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!

Metformin is the first-line treatment for type 2 diabetes in adults and children aged 10 years and above. The drug has also found applications in managing Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as Polycystic Ovary Syndrome (PCOS). But a recent study says that it may have some potential use in a non-metabolic health condition: Long COVID.

Researchers found that people who were prescribed metformin shortly after testing positive for COVID-19 had a significantly lower risk of developing Long COVID than those prescribed other medications.

How Was The Study Conducted?

Also read: 'It’s The Best-Studied Vaccine In Human History': Former CDC Adviser Busts Common Myths About COVID Vaccines

The study, titled Metformin at the Time of COVID-19 Infection and Risk of Long COVID: A Target Trial Emulation Study, was published in the Journal of Medical Virology recently.

Researchers have been exploring metformin's antiviral and anti-inflammatory effects, especially during the early stages of COVID-19 infection. They are specifically investigating if metformin could reduce the risk of Long COVID if taken soon after contracting the infection.

The researchers examined health records of more than 21 million people from the US National COVID Cohort Collaborative (N3C). They identified adults who had tested positive for COVID-19 between March 2020 and September 2023. They compared two groups:

Metformin group: People who received a new prescription for metformin within six days of their documented COVID-19 infection.

Comparison group: People who received prescriptions for other medications, including fluvoxamine, fluticasone, ivermectin or montelukast, during the same period.

The researchers excluded people who were already taking metformin or had conditions like diabetes, PCOS or gestational diabetes that could explain why they were prescribed the drug.

After statistical adjustments to make the groups more comparable, the researchers compared 248 people in each group. They then tracked the development of Long COVID or death over the following 180 days (six months).

Also read: Can Low-Dose Naltrexone Ease Long COVID Symptoms? New Study Examines The Evidence

Can Metformin Help Reduce The Risk Of Long COVID?

People who were prescribed metformin within six days of a COVID-19 infection had a 53% lower relative risk of Long COVID or death compared to those on other medications.

“Metformin prescription within the week following documented SARS-CoV-2 infection was associated with a 53% reduction in LC/D [long COVID or death] over 6 months in this primarily Omicron-infected sample,” wrote the authors, led by researchers from the University of Minnesota Medical School.

The study found that the risk of Long COVID or death within six months was 4.0% in the metformin group as 10 out of 248 people developed symptoms.

In the comparison group, the number was 8.5% as 21 out of 248 people presented symptoms of Long COVID. Overall, the weighted chance of Long COVID or death in patients on metformin or control treatment within six days of diagnosis was 6.3%. The absolute difference between the two groups was 4.5 percentage points.

“These results are also consistent with a recent sequential target trial analysis in the United Kingdom that assessed metformin started within 90 days of infection, HR [hazard ratio] 0.36,” the authors wrote. “The replication of results in clinical trials is important for informing treatment guidelines.”

More About Long COVID

Long COVID refers to symptoms that occur after a SARS-CoV-2 infection and cannot be explained by another diagnosis.

Symptoms may include brain fog, fatigue, cognitive difficulties, breathlessness, sleep disturbances and problems with everyday activities. These symptoms may last for months or even years.

Research has also suggested that brain inflammation may persist even after the virus is no longer detectable.

Some people improve over time, while others experience prolonged illness that affects their ability to lead routine lives.

When a woman is diagnosed with breast cancer, the conversation tends to centre on surgery, chemotherapy and targeted drugs. At She Takes Charge, a unique forum held in Delhi, eminent women oncologists turned to what comes with it: the fear, the diet confusion, the follow-ups, the return to work, and beyond just treating the cancer.

She Takes Charge brings leading women oncologists from across India onto one platform to improve breast cancer survivorship care. It extends the Take Charge campaign, launched by Novartis with Times Network in October 2025, which aims to help patients and their families advocate for themselves, hold informed discussions with their doctors and make the choices that are right for them. The campaign shifts the focus from survival alone to empowered living, with an emphasis on lowering the risk of recurrence while protecting quality of life. It reached around 90,000 people through its website last year.

The Delhi chapter, the first of the forum, was organised by Times Network and Novartis with the Hansa MedCell team, and was attended by oncologists in person and online. It is a pilot, meant to shape counselling toolkits for patients and paramedical staff around three themes: support, heal and empower.

