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!

The Supreme Court of India, in a landmark judgment allowed 32-year-old Harish Rana, who had been living in a vegetative state for last 13 years, the right to die. This means, that the apex court allowed passive euthanasia for Rana. The bench comprising Justice JB Pardiwala an Justice KV Vishwanathan allowed the withdrawal of life support of Rana, who has been in a coma and kept alive on tubes for breathing and nutrition after he sustained severe head injuries following a fall from a building in 2013 in Chandigarh.

The judgment is a win, however, Ashok, Rana's father said that his feelings are mixed. "As a father, this is extremely painful. But on humanitarian grounds, this is the best we can do for my son." He continued, "It is just not a matter of my son, but there are many others in such a state in the country. I think it is the grace of God who guided the Supreme Court judges... I am happy that with this judgments, many others may find a way."

While, this is a landmark judgment, India's conversation on right to die has evolved slowly. What shaped the judgment is also the years old case of Aruna Shanbaugh. This was the case that set the legal framework for right to die, so it could be implemented in practice years later in Rana's case.

Read: Supreme Court Allows 1st Passive Euthanasia For Man In Vegetative State For 13 Years

The Cases That Shaped India's Right To Die

If one could trace the earliest debates that began around the "right to die", one could not overlook Gian Kaur v. State of Punjab (1996). This is where a three-judge bench of the Supreme Court upheld the constitutional validity of the offence of abetment of suicide under the Indian Penal Code. The apex court ruled that right to life under Article 21 does NOT include a right to die.

While the court did not rule on the validity of active or passive Euthanasia, it did make an important observation, which was later used in the coming euthanasia jurisprudence.

The court noted that the right to live with human dignity would also mean the existence of such a right upto the end of natural life. This means the right to a dignified life upto the point of death, which also includes a dignified procedure of death.

Fast forwarding to 2006, the 196th Law Commission of India said that withholding life support or medical treatment of terminally ill patients does not attract criminal liability of attempt to suicide. The court noted that such a action should be done provided it is done in the best interest of the patient.

Read: Supreme Court Steps In For 31-year-old's Passive Euthanasia Plea Who Has Been In Vegetative State For 10 Years

Aruna Shandbaug Case

In India, euthanasia is allowed under strict guidelines and is only legalized with the withdrawal of life support for terminally ill patients, which means, passive euthanasia. The landmark case if of Aruna Shanbaug, a nurse at King Edward Memorial Hospital who had been kept in a vegetative condition for more then four decades for finally to be granted passive euthanasia, that too "only by legislation", which means the process must be followed until Parliament makes legislation on this subject.

Shanbaug was a victim of a brutal sexual assault in 1973 that deprived oxygen supply to her brain. In 2009, journalist Pinki Virani approach the Supreme Court to seek permission for euthanasia on Shanbaug's behalf. This was met with much criticism, including from the community of nurses who were taking care of Shanbaug since decades. However, many reports show that despite the care, Shanbaug's condition in hospital continued to worsen.

The court in 2011 refused euthanasia largely due to the opposition from hospital staff who cared for her. However, it did deliver a historic ruling and legalized passive euthanasia in India, subject to prescribed safeguards and High Court approval, and made it lawful "only by legislation", as explained above.

The Important Of Living Will And Right To Die With Dignity

Dr Rajeev Jayadevan, a physician with extensive international clinical experience and a strong interest in public health wrote for Health and Me on the importance of living will. He also noted that recent legal developments "have highlighted the importance of advance planning for end-of-life care".

Read: Harish Rana Case Highlights Why Planning For A Living Will Is Important

The doctrine evolved further in Common Cause v. Union of India (2018), when a Constitution Bench of the Supreme Court led by then Chief Justice Dipak Misra recognized that the right to die with dignity is part of Article 21 of the Constitution.

The court ruled that passive euthanasia is legally valid. It said that while the sanctity of life must be respected, in cases of terminal illness or patients in a persistent vegetative state with no hope of recovery, priority should be given to the patient’s advance directive and right to self-determination.

