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!

This year had been a year of flu, fiver, bacterial illness and more. One of the over the counter medicine that many people often buy, or is prescribed, especially for bacterial infections is Amoxicillin.

What Is Amoxicillin?

It is a widely prescribed antibiotic that is used to treat bacterial infections in children and adults. It is part of the penicillin class of medications and it inhibits the growth of bacteria and allows the immune system to efficiently eliminate the infection. It is commonly used to treat bacterial infections affecting the respiratory tract, urinary tract, and skin.

However, about 5 to 10 per cent of children prescribed this may develop skin rashes as a common side effect. A rash can develop in two forms: allergic and non-allergic. A rash from the drug Amoxicillin could last up to a week.

What Kind Of Rashes Are Caused By Amoxicillin?

A Maculopapular rash is a flat rash that occurs like red patches, raised bumps and spreads over the body.

Hives are itchy, raised red or skin-colored welts that can change shape and location.

Erythema Multiforme are more severe, featuring target-like lesions or bull's-eye shapes with central red spot, pale ring, and red outer ring.

Anaphylactic Reaction is a rare but severe allergic reaction that includes symptoms like difficulty in breathing, swelling of the face, lips, or tongue, hives and rapid drop in blood pressure.

Non-Allergic Amoxicillin Rash are flat, red spots that may be slightly raised, but not harmful. These usually appear o the 5th to 7th day after the start of amoxicillin and can appear on the chest, abdomen, back, face, arms, and legs. It may get worse before it starts to get better.

What Signs Should You Look Out For?

Warning signs include rashes within two hours of the first amoxicillin dose, difficulty breathing or swallowing, or very itchy hives.

The allergic reaction is caused by one's immune system reacting to that medication as if it were a foreign invader in the body.

More girls than boys develop these rashes, and in children this is even more common. In fact, the rash by amoxicillin was first noted in 1960s, in children who were being treated with ampicillin, recorded the Journal of Pediatrics.

What Can You Do If You Get Amoxicillin Rashes?

Among treatment, the first step should be to see your physician and immediately stop taking the medication. Drinking water and enough fluids can also help. Your doctor too would prescribe you medications and lotions to soothe your itching.

Hives can also be treated with the over the counter drug Benadryl. However, you must go see your doctor or GP, and not self medicate.

A doctor may treat the rash in various ways, including stopping the medication as the first line of defense. Then the doctor may give oral antihistamines (e.g., cetirizine) for the itch. Some doctors may use topical steroids to help with the itch and redness.

Before visiting your doctor, take photos of your rash, send it to your GP, as if it is contagious. Even after you start the treatment, stay in touch with your healthcare provider for any development.

The World Health Organization (WHO), notes that 36% of world's rabies deaths come from India, and a 2024 Lancet study notes that the country accounts for over one-third of global rabies deaths. When we spoke to Dr Aniket Mule, Consultant Internal Medicine at KIMS Hospital, Thane, he said that it is not just dog bites that lead to rabies, but it could happen from any rabies-susceptible animal. The first line of defense after you clear your wound immediately is to get the rabies vaccine. "Rabies vaccination is required for bites or scratches from any rabies-susceptible animal, including cats, monkeys, bats, foxes, and other wild mammals," he pointed out. As the country's apex court ruled and issued directives on stray dogs, focusing on public safety by ordering their removal, global health organizations, including WHO point out that this is not the right way to deal with rabies issue. Comprehensive methods including evidence=based strategies that center on mass dog vaccination is the key to the problem.

However, before this could be implemented, here's what you should know about dog bites and rabies.

What To Do After A Dog Bites Or Scratches You?

Dr Mule points out that even when there are minor scratches, without bleeding, you must get a rabies shot. "Rabies can be contracted through broken skin. Such exposures still require medical evaluation and, in most cases, rabies vaccination."

Read: In An 'Exceptionally Rare' Case, Man Dies Of Rabies After Kidney Transplant

What Should One Do Immediately After Being Bitten Or Scratched?

• Wash the wound immediately for at least 15 minutes with soap and running water
• Apply an antiseptic such as povidone-iodine
• Do not apply home remedies like turmeric, chili or oil
• Seek medical care promptly for rabies vaccination and possible immunoglobin

Dr Mule points out that the rabies vaccine should be started as soon as possible. "Ideally within 24 hours of a bite or scratch. However, even if there is a delay of days or weeks, vaccination should still be started immediately as rabies has a variable incubation period," he says.

After the bite, the immediate medical attention involves rabies post-exposure prophylaxis or PEP, and with a tetanus booster. Some rabies vaccines also use saline water as the diluent to reconstitute the freeze-dried powder before injection.

