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!

Many people do not realise just how closely mental health and liver health are connected—especially when alcohol becomes a go-to coping strategy for stress, anxiety, or emotional overwhelm. What may seem like temporary relief can quietly evolve into a pattern that affects both the mind and the body in significant ways. Dhara Ghuntla, Psychologist affiliated with Sujay Hospital, 7 Hills Hospital, Criticare Hospital, in an interaction with Health and Me, spoke about the impact of stress, alcohol use and emotional eating on the liver.

In today’s fast-paced, high-pressure lifestyle, it is common for individuals to turn to alcohol to unwind or escape difficult emotions. In the short term, alcohol can create a sense of relaxation or numbness. However, over time, this reliance can shift into a habitual coping mechanism and eventually into dependence. While the psychological impact is often discussed, the physical consequences—particularly on the liver—are just as important.

The liver plays a critical role in detoxifying the body. Regular alcohol consumption places it under constant strain, impairing its ability to function effectively. Over time, this can lead to conditions such as fatty liver, inflammation, and even long-term liver damage. What makes this especially concerning is that early-stage liver issues often present with little to no obvious symptoms, allowing damage to progress unnoticed.

At the same time, liver health has a direct influence on mental well-being. When the liver is compromised, it can affect energy levels, mood regulation, and cognitive function. People may experience increased fatigue, irritability, anxiety, low mood, or emotional instability. This happens because the liver plays an indirect but essential role in brain health through metabolism and toxin clearance.

The Vicious Cycle

This creates a self-perpetuating loop. A person feeling stressed, low, or anxious may turn to alcohol for relief. While it may help temporarily, it simultaneously places stress on the liver. As liver function declines, mental health symptoms—such as fatigue, irritability, anxiety, or low mood—can worsen. This often leads the individual to consume more alcohol, reinforcing the cycle.

Adding another layer, many individuals who rely on alcohol are often dealing with underlying issues such as depression, anxiety, sleep disturbances, or chronic life stressors. Alcohol is frequently used as a form of self-medication. However, instead of addressing these root concerns, it masks them temporarily while deepening both psychological and physical harm. Over time, this pattern increases dependency and makes recovery more complex.

The Gut–Liver–Brain Connection

Liver health is also closely tied to gut function and brain health. When the liver is under stress, digestion can be affected, nutrient absorption may decline, and energy levels can drop. This interconnected system—the gut, liver, and brain—plays a key role in emotional regulation and overall well-being. Disruptions in one area can ripple across the others, influencing how a person thinks, feels, and functions daily.

Breaking the Pattern

Recognising this connection is the first step towards change. Instead of turning to alcohol, healthier coping strategies can help regulate stress and support both mental and physical health. Practices such as yoga, meditation, regular exercise, journalling, and maintaining a balanced diet can significantly improve resilience and emotional stability.

Prioritising mental well-being, addressing underlying psychological concerns, and protecting liver health are not separate goals—they are deeply interconnected. Seeking timely support, whether through therapy, lifestyle changes, or medical guidance, can help break the cycle.

Reducing or eliminating alcohol use is not just about avoiding physical harm; it is about creating space to heal the underlying causes of stress and emotional distress. Supporting the liver, nurturing the gut, and caring for mental health together can lead to more sustainable and meaningful well-being.

You pick up a jar on the kitchen shelf and shudder. You take a flight of stairs, and that old pain sinks into your hip. You get up in the morning, and your shoulder feels as though it has been wrung out. You attribute it to age, to a long day on your feet, to just how things are now. But what if your body is trying to tell you something very particular and you have been missing it?

Dr Apoorv Dua, Consultant, Orthopaedics, ISIC Multispeciality Hospital, in an interview with Health and Me, said that this may be a sign of bursitis—a condition that is much more widespread than most people realise, and much more treatable than most people are aware. The expert went on to answer common questions regarding extreme pain that comes with this condition.

What is bursitis?

Bursae are small, fluid-filled sacs located between your bones, muscles, and tendons. Imagine them as the natural cushioning system of the body—shock absorbers that ensure your joints move smoothly and painlessly. Under normal circumstances, you do not even think about them. However, when inflamed, due to repetitive motion, prolonged pressure, injury, or infection, they make their presence known in a very noticeable manner. This is bursitis. Although it most often appears in the shoulder, elbow, hip, and knee, it may occur in nearly any joint in the body.

Who gets bursitis—and why?

This is where the lifestyle connection cannot be overlooked. Bursitis does not discriminate, but it has definite patterns. The weekend warrior who runs ten kilometres on Saturday after sitting at a desk all week. The housewife who spends hours cleaning floors or squatting in the kitchen. The office worker who has been stooped over a computer. The gym enthusiast who does not warm up. The retired teacher who begins a walking routine too vigorously. All these individuals may be silently placing stress on their bursae, and in many cases, bursitis is the eventual outcome.

