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!

Come Saturday morning, many people have just one thing on their mind: catching up on sleep. After a week of early mornings, office deadlines, late-night screen time and household responsibilities, the weekend feels like the perfect opportunity to stay in bed for a few extra hours. Some people even sleep until noon, believing that the extra rest will make up for all those late nights. But is it really possible to undo five days of poor sleep in just two days?

Unfortunately, the brain doesn't work that way. Sleeping longer over the weekend can certainly help you feel less tired, but it cannot completely compensate for a week of inadequate sleep.

Sleep is much more than physical rest. It is when the brain gets down to some of its most important work. Memories are processed, information gathered during the day is organised, and the brain gets an opportunity to recover from constant activity. When we repeatedly cut short our sleep, these processes can suffer.

Why Do We Feel Better After Sleeping In?

Think about how you feel after several nights of going to bed late. You may find yourself forgetting small things, struggling to concentrate during meetings or becoming unusually irritable over minor issues. These are some of the ways sleep deprivation can affect everyday functioning.

Sleeping for a few extra hours over the weekend can ease some of this fatigue. You may feel more alert and find it easier to concentrate. However, feeling refreshed is not necessarily the same as being fully recovered. Certain effects of repeated sleep restriction, particularly on attention and reaction time, can take longer to resolve.

Can Weekend Lie-ins Disturb Your Sleep Cycle?

There is another side to this weekend habit that people rarely consider. If you sleep at 11 pm during the week but stay awake until 2 or 3 am on Friday and Saturday, your body's internal clock can get disrupted.

This internal timing system, called the circadian rhythm, helps regulate when you feel sleepy and when you wake up. Large changes in sleep timings can make it harder to fall asleep on Sunday night. Before you know it, Monday morning arrives and you are back to feeling exhausted.

It becomes a familiar cycle: insufficient sleep during the week, prolonged sleep on weekends and difficulty getting back into a routine.

What Does Repeated Sleep Deprivation Do To The Brain?

One of the biggest areas affected is memory. Sleep plays an important role in consolidating information, which is why a poor night's sleep can make it harder to remember things or absorb new information the following day.

It can also affect emotional regulation. People who regularly sleep less may become more impatient, anxious or sensitive to everyday stress. Their ability to focus and make decisions may also take a hit.

Persistent sleep deprivation has also been associated with metabolic and cardiovascular problems. It is therefore important not to treat poor sleep as an unavoidable part of a demanding work schedule.

What Is A Healthier Way To Catch Up On Sleep?

Rather than depending on Saturday and Sunday to recover, try making small changes to your routine throughout the week.

• Keep a consistent schedule: Try to go to bed and wake up at roughly the same time every day.
• Don't compromise on sleep duration: Most adults need around seven to nine hours of sleep each night.
• Put your phone away before bedtime: Late-night scrolling can keep the mind stimulated and delay sleep.
• Be mindful of caffeine: That evening cup of coffee may be affecting your ability to fall asleep.
• Step outdoors in the morning: Natural daylight helps regulate the body's sleep-wake cycle.
• Pay attention to persistent tiredness: If you wake up exhausted despite getting enough sleep, speak to a doctor. Sleep disorders such as obstructive sleep apnoea may need to be ruled out.

Your brain needs rest every day, not just when the calendar says it is the weekend. Instead of treating sleep as something you can postpone and recover later, make it a non-negotiable part of your daily routine.

For decades, vaccines have transformed numerous fight against aggressive infectious diseases, saving millions of lives. Still, despite years and years of research proving their effectiveness, there is still significant skepticism surrounding vaccination. One of the most enduring claims is that vaccines, especially the measles, mumps and rubella (MMR) vaccine, can cause autism.

The belief that vaccines can cause autism has been debated for decades, despite a solid body of research failing to establish a link between the two.

In an exclusive interview with HealthandMe on World Immunization Day, Dr. Paul Offit, paediatrician and director of the Vaccine Education Center at Children’s Hospital of Philadelphia and former member of the CDC’s Advisory Committee on Immunization Practices, explained why the vaccine-autism claim is a myth difficult to debunk.

Why Is The Vaccine-Autism Issue Still Debated?

