiviral medicines may be prescribed in appropriate cases, along with supportive treatment.

The Delhi government's advisory recommends several basic measures to reduce transmission. People are being urged to wear masks in crowded places, cover their mouth and nose while coughing or sneezing, wash their hands frequently and avoid close contact with people showing respiratory symptoms.

Residents have also been advised not to touch their eyes, nose or mouth unnecessarily and to avoid spitting in public places.

People who develop flu-like symptoms should stay away from others where possible and seek medical advice, particularly if symptoms become severe.

Strenghtening Healthcare System

Authorities have also increased monitoring across the healthcare system. Thirty-five hospitals are under special surveillance, while referral laboratories at AIIMS and the National Centre for Disease Control (NCDC) are available for testing and confirmation.

Hospitals and district health authorities have been asked to strengthen monitoring of influenza-like illness, severe respiratory infections and COVID-19.

Union Health Minister JP Nadda has also reviewed Delhi's preparedness amid the rise in H1N1 cases, with authorities instructed to focus on surveillance, early detection and timely treatment.

Chronic kidney disease is a disease whereby the patient's kidneys progressively lose their capacity to filter wastes and excessive fluids from the blood stream.

Since kidney damage develops slowly, many individuals might not experience any signs in the early stages of the disease. It is therefore critical for individuals to know about the stages of CKD in order to appreciate the significance of kidney monitoring and timely medical intervention.

Stage 1: Mild Kidney Damage

At stage 1, patients' kidney functions will be relatively normal (eGFR level of 90 or more). However, there will be some indication of kidney damage for example presence of protein in urine. Individuals usually show no symptoms. Controlling diseases like diabetes and high blood pressure can delay progression of CKD.

Stage 2: Mild Loss of Function

This CKD stage is indicated by an eGFR level of 60 – 89 as well as kidney damage. There will probably be no symptoms or very mild symptoms at this stage.

Also read: US CDC Says COVID ‘Growing’ In Nearly Every State: What You Should Know

Stage 3: Moderate Loss of Kidney Function

This stage reflects the moderate loss of kidney function and features an eGFR ranging from 30-59. It normally involves two sub-stages that can be either 3a or 3b. Some of the symptoms of kidney failure can be fatigue, swelling of legs or ankles, changes in urination, or hypertension.

Stage 4: Loss of Kidney Function Is Severe

The fourth stage means that there is a severe loss of kidney functionality, which can be measured by eGFR of 15-29. It normally entails such symptoms as vomiting, swelling, tiredness, or changes in appetite. Health specialists discuss the possibilities of treatment of end-stage kidney disease with their clients and prepare them for getting a new kidney.

Also read: US Woman Paralyzed After Potassium Mistakenly Given During Knee Replacement Surgery

Stage 5: Kidney Failure

Stage 5 is indicated by eGFR being below 15 or the inability of kidneys to perform their functions properly. Waste products and extra fluids can accumulate in the blood and cause life-threatening conditions. Depending on the condition of a patient, the treatments may include dialysis, kidney transplantation, or supportive therapy.

Maintaining Good Kidney Function

The progression of CKD may not always be swift and early detection can make all the difference. The management of blood pressure and sugar, heeding medical advice, living a healthy lifestyle and regular medical check-ups can help preserve kidney functions. If anyone experiences consistent swelling, alteration in urinary habits or feels unusually tired among other symptoms, they should visit a Nephrologist.