The judgment also introduced the concept of advance medical directives, or “living wills”.

A living will is a written document in which a person can specify in advance the medical treatment they wish to receive if they become terminally ill or are no longer able to give informed consent.

It can also allow family members to withdraw life support if a medical board determines that the patient cannot recover.

The ruling strengthened patient autonomy by allowing people to make decisions about their end-of-life care even when they cannot communicate those wishes later.

What Has Changed Through Judgments?

While the 2018 ruling recognized living wills and passive euthanasia, the process was very complicated. It required approvals and countersigning by a judicial magistrate and multiple procedural steps, which made it difficult for families and hospitals to follow.

In 2019, the Indian Council of Critical Care Medicine told the Supreme Court that these rules were too hard to implement.

Read: Passive Euthanasia: Harish Rana’s Case May Reshape End-of-life Protocols, Say Experts

In 2023, a Constitution Bench simplified the process. Living wills no longer need a magistrate’s signature and can be attested by a notary or gazetted officer. More than one family member can be named as a decision-maker. Hospitals now rely on two medical boards that must give an opinion within 48 hours, and they only need to inform a magistrate rather than seek approval.

The issue came to the forefront in the case of Harish Rana, who suffered severe brain injuries after a fall in 2012 and showed no recovery for 13 years. In 2024, his family approached the Supreme Court seeking permission to withdraw life support.

The court allowed it, saying continuing treatment was not in his best interest.

Legal experts say this marks a major shift in India’s approach to passive euthanasia. Over the years, court rulings have strengthened the idea that the right to die with dignity is part of Article 21, simplified procedures for living wills, and shown greater willingness to balance the sanctity of life with dignity at the end of life.

A new analysis by the American Cancer Society observed that colon cancer or colorectal cancer has now become the leading cause of cancer death in US for people under 50. As per the report from the American Cancer Society, adults who are 65 or younger comprise nearly 45 per cent of all new colorectal cancer cases. This is a significant increase from 27 per cent in 1995.

Dr Timothy Cannon, director of the Molecular Tumor Board and co-director of the Gastrointestinal Cancer Program at Inova in Virginia who spoke to Fox News Digital said, "Once considered a disease that primarily affected people over 50, we are now seeing increasing diagnoses in patients in their 20s, 30s and 40s — making it even more important not to dismiss symptoms based on age alone."

How Can You Detect Colorectal Cancer?

Doctors and experts across say that early screenings could help. Health officials recommended screenings to start at the age 45 and continue through age 75 for adults at "average risk".

Other ways could also be stool-based test that are used to detect blood or DNA changes, which could be potential indicators of colorectal cancer.

A colonoscopy is another method, a medical procedure that allows a doctor to examine the inside of a patient's colon and rectum. It uses a thin, flexible tube with a camera on the end. It is typically done every 10 years for adults at average risk.

"Colonoscopy remains the gold standard because it not only detects cancer early but can also prevent it by identifying and removing precancerous polyps," said Cannon.

Dr Michael Martin, who is a California-based physician, however, emphasized that colonoscopy is usually done for younger patients who are at higher risk.

As per Dr Martin, Stool-based tests are appropriate screening options for average-risk adults, but they are not the best choice for people with significant family history, inflammatory bowel disease, hereditary syndromes or alarm symptoms. If symptoms are present, the goal is not screening but diagnosis, and colonoscopy is usually the more appropriate test."

Who Should Get Screened For Colorectal Cancer Before 45?

There are three kinds of people who could get their colon cancer screened before turning 45. Experts suggest these people are as followed:

People With Strong Family History

The American College of Gastroenterology recommends early screening if one first-degree relative is diagnosed with colorectal cancer, or an advanced polyp before age 60, or if two first-degree relatives are diagnosed at any age.