Also read: EXCLUSIVE: Ex-CDC Vaccine Advisor Says Measles Outbreak Bigger Than Reported, Slams RFK Jr’s ‘No-See Evil’ Approach

According to Dr Paul Offit, the controversy can be traced back to a 1998 paper that claimed the measles, mumps and rubella (MMR) vaccine caused autism. “I think it was born in that 1998 paper that MMR caused autism,” he said.

He said that the paper did an excellent job at convincing the masses that the adverse events related to vaccines can be long-standing and irreversible, like autism. Offit said the original claim had a lasting effect on public understanding of vaccine safety.

He said, “It’s very hard to unring the bell once you've rung it. I think it's hard to unscare people.”

He said the public-health and academic communities responded by conducting study after study to examine the alleged association. “But vaccines don't cause autism,” Offit said.

He believes that the research conducted after the 1998 paper helped address the concern. He said, “The question has been answered. Most parents of children with autism no longer believe that's the case. So I think that those studies were of value,” he said.

The 1998 paper by Andrew Wakefield and colleagues, which suggested a connection between the MMR vaccine and autism, was later retracted by The Lancet. Subsequent research has not established that MMR vaccination causes autism.

Offit said vaccines had been studied extensively as a possible environmental factor in autism. “Vaccines are probably the best studied environmental factor and that ain't it,” he said.

Autism-Vaccine Debate Is Distracting Essential Research

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

Dr. Offit said that genetics plays an important role in autism, while several factors related to maternal health and pregnancy have also been associated with the condition. He said, “About 80% of autism is genetic.”

He added, “There are a number of sort of factors regarding maternal health, regarding maternal drugs, infections during pregnancy that are associated with autism.”

His comments highlight the need to understand autism through research into its different possible causes rather than focusing on vaccines. To which, Offit said that the vaccine-autism controversy has affected essential autism research.

When asked whether vaccine debates were diverting resources from research into autism causes and diagnosis, he pointed to the work of Alison Singer at the Autism Science Foundation and said there were several promising areas of investigation.

However, he criticised anti-vaccine groups for continuing to use autism as part of their arguments against vaccination. “I think that anti-vaccine groups have sadly taken the autism story hostage,” he said.

He argued that this had reduced the attention and resources that could go towards more promising areas of autism research. “So they hurt children with autism in the end,” he said.

On Revising Autism-Vaccine Debate

When asked what new evidence could make him reconsider his position on vaccines and autism, Offit said he would be open to changing his mind if a particular standard of scientific evidence were met.

“If there was an excellent retrospective study that controlled for things like healthcare seeking behavior, socioeconomic background, medical background, maternal health, et cetera, that was published in an excellent scientific journal and reproduced, then I'm willing to change my mind,” he said.

He added that a study would have to account for factors that could influence the results and be independently reproduced. “But until then, you're just hearing a lot of conspiracy theory and hand-waving,” he said.

Delhi's air quality deteriorated significantly after Diwali. Several monitoring stations recorded ‘severe’ air quality on Monday morning (November 9) after a night of Diwali festivities which resulted in widespread emission of firecracker smoke. It worsened the situation in a city already grappling with soaring air pollution due to vehicular exhaust, construction dust and stubble burning in neighbouring states.

Due to this, Delhi residents, who continue to breathe polluted air, may face symptoms like scratchy throat, coughing and irritation. But how can you tell whether your sore throat is caused by pollution or an infection that needs medical attention?

How Does Air Pollution Cause A Sore Throat?

Polluted air contains particulate matter, including PM2.5, as well as gases and other irritants. When inhaled, these pollutants come into contact with the lining of the nose, throat and respiratory tract, triggering irritation and inflammation.

Dr. Rahul Sharma, Director, Pulmonology & Critical Care, Fortis Greater Noida told HealthandMe, “People exposed to high levels of pollution may experience throat irritation, dryness, a burning sensation, frequent coughing and discomfort while swallowing. These symptoms may be more noticeable in people who spend long hours outdoors and are difficult to control.”

People with asthma, allergies or existing respiratory conditions may be more sensitive to these pollutants.

Dr Sharma added, “Pollution can also aggravate existing respiratory conditions like asthma and allergic airway disease. It is important to remember that a sore throat is not always due to infection; environmental exposure can also be a cause.”

