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!

Bajau Sea Nomads have evolved beyond human limits. But how is that even possible? Remember Charles Darwin's theory of natural selection? The survival of the fittest? This is what kept the Bajau Sea Noamds going, and evolving.

The Bajau people are sea nomads who survive by collecting shellfish from the sea floor. They come from South-East Asia, and study shows that they have developed bigger spleen for diving. They are known as 'Sea Gypsies' and are known to hold their breath for over five minutes, whereas highly trained professionals can hardly hold their breath for three to four minutes. Bajau divers spend hours underwater for fishing. They are also the world's only community of self-sufficient sea nomads, reported The Guardian.

How The Bajau Sea Nomads Evolved: What Does The Study Say?

A study published in the academic journal Cell notes that the effect of their underwater lifestyle reflected on their biology. Their spleens were larger than those of other people from the region.

How The Bajau Sea Nomads Evolved: How Does A Spleen Work?

Tucked just beside the stomach, the spleen is roughly the size of a fist and usually flies under the radar. Its everyday job is to filter old red blood cells from the blood. But under the right conditions, it can also act like a built-in oxygen reserve.

This hidden ability is especially important for the Bajau people, often called “sea nomads,” who live across parts of the southern Philippines, Indonesia and Malaysia. Numbering roughly a million, the Bajau have relied almost entirely on the ocean for generations.

“For possibly thousands of years, they have been living on houseboats, travelling from place to place in the waters of South-East Asia and visiting land only occasionally,” said Melissa Ilardo from the University of Copenhagen, speaking to the BBC’s Inside Science. “Everything they need, they get from the sea.”

Read: A Genetic Disorder Caused This Indonesian Tribe To Have Sparkling Blue Eyes

How The Bajau Sea Nomads Have Evolved?

The Bajau are known for their extraordinary free-diving abilities. When diving in the traditional way, they spend up to eight hours a day at sea, with around 60 percent of that time underwater. Individual dives can last anywhere from 30 seconds to several minutes, often reaching depths of more than 70 metres.

What makes this even more remarkable is the equipment. Many Bajau divers use little more than a wooden mask or simple goggles and a weight belt. No oxygen tanks, no wetsuits, no modern diving aids.

This lifestyle prompted researchers to ask whether the Bajau body has adapted over time to support such extreme breath-hold diving.

According to Dr Ilardo, the spleen was an obvious place to look. Humans, like many marine mammals, have a natural “dive response” that kicks in when we hold our breath and submerge ourselves in water, especially cold water.

“When this response is triggered, your heart rate slows down,” she explained. “Blood vessels in your arms and legs constrict to preserve oxygen-rich blood for vital organs like the brain and heart.”

The final part of this response involves the spleen.

How The Bajau Sea Nomads Evolved: An enlarged Spleen Boosts Oxygen

The spleen acts as a reservoir for oxygenated red blood cells. When it contracts during a dive, it releases these cells into the bloodstream, giving the body a temporary oxygen boost.

“It’s like a biological scuba tank,” Dr Ilardo said.

For people like the Bajau, who dive repeatedly every day, this spleen contraction can make a crucial difference, helping them stay underwater longer and recover faster between dives.

In short, what seems like an ordinary organ plays an extraordinary role, revealing how the human body can adapt in remarkable ways to extreme environments.

One child in India dies every nine minutes from an infection caused by antibiotic-resistant bacteria, as it becomes one of the top 10 global public health threats, experts warn.

Dr HB Veena Kumari of the Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, claims: "The Covid-19 pandemic has significantly contributed to rising antimicrobial resistance. The World Health Organisation projects that 10 million deaths will occur annually by 2025."

According to the National Foundation for Infectious Diseases, antibiotic resistance occurs when bacteria in the body learns to withstand and remain unaffected by the medicines (antibiotics) meant to kill them.

In such cases, doctors have to switch to different antibiotics, but these backup medicines might not work as well or might cause more side effects. Additionally, infections may also worsen over time as bacteria can become resistant to all available drugs.

Alarmingly is that these tough, drug-resistant bacteria can spread from one person to another, both in hospitals and at home.

According to Dr TS Balganesh, Gangagen Biotechnologies, nearly 36 percent of haemodialysis patients die from fatal infections, which is second only to cardiovascular diseases as a cause of death.

He tells Deccan Herald: "The risk for infective endocarditis in haemodialysis patients is approximately 18 times higher than in the general population and up to 58 percent of these episodes are caused by a bacteria named 'S aureus', with an in-hospital mortality of more than 50 percent."