Read: Australia Issues Advisory Warning Travelers Of Counterfeit Rabies Vaccines Found In India

The temperature of the vaccine matters. "Rabies vaccines are temperature-sensitive and must be stored between 2°C and 8°C. Exposure to heat or freezing can reduce vaccine potency. Poor cold-chain maintenance is a known reason for vaccine failure in rare cases," points out the doctor.

Cases Of Rabies Coming Back After Vaccination Course Has Been Done

Dr Mule points out that in order to avoid such things happening, one must ensure immediate wound washing, timely vaccination, and correct use of Rabies Immunoglobulin or RIG. Rabies can come back if these following things occur:

• Delay in starting vaccination
• Failure to administer Rabies Immunoglobulin (RIG) in severe (Category III) exposures
• Improper wound cleaning
• Incorrect injection site (gluteal region)
• Poor vaccine storage (cold-chain failure)

Dr Mule points out that the vaccine should be given intramuscularly in the deltoid or upper arms for adults, as gluteal or buttock injections could lead to inadequate absorption and reduce effectiveness.

How Many Doses Should One Get?

• For someone not previously vaccinated, the current standard is 4 doses on days 0, 3, 7, and 14 (intramuscular schedule).
• In some government programs or intradermal schedules, 3–4 doses may be advised.
• Previously vaccinated individuals require only 2 booster doses (days 0 and 3).

The exact schedule depends on vaccination history and the protocol followed.

Winter in India is often associated with sardio ke laddoo, but also with increasingly sedentary lifestyle, worsening air pollution, all of which leads to more time spending home than to going out, taking a stroll, working out and more. This is why as winter sets in, India also sees a quiet but consistent rise in non communicable diseases, or NCDs, conditions that now account for nearly two thirds of all deaths in the country. Heart disease, diabetes, thyroid disorders, fatty liver disease and arthritis continue to rise across age groups, driven by sedentary lifestyles, dietary excess and delayed diagnosis.

Winter can further aggravate these risks. Physical activity drops, calorie dense foods become routine, sunlight exposure reduces and metabolism changes. Studies and hospital data in India have repeatedly shown that heart attacks and strokes tend to spike during colder months. Blood vessels constrict, blood viscosity increases and cholesterol levels often rise. Blood sugar control also becomes more challenging, while joint pain and stiffness worsen for many.

Dr. Mayanka Lodha Seth, Chief Pathologist at Redcliffe Labs, says the problem is not seasonal food but seasonal neglect. “Traditional winter foods are not harmful on their own. The real risk comes from consuming them without understanding what is happening inside the body,” she explains. “Winter tends to mask symptoms while quietly worsening internal imbalances.”

With India already home to over 100 million people living with diabetes and a similar number estimated to be prediabetic, preventive testing becomes crucial. Doctors recommend five key tests that can offer a clearer picture of health before winter indulgence begins.

Blood Sugar Levels

Diabetes is one of the fastest growing NCDs in India, and a large proportion of cases remain undiagnosed. Winter diets high in sugar and fat can trigger frequent glucose spikes. Testing fasting blood sugar and HbA1c helps identify early risk and prevents long term complications affecting nerves, kidneys and the heart.

Lipid Profile

High cholesterol is a major contributor to cardiovascular disease, which remains India’s leading cause of death. Reduced activity in winter often pushes lipid levels higher. A lipid profile helps assess heart risk and guides dietary and lifestyle moderation before damage sets in.

Liver Function Test

Non alcoholic fatty liver disease is increasingly common in India, even among younger adults. Excess sugar and fat intake during winter can worsen liver fat accumulation. Early liver testing can flag reversible changes before they progress to chronic liver disease.

Thyroid Function Test

Thyroid disorders affect millions in India, especially women, and often go unnoticed. Symptoms like weight gain, fatigue and cold intolerance are frequently brushed off as winter sluggishness. A simple thyroid test helps distinguish seasonal lethargy from hormonal imbalance.

Vitamin D and Vitamin B12 Levels

Vitamin D deficiency is widespread due to limited sun exposure in winter, while Vitamin B12 deficiency remains common because of dietary patterns. Both deficiencies are linked to low immunity, muscle pain, bone weakness and worsening joint discomfort.

Dr. Seth adds, “Preventive diagnostic testing allows people to make informed choices. It helps them enjoy winter foods in moderation without unknowingly worsening an underlying condition.”

As NCD related healthcare costs continue to rise in India, early testing offers both health and financial protection. Winter comfort does not have to come at the cost of long term health. Staying informed may be the most effective preventive step this season.