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!

Cardiovascular-kidney-metabolic (CKM) syndrome is emerging as a major public health threat, according to new guidelines from the American Heart Association (AHA), which identify obesity as a key driver of the condition's development and progression.

The guidelines, jointly issued by the AHA and the American College of Cardiology (ACC), reframe excess weight as more than a number on the scale, describing it as a significant health risk closely linked to diabetes, chronic kidney disease and cardiovascular disease.

According to the AHA, nearly 9 in 10 adults in the United States have at least one condition associated with CKM syndrome. These include high blood pressure, abnormal cholesterol and other lipid disorders, high blood sugar, reduced kidney function and excess body weight.

With obesity rates continuing to rise, the guideline urges healthcare professionals to have prevention-focused conversations with patients about maintaining a healthy weight to reduce the risk of future heart, kidney and metabolic diseases.

“CKM syndrome is a real, rising public health threat,” said Chiadi E. Ndumele, an American Heart Association volunteer and chair of the writing committee for the new guideline.

“In terms of CKM health, weight is not just about a number on a scale — people with the same body weight can have very different health profiles. Rather, what’s most important is how fat tissue affects your metabolic health. This includes how your body manages blood sugar levels and how fat is used and stored,” Ndumele, who is also director of obesity and cardiometabolic research at Johns Hopkins University in Baltimore.

The New CKM Syndrome Guideline

Also read: Bryan Johnson's Autoimmune Gastritis: US Doctor Explains the Hidden Signs of Autoimmune Disease

The updated guideline replaces the 2013 recommendations for managing overweight and obesity. CKM syndrome itself was first formally defined by the American Heart Association in 2023.

The guideline highlights several strategies to improve the prevention and treatment of CKM syndrome:

• Use the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) equations to estimate 10-year and 30-year cardiovascular disease risk. Unlike previous tools, PREVENT incorporates kidney and metabolic health factors for a more comprehensive risk assessment.
• Screen patients for social determinants of health, including food insecurity, housing instability and financial strain, which can increase the risk of CKM syndrome.
• Promote coordinated, multidisciplinary care focused on healthy lifestyle behaviors, including physical activity, nutrition, weight management, blood pressure control, blood sugar management and cholesterol reduction.
• Alongside lifestyle interventions, use medications and surgical therapies when appropriate to manage blood pressure, cholesterol, blood sugar and obesity while protecting heart and kidney health.
• For the first time, the guideline recommends GLP-1-based therapies for select individuals with obesity and/or Type 2 diabetes who are at elevated cardiovascular risk. Metabolic and bariatric surgery is also recognised as an effective treatment option for eligible patients.

How Can CKM Syndrome Be Prevented?

Read More: Are You Getting The Right Cholesterol Test? ApoB May Be Better Than LDL

The guideline emphasizes that early lifestyle changes can significantly reduce the risk of heart attack, heart failure, stroke and kidney failure.

People are encouraged to follow the AHA's Life's Essential 8, which promotes

• regular physical activity,
• a heart-healthy diet,
• maintaining a healthy weight,
• controlling blood pressure,
• maintaining blood sugar
• better cholesterol control,
• avoiding tobacco,
• getting sufficient quality sleep.

The monsoon brings welcome relief from the heat, but it also creates conditions that make infections spread more easily among children. Parents should understand that a few common household mistakes can increase the risk of illness in children during this time of year. So, parents must exercise caution and take utmost care of their children during those rainy days.

Why Monsoon Raises Infection Risk in Children

The arrival of the monsoon often means more time spent indoors for children, muddier surroundings, and increased exposure to germs. So, the main focus of parents is on protecting their children from rain and cold weather. However, parents must understand that certain everyday habits at home may unknowingly increase the risk of respiratory infections, stomach illnesses, and mosquito-borne diseases.

Common Mistakes Of Infections In Children

So, many children can get drenched during those heavy rains and remain in wet clothes or footwear for long periods after returning from school or outdoor activities. Damp socks and shoes can create an environment where germs and fungal infections thrive. Parents should ensure that children change into dry clothes and footwear as soon as possible. Moreover, stagnant water collected in flower pots, buckets, coolers, balconies, and outdoor containers can become breeding grounds for mosquitoes, raising the chances of dengue, malaria, and chikungunya in children.