What Does WHO Say?

One out of every six serious infections confirmed in labs worldwide last year could not be killed by the antibiotics meant to treat them.

Between 2018 and 2023, the problem of antibiotics failing (called resistance) got much worse. For many common types of germs, resistance went up by 5% to 15% every year. The growing inability of these essential medicines to work is a huge threat to people everywhere.

Which Antibiotics Are People Becoming Resistant To?

The WHO's latest report is the most detailed look yet at this issue. It reports on how much resistance exists across 22 different antibiotics, which include common drugs used to treat everyday illnesses. The report focused on eight common types of bacteria that cause things like:

• Urinary tract infections (UTIs)
• Stomach and intestinal infections
• Dangerous blood infections
• Gonorrhoea

Additionally, Dr Obaidur Rahman of Dr Ram Manohar Lohia Hospital has also warned that the country’s casual use of Azithromycin, sold under brand names such as Zithromax, Azee and Zmax, has worsened its effectiveness and pushed India closer to a major public health challenge.

A drug often prescribed for sore throats and upper respiratory tract infections, Dr Rahman noted that Azithromycin was once effective against Mycoplasma Pneumonia, a bacterium responsible for pneumonia in adults and children.

READ MORE: India’s New Antibiotic in 30 Years Offers Hope Against Antibacterial-Resistant Infections

However, this is no longer the case as India now shows an alarming 80 to 90 percent resistance to the drug when treating infections caused by this bacterium. A medicine that once addressed a wide range of respiratory problems is no longer reliable for many patients.

The surgeon has since urged people to avoid taking antibiotics without proper medical advice. Most seasonal respiratory infections resolve on their own, and unnecessary drugs only add to the resistance problem.

Supreme Court on Friday declared the right to menstrual health as part of the right to life under Article 21 of the Constitution. The court issued a slew of directions to ensure that every school provides biodegradable sanitary napkins free of cost to adolescent girls. The guidelines also ensured that schools must be equipped with functional and hygienic gender-segregated toilets. The Court directed the pan-India implementation of the Union's national policy, 'Menstrual Hygiene Policy for School-going Girls' in schools for adolescent girl children from Classes 6-12.

Read: Menopause Clinics Explained: Latest Launch By Maharashtra And Kerala Government

Supreme Court Declares Menstrual Hygiene As Part Of Right To Life: Here Are the Directions

A bench comprising Justice JB Pardiwala and Justice R Mahadevan passed the following directions:

• All States/UT must ensure that every school, whether government-run or privately managed, in both urban and rural areas, is provided with functional gender segregated toilets with usable water connectivity.
• All existing or newly constructed toilets in schools shall be designed, constructed and maintained to ensure privacy and accessibility, including by catering to needs of children with disabilities.
• All school toilets must be equipped with functional washing facilities and soap and water available at all times.
• All states/UTs must ensure that every school, whether government-run or privately managed, in both urban and rural areas, provide oxo-biodegradable sanitary napkins manufactured in compliance with the ASTM D-6954 standards free of cost. Such sanitary napkins must be made readily accessible to girl students, preferably within toilet premises through sanitary napkin vending machines or, where not visible, at a designated place.
• All States/UTs must ensure that every school, whether government-run or privately managed, in both urban and rural areas establish menstrual hygiene management corners. It must be equipped with spare innerwears, uniforms, disposable pads and other necessary materials to address menstrual urgency.

The court also issued directions for the disposal of sanitary waste. Justice Pardiwala said, "This pronouncement is not just for stakeholders of the legal system. It is also meant for classrooms where girls hesitate to ask for help. It is for teachers who want to help but are restrained due to a lack of resources. And it is for parents who may not realise the impact of their silence and for society to establish its progress as a measure in how we protect the most vulnerable. We wish to communicate to every girlchild who may have become a victim of absenteeism because her body was perceived as a burden when the fault is not hers."

Read: Menstrual Cups To Replace Sanitary Napkins In Karnataka Government Schools

Why Is This Judgment So Important?

In India, menstruation is still seen as taboo. In fact, there is a lot of shame around it. Menstrual shame is the deeply internalized stigma, embarrassment, and negative perception surrounding menstruation, which causes individuals to feel unclean, or "less than" for a natural biological process. This judgment thus is an effort to do away with the shame rooted in cultural, social, and religious taboos, which is often the reason why many girls drop out, or due to lack of awareness, develop health adversities.