Symptoms That Are Critical

There are red flags which could hint you to get the screening done before 45, they include:

• Rectal bleeding with bright red blood
• Dark or black stools
• Blood in stool
• Persistent changes in bowel habits like constipation or diarrhea
• Unexplained iron deficiency or anemia
• Ongoing abdominal pain or cramping
• Unexplained weight loss
• Persistent sensation that bowel is not emptying fully

Genetic Condition

Some people with certain genetic condition could have an increased risk of colon cancer, this includes people with Lynch syndrome. This is an inherited DNA mutation that increases lifetime risk. People with this condition should get a colonoscopy every one to two years starting from the age 20 to 25 years, or two to five years before the youngest diagnosed family case, note the National Cancer Institute.

Every year, on March 13, World Sleep Day is observed, with this year's theme being "Sleep Well, Live Better". In many ways, it is true, as the National Institutes of Health, US, notes that sleep helps with almost everything in your life. A good sleep helps with learning and the formation of long-term memories. Not getting enough sleep or enough high-quality sleep could lead to problems, affect your mood, immune system and your learning capabilities. So, to be true to the theme of "Sleep Well, Live Better", Health and Me, based on what experts told The New York Times (NYT), came up with six day-time habits that will help you sleep better.

Why is it important? Much conversation that happens around good sleep focuses on nighttime routine, but what you do throughout the day also impacts how well you sleep.

Speaking to NYT, Joseph Dzierzewski, senior vice president of research and scientific affairs at the National Sleep Foundation, noted that daily habits play a critical role in regulating sleep patterns. According to him, the choices people make during the day can be just as important as their bedtime routines.

Morning Sunlight Is Important

As per Dr Indira Gurubhagavatula, a professor of sleep medicine at the University of Pennsylvania Perelman School of Medicine, who also spoke to NYT, getting sunlight within an hour of waking helps suppress sleep-inducing hormones and signals the body to shift into "wake mode". This helps reset body's internal clock so that it naturally becomes tired again by bedtime.

While spending an hour outdoors may not always be feasible, experts say even short bursts of light exposure help. Opening the blinds, sitting by a window, or having morning coffee on a balcony can make a difference. Even about 10 minutes of sunlight is better than none.

Read: Not Boarded Any Flight And Still Monday Feels Like A Jetlag? You Are Not Alone

A Consistent Mealtime

Experts note that the body operates on a 24-hour internal clock known as the circadian rhythm, which regulates sleep and wake cycles. The digestive system also plays a role in this rhythm and responds to cues about when food is consumed.

Eating meals at inconsistent times may disrupt this rhythm and potentially affect sleep quality.

A consistent meal time also helps with healthy habits and helps you to avoid digestive discomfort and acid reflux during sleep.

Caffeine Habits: Is It Time To Rethink It?

Dr. Charlene Gamaldo, a neurologist and sleep medicine specialist at Johns Hopkins Medicine, told NYT that caffeine stays in some people's systems much longer than others. In slow metabolizers, caffeine from a morning coffee could remain in the body for more than 12 hours, potentially interfering with sleep.

Time Your Medication For Early Hours

According to Dr. Gurubhagavatula, certain drugs, including decongestants such as phenylephrine and pseudoephedrine, medications used for ADHD and asthma, some antidepressants, and oral steroids, may have stimulating effects.

This is because some medication could make it harder for you to fall or stay asleep, when taken late in the day.

Be Consistent When You Wake Up

Experts say that frequently changing wake-up times, even on weekends, can disrupt the circadian rhythm and make it harder to maintain a healthy sleep schedule. However, the timing does not need to be exact. Staying within about 30 minutes of the usual wake-up time is generally sufficient to maintain consistency.

Be Attentive Towards Your Workout Timing

Regular exercise is widely associated with better sleep, and health guidelines recommend at least 150 minutes of moderate aerobic activity each week. However, for some people, exercising too close to bedtime may make it harder to fall asleep. Strenuous workouts can temporarily increase body temperature and raise stress hormones and endorphins, which may keep the body alert.