Many families keep doors and windows closed throughout the day to prevent rainwater from entering the house. However, limited air circulation can lead to the growth of mold, dampness, and indoor allergens, which may trigger respiratory infections, coughing, wheezing, and allergies in children. Even having uncovered food, improperly stored leftovers, or contaminated water can increase the risk of stomach infections, diarrhea, vomiting, and food poisoning in children.

Tips Parents Should Follow During the Monsoon

Parents should ensure that the child changes wet clothes, socks, and shoes immediately after returning home. Parents should empty and clean containers that can collect stagnant water from time to time. Use mosquito nets, screens, and child-safe mosquito repellents to prevent mosquito bites. Keep rooms well ventilated whenever the weather permits. The child should follow good hand and personal hygiene, eat freshly cooked food, and drink safe drinking water.

The parents should ensure to wash fruits and vegetables thoroughly before consumption. The child should eat a nutritious diet, sleep well, and stay hydrated to boost immunity and prevent any illness. Parents should seek immediate help if the child is having any symptoms, such as a cough or allergies, and follow the expert's guidelines. Parents should not give any medication to the child on their own without the doctor's knowledge. So, parents should stay alert during the monsoon and help the child stay healthy.

Billionaire entrepreneur Bryan Johnson, known for meticulously tracking his health and pursuing longevity, recently revealed that he has been diagnosed with Autoimmune Gastritis, an incurable autoimmune condition in which the body's immune system attacks the stomach lining.

Describing the disease on social media platform X, Johnson said: "My stomach is eating itself." He also noted that despite undergoing extensive medical evaluations over the years, the condition went undetected because autoimmune diseases often develop quietly, with symptoms that can easily be mistaken for everyday health issues such as fatigue or digestive discomfort.

According to the Centers for Disease Control and Prevention (CDC), autoimmune diseases occur when the immune system mistakenly attacks the body's own healthy cells and tissues, triggering inflammation and damage to organs or other body systems.

The burden of these conditions is significant. In May 2025, researchers from the Mayo Clinic and collaborating institutions estimated that nearly 15 million Americans are living with one or more of 105 recognized autoimmune diseases.

Symptoms Can Be Easy to Miss

Because autoimmune diseases often begin with vague, non-specific symptoms, they can remain undiagnosed for months—or even years.

Dr. Cory Rice, a US-based Functional Medicine physician, said these warning signs frequently go unnoticed until the disease has progressed.

"First and foremost, symptoms of autoimmune disease can come and go, and be on and off, or they can be more persistent in nature," he told Newsweek.

Also read: Paxlovid Safe for Children Aged 6 And Older, New Study Finds

The Hidden Signs You Shouldn't Ignore

While symptoms vary depending on the various autoimmune conditions, several early warning signs are shared across many autoimmune diseases.

According to Dr. Rice, common symptoms include:

• Fatigue
• Low-grade fever
• Joint pain
• Unexplained rashes or hives
• Dry eyes and dry mouth
• Numbness or tingling in the hands or feet
• Mouth ulcers
• Increased sensitivity to cold temperatures

He said when people suffer from fatigue, "it is usually both profound and debilitating."

Dr. Rice explained that many people try to manage this overwhelming exhaustion by relying on caffeine and other stimulants, taking thyroid medications or hormone treatments, or opting for therapies such as intravenous infusions and vitamin B12 injections.

However, when an underlying autoimmune disease is responsible, these approaches often fail to provide lasting relief.

Read More: Can Arsenic, Lead and Other Metals In Tampons Pose A Health Risk? FDA Says No

Why Autoimmune Diseases Are Often Diagnosed Late

One of the biggest challenges in diagnosing autoimmune diseases is that their symptoms overlap with those of many other medical conditions.

Johnson also said that "2-5 per cent of people have this (autoimmune disease). Likely more, because it hides".

Symptoms may also appear intermittently before becoming more persistent.

"It all depends on the disease process in play and the severity or progression of the disease itself in a particular person as to whether symptoms are more constant or intermittent," Rice said.

He added that many primary care physicians are not routinely trained to identify autoimmune diseases in their early stages. As a result, patients are frequently referred to specialists, including rheumatologists, only after symptoms have become more pronounced.

"Unfortunately, by this point, the autoimmune disease may already be far along in whichever parts of the body are impacted," he said.

Dr. Rice emphasized that recognizing symptoms early and obtaining a timely diagnosis can help slow disease progression and improve long-term outcomes.