Age also plays a role—the bursae, like most of our connective tissue, grow weaker with age. Certain medical conditions such as rheumatoid arthritis, gout, and diabetes can increase the risk. However, in many instances, the cause is simply the way we move—or do not move—in our day-to-day lives.

What does bursitis feel like?

A key characteristic of bursitis is pain that is disproportionate to the activity causing it. Reaching overhead, sitting on a hard surface, pressing on your elbow, or walking downhill—these are not dramatic movements, yet with bursitis, they may trigger a sharp, deep, or burning pain that interrupts you mid-action. The affected joint is usually swollen and tender. The area may feel warm to the touch. Movement becomes guarded. Sleep, particularly in cases of shoulder bursitis, can be difficult, as lying on the affected side aggravates the pain.

The challenge with bursitis is that its symptoms can resemble other conditions—tendinitis, arthritis, a muscle strain, or even a ligament tear. Many individuals self-diagnose, self-treat with painkillers, and hope it will go away. Sometimes it does. However, chronic, untreated bursitis may persist for months and, in some cases, lead to complications.

Bursitis diagnosis

A thorough clinical examination is usually the first step. A skilled orthopaedic specialist can identify the affected bursa through specific physical assessments. Imaging, such as ultrasound or MRI, may be recommended depending on the case to confirm the diagnosis, rule out structural damage, or guide treatment.

If infection is suspected—indicated by increased redness, fever, and rapidly worsening pain—fluid may be aspirated from the bursa and tested. Septic bursitis is a serious condition that requires immediate medical attention and is treated differently from the more common non-infectious type.

Bursitis treatment

The encouraging fact about bursitis is that it responds well to treatment, particularly when detected early. Most cases are managed with a combination of rest, activity modification, ice application, and anti-inflammatory medication. Physiotherapy also plays an important role, helping to correct movement patterns, strengthen supporting muscles, and restore the full range of motion.

In more persistent cases, a corticosteroid injection into the bursa may provide rapid and significant relief by reducing inflammation at its source. Surgery is rare and is typically considered only in chronic, recurrent cases that do not respond to conservative treatment.

Prevention is better

In many instances, bursitis is linked to lifestyle—and that presents an opportunity for prevention. Even small changes can help: warming up before exercise, avoiding excessive strain on joints, maintaining a healthy weight to reduce pressure on hips and knees, and ensuring workstations are ergonomically designed.

Pain often becomes background noise—something we get used to, work around, and push through. However, bursitis reminds us that the body communicates with precision. That pain when you pick up a jar, that discomfort on the stairs—it is not simply ageing. It is a signal worth discussing with your doctor.

The bulge that appears when an internal organ pushes through a weakened muscle wall will not recede with rest or medication—it will, in most cases, grow larger and more uncomfortable over time. Surgery is the only definitive treatment. What has changed significantly in recent years is what that surgery looks like and what recovery from it requires.

Dr Rajesh Sharma, Director – General Surgery, Minimal Access & Bariatric Surgery, CK Birla Hospitals, Jaipur, in an interview with Health and Me, spoke about the introduction of robotics in hernia treatment and how it can benefit patients.

How hernia surgeries are becoming less painful

With advances in surgical technology, minimally invasive approaches have significantly improved patient outcomes. One of the most important developments in recent years is robotic-assisted hernia surgery using the da Vinci Surgical System. In robotic surgery, the surgeon operates from a console equipped with a high-definition, three-dimensional, magnified view of the surgical field. The robotic system translates the surgeon’s hand movements into extremely precise movements of miniaturised instruments inserted through small incisions. The system also filters natural hand tremors and provides a greater range of motion than the human wrist, enabling meticulous dissection and suturing.

For hernia repair, these capabilities allow surgeons to perform delicate steps such as accurate defect closure and optimal mesh placement, which are important for the long-term durability of the repair.

Benefits for patients

Robotic hernia repair offers several advantages for patients:

1. Smaller incisions and minimal scarring
2. Reduced postoperative pain
3. Lower risk of wound complications
4. Shorter hospital stay
5. Faster return to normal activities

Because the procedure is minimally invasive, most patients experience earlier mobilisation and quicker overall recovery compared with traditional open surgery. Robotic surgery is particularly useful in complex, recurrent, or large ventral hernias, where precise reconstruction of the abdominal wall is important. While not every hernia requires a robotic approach, the technology expands the surgeon’s ability to perform advanced minimally invasive repairs with improved ergonomics and visualisation.

The future of hernia surgery

The integration of robotic platforms such as the da Vinci system represents a major step forward in modern general surgery. By combining surgical precision with minimally invasive techniques, robotic hernia repair aims to enhance patient comfort, improve recovery, and deliver durable surgical outcomes.