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!

A 27-year-old woman in US' state of Arizona suffered a cardiac arrest after using kratom, an over-the-counter supplement she purchased at a local gas station.

Amanda Goodsell, who had never taken kratom before, suffered a cardiac arrest after nearly a week of using the supplement and is now on life support, according to her family.

The mother of 3½-year-old twins tried the kratom gummies at the suggestion of her husband, Mike Goodsell, while seeking relief from persistent leg pain.

“Everybody knew what Kratom was. So I was like, well, okay, well, here, just take this. You could just buy it at the gas station. It’s not going to hurt you,” Mike Goodsell was quoted as saying to the media.

Nearly a week later, Mike found his wife unresponsive in their bed, and rushed her to the hospital, where she was placed on life support

“She like, was like red and her lips were blue, and she was foaming. So I like jumped out of bed. I grabbed her, and then (I) was trying to wake her up,” he said.

“They had to have her on a ventilator to help her breathe. And then they had to put her on a bunch of medications because her heart percentage was at 15%,” Mike added.

After spending two weeks in the hospital, Amanda Goodsell's condition began to improve. Although she has shown significant improvement, as per the doctors she will need a defibrillator and heart medication for the rest of her life.

Also read: Legionnaires' Disease Claims 5th Life In New York City: Health Officials

What Is Kratom?

Kratom is a plant-based substance derived from the Mitragyna speciosa tree, native to Southeast Asia. Traditionally used in countries such as Thailand and Malaysia for pain relief and increased energy, it has gained popularity in the US as an over-the-counter supplement.

Kratom is sold in multiple forms, including powders, capsules, teas, drinks and gummies.

Although it remains legal in many parts of the US, the Food and Drug Administration (FDA) has classified kratom as a "drug of concern" and has not approved it for any medical use.

According to the Substance Abuse and Mental Health Services Administration's National Survey on Drug Use and Health, an estimated 1.7 million Americans aged 12 and older used kratom in 2021.

The substance, sometimes referred to as "gas-station heroin," is banned in at least eight US states—Alabama, Arkansas, Connecticut, Indiana, Louisiana, Tennessee, Vermont and Wisconsin. Several other states, including Iowa and Idaho, are considering restrictions or outright bans.

Why Does The FDA Warn Against Kratom?

Read More: Hantavirus Claims 3 Lives In Venezuela: What The Rat-borne Virus Does To The Brain

According to a University of Virginia study, there were 43 hospitalizations linked solely to kratom in 2015. By 2025, that number had risen to 538. Researchers said the increase coincided with the emergence of highly concentrated synthetic products, including 7-OH.

The FDA has stated that kratom should not be used as a dietary supplement.

"Kratom is not appropriate for use as a dietary supplement. FDA has concluded from available information, including scientific data, that kratom is a new dietary ingredient for which there is inadequate information to provide reasonable assurance that such ingredient does not present a significant or unreasonable risk of illness or injury."

The agency has warned consumers not to use kratom because of the risk of serious adverse events, including liver toxicity, seizures and substance use disorder (SUD).

The FDA also notes that, in rare cases, deaths have been associated with kratom use, although these cases usually involved other drugs and the contribution of kratom remains unclear.

The agency is also aware of cases involving neonatal abstinence syndrome, in which newborns experienced withdrawal symptoms such as jitteriness, irritability and muscle stiffness following prolonged exposure to kratom during pregnancy.

When it comes to climate change, we often visualise melting glaciers, rising sea levels, raging wildfires, or record-breaking heatwaves. But scientists are increasingly warning that climate change could also be silently affecting one of the body's most vital organs: the brain.

From rising mercury levels and worsening air pollution to floods, wildfires, and hurricanes, climate-related catastrophes are exposing millions of people across the world to conditions that could increase the risk of neurological disorders.

On World Brain Day, let's look at why brain health is another reason to take climate change seriously.

Effect Of Heatwaves On Brain Health

This can lead to poor concentration, slower reflexes, memory decline, headaches, confusion, and poor decision-making.

Older adults are particularly vulnerable because the brain's ability to regulate body temperature declines with age.

People living with neurological disorders like dementia, Parkinson's disease, multiple sclerosis, or epilepsy may also find that their symptoms worsen during periods of intense heat.

Also read: Will Waterborne Diseases Rise In The Future? New Study Says Climate Change Could Be A Major Driver

Effect Of Air Pollution On Brain Health

Climate change is worsening air pollution in many parts of the world by increasing wildfire smoke, ground-level ozone, and fine particulate matter.

These tiny pollutants, especially PM2.5, are small enough to enter the bloodstream and may even reach the brain. Studies have linked long-term exposure to air pollution with:

• Faster cognitive decline
• Memory impairment
• Increased risk of dementia
• Higher risk of stroke
• Parkinson's disease
• Poor brain development in children

Scientists believe air pollution may trigger chronic inflammation and oxidative stress, both of which can damage brain cells over time.

Also read: Europe Heatwave Causes 10,000 Excess Deaths; England, Wales Record 2,700 More Fatalities

Effects Of Wildfires On Brain Health

While smoke affects the lungs, it can also impact the brain.

Wildfire smoke contains fine particles and toxic chemicals that have been associated with headaches, reduced attention, poorer cognitive performance, and increased emergency visits for neurological conditions.

People with existing neurological diseases may experience worsening symptoms during periods of heavy smoke exposure.

Also read: Dangerous Heat Dome To Grip Eastern US, Canada, Putting Over 220 Million Lives At Risk: How To Stay Safe

Extreme Weather Can Accelerate Brain Ageing

Climate change is also increasing the frequency and intensity of floods, hurricanes, droughts, and other natural disasters. Beyond physical injuries, these disasters can leave lasting effects on the brain and mental health. People affected by climate disasters often experience:

• Anxiety
• Depression
• Post-traumatic stress disorder (PTSD)
• Sleep disturbances
• Chronic stress

Children, older adults, and disaster survivors are among the groups most vulnerable to these long-term psychological effects.

How To Protect Your Brain?

While tackling climate change is a long-term strategic plan, individuals can maintain few self-care habits to reduce the risks. Experts recommend:

• Staying hydrated during heatwaves
• Avoiding outdoor activity during peak afternoon heat
• Monitoring local air quality before going outside
• Wearing a well-fitting mask during heavy wildfire smoke or severe pollution
• Keeping homes cool whenever possible

Brain health is often associated with old age, but according to neurologists, the foundation for healthy cognitive function is laid much earlier.

On World Brain Day, they warned that the 30s and 40s are a crucial period to protect the brain, as lifestyle habits and underlying health conditions can quietly affect memory, concentration, and overall cognitive health.

Brain Ages Alongside the Heart

Speaking to HealthandMe, Dr. Gurucharan Adoor, Neurologist, Apollo Hospitals Bannerghatta Road, Bengaluru, said brain health is closely linked to cardiovascular health. High blood pressure, high cholesterol, and elevated blood sugar can silently damage the brain years before noticeable symptoms appear.

His advice? Make preventive health checks a routine by monitoring blood pressure, blood glucose or HbA1c, cholesterol, weight, and waist circumference—especially for people with a family history of diabetes, stroke, or early heart disease.

Brain Fog A Warning Signal

Also read: Neurological Disorders Emerging As India's Next Major Public Health Challenge, Say Experts

Dr. