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!

For most people, the arrival of monsoon brings welcome relief from the scorching summer heat. For physicians, however, it also signals the beginning of a season when managing chronic lifestyle diseases becomes significantly more challenging.

High humidity, fluctuating temperatures and a sharp rise in seasonal infections create conditions that can quietly destabilise diabetes, hypertension and heart disease, even in people whose conditions are otherwise well controlled.

Lifestyle diseases are often thought of as long-term conditions that progress gradually. Yet they are also highly sensitive to environmental changes. During the monsoon, the body works harder to regulate temperature and maintain normal circulation. High humidity reduces the body'sability to cool itself efficiently, increasing the workload on the heart. At the same time, sudden shifts between hot outdoor conditions and cold indoor environments can influence blood vessel function, leading to fluctuations in blood pressure. These physiological changes may seem subtle, but for individuals living with chronic illnesses, they can increase the likelihood of complications.

The season also brings a surge in viral, bacterial and mosquito-borne illnesses. Infections such as influenza, gastroenteritis, dengue, and fungal diseases are becoming more common, placing additional stress on the body. For people living with diabetes, even a relatively minor infection can upset blood sugar control. The body's response to illness triggers the release of stress hormones that increase blood glucose levels. In contrast, changes in appetite and food intake during illness may increase the risk of both hyperglycaemia and hypoglycaemia if medications or insulin are not adjusted appropriately under medical supervision.

Beyond infections, the monsoon often disrupts everyday routines that are essential for effective diabetes management. Reduced physical activity due to persistent rainfall, missed walks, and a greater tendency to indulge in fried, calorie-dense comfort foods can contribute to poor glycaemic control. Prolonged exposure to damp conditions, particularly from wearing wet or closed footwear for extended periods, also increases the risk of fungal infections and delayed wound healing—complications that people with diabetes are already more susceptible to. While these changes may appear routine, together they can make diabetes significantly more difficult to manage during the rainy season.

Seasonal changes equally influence hypertension, although the effects are often less obvious. Variations in temperature and atmospheric pressure can cause blood vessels to constrict or relax, leading to fluctuations in blood pressure. Dietary habits also tend to shift during the rainy season, with increased consumption of salty snacks, pickles, and processed foods, which contribute to sodium overload and fluid retention. Because hypertension frequently remains symptomless, many people assume they are doing well despite missing medicines or delaying routine blood pressure checks. Unfortunately, uncontrolled blood pressure often comes to light only after a serious complication such as a stroke, heart attack, or acute cardiac event.

By Dr. Manjeeta Nath Das, Associate Director – Internal Medicine, PB Health

A cough that lingers for weeks is often dismissed as a stubborn cold, allergy, or lung infection. However, ENT specialists warned that in some cases, the real cause may be acid reflux, a condition that can affect the throat even without the typical symptom of heartburn.

Doctors told HealthandMe that recognizing the signs early can help patients receive the right treatment and prevent long-term complications.

When Does Acid Reflux Trigger a Chronic Cough?

According to Dr. Nishit Shah, ENT/Otorhinolaryngologist at Bombay Hospital, acid reflux, also known as gastroesophageal reflux disease (GERD), does not always present with chest burning.

"Sometimes people with reflux do not feel the usual symptom of heartburn in their chest. Instead, the acid from their stomach goes up into their throat, irritates it, which can cause a dry cough that will not go away, a hoarse voice, or a feeling that something is stuck in their throat," Dr. Shah told HealthandMe.

He advised that if a cough lasts for more than eight weeks and does not improve with usual medicines, acid reflux should be considered as a possible cause.

"It is very important to know what is causing your cough because if you just treat the cough, the acid reflux can still be hurting your throat," Dr. Shah said.

Not Every Throat Symptom Is Acidity

Also read: 'Let's Fix Our Food': India Launches New Policy To Fight Childhood Obesity, Boost Nutrition

However, not every throat symptom should be dismissed as acidity.

Dr. Alok Aggarwal, Chairperson, ENT, Sir Ganga Ram Hospital, said silent reflux often presents as intermittent throat irritation, a sensation of something stuck in the throat, or occasional voice changes.

"These symptoms are often judged as acidity by the common man, and people start self-medicating with antacids and even ayurvedic medicines. Less do they know that this can be a symptom of some underlying ENT disease," he said.

He explained that laryngopharyngeal reflux disease (LPRD) occurs when food or semi-digested food enters the pharynx, irritating its lining.

"It causes symptoms such as throat irritation, burning sensation, pain in throat, nasal irritation, globus sensation and change in voice," Dr. Aggarwal told HealthandMe.

ENT Evaluation Is Essential

Read More: Japanese PM Sanae Takaichi Sleeps 3 Hours A Night: How Much Sleep Do You Really Need?