In attendance were Dr Meenu Walia, Dr Pankaj Goyal, Dr Seema Singh, Dr Jyoti Wadhwa, Dr Priya Tiwari, Dr Saphalta Baghmar and Dr Kripa Bajaj. While, many joined virtually and included Dr Shalaka Joshi, Dr Shona Nag, Dr Jovita Martin and Dr Sailakshmi Dayana. Dr Priya Parmar, chief operating officer of the Indian Cancer Society in Delhi, who helped shape the Take Charge initiative, offered the patient perspective.

Information in her own language

“We need women to be armed with information,” Dr Parmar said, adding that it must come in a language the patient understands. She noted that a simple question such as “what should I eat” can hide something larger: a woman now living on dal, bhaat and aloo, and feeling guilty about what her illness has cost her family.

One size does not fit

Doctors suggested tailoring material by age, education and employment, and urged organisers to add economic status. Dr Dayana, a gynae-oncologist at Apollo Hyderabad, said women with a strong family history or a BRCA mutation need more intensive counselling, since they worry about what they may have passed on to their children. Others asked for separate content for women under 30, and for material that follows the treatment a patient is receiving.

Anticipate, then share the load

Moderating the support segment, Dr Walia said the aim is “treating the woman in totality.” She argued that side effects should be anticipated and managed early, with the whole treating team, including nurses and paramedical staff, ready to answer simple questions on food and nausea. One oncologist said the antiemetic section of the toolkit should reflect that a 2.5 mg dose of olanzapine, tested in a Tata Memorial randomised trial, had led to a change in NCCN guidelines.

Doctors also spoke of the burden on the treating oncologist. Patients in India often expect one doctor to explain the diagnosis, the treatment, the diet and the exercise, and some consultations run to an hour. Participants called for trained support staff and counsellors to share the work.

Video, volunteers and time alone

Doctors agreed that patients forget much of what they hear in the consulting room. Many now ask patients to record counselling sessions, and Dr Dayana said she wished for “a better and animated, a better edited video” to offer instead. Video was also seen as the way to reach women outside the metros, who may not see a specialist often. Dr Joshi described pre- and post-operative classes at her hospital, led by patient volunteers for almost a decade and now being converted into a QR code. Dr Baghmar urged oncologists to give each patient five to ten minutes alone, away from family members who often speak for her.

Myths on the plate

Diet drew the liveliest debate, with sugar, keto diets and boiled fruit coming up repeatedly. Dr Joshi’s advice was simple: “roti, sabzi, dal, rice is a kind of a square Indian meal that cannot go wrong.” Another oncologist said she sets no restrictions beyond avoiding food that is too spicy, too oily or cooked by someone whose hygiene is unknown. One doctor raised weight gain after treatment, noting that some patients on endocrine therapy ask about weight-loss injections. The advice was to check thyroid function and see an endocrinologist, not to give blanket advice.

On exercise, doctors favoured mild activity such as walking and yoga during treatment and strength work afterwards, always cleared by the treating oncologist. The group agreed to build evidence-based consensus documents on diet and sexual well-being.

Beyond the breast

Participants asked for content on contraception, pregnancy after treatment, genetic testing, screening for other cancers, breast prostheses, health insurance and caregivers, described by one doctor as a neglected pillar of cancer care. Doctors also flagged two issues that are often missed. Young women need counselling on preserving their eggs before chemotherapy, and some patients develop shoulder and spine problems after mastectomy that are mistaken for other pain. Follow-up testing was another gap: doctors said some clinicians still order routine chest X-rays, and the group wants a consensus on which scans are needed.

Novartis demonstrated two tools: an offline HTML tool for HR-positive, HER2-negative early breast cancer that walks patients through a treatment plan, and a patient microsite that adds follow-ups and medication reminders to a phone calendar. Feedback from She Takes Charge will feed into a white paper.

Ahead of Diwali festivities, Delhi is once again battling its annual air pollution crisis. The city's air quality index (AQI) - which measures PM2.5, fine particulate matter, has crossed 500 in some regions, entering the "hazardous" category, raising health concerns for millions in the capital.

The effects of air pollution are not just limited to physical health. Apart from your lungs and heart, long-term exposure to toxic air can render you feeling anxious, stressed, demotivated and mentally fatigued.

The reason behind this is not one-fold. The worsening of mental health due to air pollution is a culmination of many factors.