Also read: El Niño Could Worsen Dengue, Malaria And Heat Illness: Why WHO Declared A Health Emergency

Pollution-Related Sore Throat Or Infection?

The symptoms can overlap, so a sore throat alone cannot establish its cause. However, certain accompanying signs may offer clues. Experts help us understand when a sore throat is a result of inhaling particulate matter.

Dr. Sushil Upadhyay, Consultant Pulmonologist, Kailash Deepak Hospital, Delhi told HealthandMe, “Throat irritation as an early sign. A scratchy throat is the canary in the coal mine for lung inflammation. It is the first sign that your airways defenses are overwhelmed and deep inflammation is starting.”

A pollution-related sore throat is more likely to involve dryness, scratchiness, coughing and irritation of the eyes or nose.

Dr Samir Garde, Director of Dept of Pulmonology and Lung Transplant, Gleneagles Hospital, Parel, told us, “Pollution-related irritation usually causes a dry or scratchy throat, coughing and eye irritation, which may worsen outdoors or during periods of poor air quality.”

An infection, on the other hand, may be accompanied by fever and other symptoms. They may include body aches, swollen lymph nodes, painful swallowing, tonsil inflammation or white patches on the tonsils. Viral infections can also cause a runny nose, cough and fatigue.

Dr Upadhyay said, “The flu brings high fever, body aches, and extreme exhaustion. If staying inside an air-conditioned, filtered room clears your throat, it's pollution. Otherwise, think of it as flu.”

A bacterial infection such as strep throat may cause sudden throat pain, fever and difficulty swallowing, sometimes without a cough.

Also read: New COVID-19 Variant PJ.2.1 Spreads Globally: WHO Says Symptoms Resemble Cold, Flu

When Should You See A Doctor?

A mild sore throat often improves within a week. However, medical evaluation is recommended if you have difficulty breathing, cannot swallow, are drooling because you cannot swallow, or experience rapidly worsening symptoms.

Dr Upadhyay said, “Do not ignore a sore throat if it moves to your chest. If you develop wheezing, severe breathlessness or a fever, you need a medical evaluation immediately. Seek help right away if you are gasping for air or cannot finish a single sentence in one breath.”

Persistent hoarseness, a lump in the neck or a mouth ulcer lasting more than three weeks should also be evaluated.

Dr Garde recommended, “Seek medical attention if there is chest tightness, high fever or persistent symptoms. Severe breathlessness, bluish lips or difficulty speaking due to breathing problems require immediate emergency care.”

Also read: Delhi AQI Crosses 2,000 Mark After Diwali: What Happens To Your Body Within Hours Of Exposure?

How Can You Protect Your Throat During Severe Pollution?

According to the doctors, while pollution levels remain high, reducing exposure is important. They recommend:

• Avoid outdoor exercise and limit unnecessary time outside.
• Wear a well-fitting N95 or N99 respirator when going outdoors.
• Keep windows closed during periods of high outdoor pollution and use a HEPA air purifier if available.
• Drink enough water to prevent throat dryness.
• Gargle with warm salt water to soothe irritation.
• Avoid smoking, incense and other indoor sources of smoke.

Do not start antibiotics just because your throat hurts. Antibiotics do not treat throat irritation due to pollution or viral infections. They should only be used when prescribed for a confirmed bacterial infection under doctor’s supervision.

Delhi AQI After Diwali

The city's average Air Quality Index (AQI) reached 406 on November 9, placing it in the 'severe' category, according to the Central Pollution Control Board (CPCB).

But private monitoring platform AQI.in reported an AQI of 2,283, classifying the air quality as ‘hazardous’. The reading showcased a grim post-Diwali pollution peak, an issue that has turned into an annual environmental crisis.

The stark difference in readings is because India’s AQI scale is limited to 500 while other private air quality monitoring platforms measure higher readings. So even if CPCB’s data shows 500 AQI, it can mean that the amount of harmful pollutants could be much higher.

The Supreme Court had implemented restrictions on celebrating Diwali with firecrackers by limiting time between 6 am and 7 am and 8 pm and 10 pm on November 7 and 8 and allowing only green crackers. However, firecrackers were reportedly burst beyond permitted hours.