While LPRD is commonly diagnosed, Dr. Aggarwal cautioned that similar symptoms may also be caused by allergic rhino-pharyngitis, chronic rhino-sinusitis, vocal nodules or polyps, laryngeal leukoplakia, and candida infection.

"Though this comes as the most common diagnosis in clinical practice, it often overshadows some very serious conditions which mimic the symptoms, and only after a thorough ENT examination can the exact diagnosis be made," he said.

He added that these conditions can be effectively diagnosed through thorough history-taking, clinical examination, and endoscopic examination.

"As doctors, we need to educate our patients regarding the disease physiology and the differentials it carries before establishing any diagnosis. A timely and adequate intervention with planned treatment can effectively cure the patient in most cases," Dr. Aggarwal said.

Lifestyle Changes May Help Control Symptoms

Dr. Shah recommended avoiding heavy meals, especially at night, limiting fatty foods, maintaining a healthy weight, and sleeping with the head elevated to help manage acid reflux.

"If people know that acid reflux can cause a cough, they can get a diagnosis sooner, get the right treatment and finally feel better," he added.

Dr. Aggarwal stressed the importance of timely medical evaluation.

"Early diagnosis and treatment can avoid unnecessary medications and avoid missing out on serious complications. A stitch in time saves nine," he said.

Japanese Prime Minister Sanae Takaichi has sparked debate after revealing that she gets very little sleep since taking office.

In a post on X, Takaichi wrote that she had managed to get "five full hours of sleep for the first time in ages"—an improvement from her usual "zero to three hours" a night since becoming prime minister.'.

"On weekdays, by the time I get back to the residence, I'm maxed out on private time just handling bath cleaning, bathing, dinner, washing up afterward, laundry, and some light tidying," she wrote.

"So the late-night hours after that get consumed until dawn with reading materials brought back from the Prime Minister's Office or prepping for … question time."

Takaichi added that whatever free time remained was spent ironing handkerchiefs, catching up on laundry, and repairing clothes.

While the disclosure offered a rare glimpse into the pressures of Japan's highest office, it also sparked a nationwide debate about the health risks of chronic sleep deprivation.

"I think she should rest more," Democratic Party for the People leader Yuichiro Tamaki said at a news conference.

"Why doesn't her entourage provide more support to create an environment in which she can make important decisions with a fresh mind?"

However, some of Takaichi's colleagues defended her.

"Each person has their own various circumstances and behind-the-scenes stories, and on the premise of fulfilling responsibilities in public duties, I would be grateful if you could understand," Deputy Foreign Affairs Minister Ayano Kunimitsu wrote on X.

Also read: Could Poor Sleep Be One of the Earliest Signs of Alzheimer's Disease? Study Says Yes

How Much Sleep Do You Really Need?

Dr. Nitin Dange, Comprehensive Stroke and Endovascular Neurosurgeon at Lilavati Hospital and Research Centre, Mumbai, told HealthandMe that regularly missing sleep can increase the risk of neurological problems over time.

"Currently, due to hectic schedules, people are now sacrificing sleep to meet work deadlines, study longer, or spend more time on screens. Missing a few hours of sleep once in 2-3 months is harmless.

However, chronic sleep deprivation can not only cause irritation and weight gain but also neurological issues. During sleep, the brain processes memories, repairs nerve cells, regulates emotions, and clears waste products that accumulate throughout the day," Dr. Dange said.

A recent research, published in the journal Alzheimer's & Dementia, suggests that disruptions in rapid eye movement (REM) sleep, during which we dream, consolidate memory, and process emotions, could be among the earliest biological signs of Alzheimer's disease.

Dr. Priyam Bordoloi, an Internal Medicine Resident from Assam, also highlighted the dangers of sleeping less than six hours a night.

"When you hit deep sleep, your brain's glymphatic system activates. Think of it as a plumbing system that actively flushes out metabolic waste and neurotoxic proteins (like beta-amyloid) accumulated during the day. When you consistently sleep less than 6 hours, you cut this vital cleaning cycle short. The toxins build up. If you do not fix this, you are actively fast-tracking your risk for Alzheimer's, Parkinson's, stroke etc. It's a bad habit we all need to fix," he wrote on X.

Tips To Sleep Better

Experts recommend getting 7-9 hours of sleep every night for optimal brain health.

• Maintain a consistent sleep and wake-up schedule.
• Avoid screens, caffeine, and heavy meals before bedtime.
• Exercise regularly, but avoid intense workouts late at night.
• Keep your bedroom quiet, cool, and dark.
• Consult a doctor if you snore loudly, stop breathing during sleep, or feel excessively sleepy during the day.