From particulate matter triggering inflammation and negatively affecting the body’s stress response to restrictions on outdoor activities, disturbance in sleep and lack of physical activity, air pollution contributes to mental health burden in many ways.

Dr Varsha Viswanathan, psychiatrist at Athulya Senior Care and Athulya Geriatric Care Hospital, Chennai, told HealthandMe that particulate matter in polluted air can enter the bloodstream and trigger inflammatory responses.

She explained, “This may lead to oxidative stress and affect brain functions involved in mood regulation, attention, memory and emotional processing. Over time, these changes may contribute to increased irritability, mood disturbances and difficulty managing emotional responses.”

Air Pollution & Stress

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PM2.5, consists of tiny airborne particles that can penetrate into the lungs. Some can even enter the bloodstream and cause inflammation and oxidative stress. These effects may also affect the brain and its functions.

Cortisol is a hormone related to the body’s response to stress. Changes in stress regulation due to pollution may make it harder for some individuals to manage everyday challenges. Dr Viswanathan explains that air pollution may also affect the body’s stress-response system.

“Repeated exposure to environmental pollutants can affect the regulation of stress hormones such as cortisol. This may increase physiological stress and contribute to symptoms such as restlessness, heightened alertness, difficulty relaxing and persistent feelings of tension,” she says.

Air Pollution & Anxiety

Also read: Air Pollution In Delhi: Experts Warn Of Red Eyes, Itching, Watering In Children

Apart from stress, living in highly polluted cities can also cause one to feel constantly uncomfortable, uncertain and anxious. Kakul Faruqi, Senior Consultant Psychologist at LH Hiranandani Hospital, Mumbai, told HealthandMe that pollution can become a source of fear and withdrawal.

She said that someone who is prone to anxiety, breathing difficulty may be interpreted as a sign of immediate danger, which could trigger further fear and distress.

“Psychologically speaking, pollution can be a source of discomfort, fear and withdrawal. A coughing fit, trouble breathing and insomnia can exhaust an individual, making it more difficult for him or her to cope with daily stresses. An individual who is susceptible to panic attacks can experience fear and negative interpretations of physical symptoms due to trouble breathing,” Faruqi explains.

She also said that repeated exposure can also make the threat feel inescapable. Faruqi says that when individuals perceive pollution as a problem beyond their control, the resulting uncertainty can become extremely overwhelming.

Lack Of Outdoor Time May Contribute To Depression

Also read: Supreme Court Allows Green Crackers In Delhi-NCR Ahead Of Diwali: Are They Really Safe For Your Health?

Faruqi explains that pollution can make it harder to engage in behaviours that support psychological health.

When pollution levels are high, people normally avoid spending time outside socialising, exercising, walking, and spending time in green spaces. These activities often provide opportunities for physical movement, social connection and relaxation. Missing out on these activities can affect one emotional and mental well-being.

“The reduction in outlets for relaxation, in addition to experiencing feelings of loneliness and frustration, can lead to depression,” she says.

Dr Viswanathan also highlights how poor air quality can disrupt sleep, physical activity and normal social routines, which could further worsen mental well-being.

“Inadequate sleep and reduced physical activity can, in turn, affect emotional regulation, concentration and the ability to cope with everyday stress,” she says.

How To Protect Your Mental Health When AQI Is High?

When AQI is high, it is important to reduce exposure but at the same time, maintaining routines that help psychological well-being is also important. Faruqi recommends checking air quality in one’s locality, adjusting exercise habits accordingly and making an effort to preserve sleep and social interaction.

Some practical measures include:

• Adjust outdoor activities: Check local air quality levels and move exercise indoors when pollution is high. Avoid strenuous outdoor activity during severe pollution.

• Maintain physical activity: Indoor exercise can help preserve movement and routine when outdoor conditions are unsuitable.

• Protect sleep: Maintain regular sleep and wake times, and reduce indoor pollution where possible.

• Stay socially connected: Continue interacting with friends and family, even when outdoor meetings are difficult.

• Limit repeated pollution checking: Stay informed through reliable sources, but avoid continuously monitoring pollution levels without taking practical steps to reduce exposure.

• Seek professional support: Constant anxiety, depressive symptoms or difficulty carrying out everyday activities should not be ignored.

Faruqi advises that “if one experiences persisting anxiety, depression, or impairment in functioning, a visit to a mental health professional would be advisable.”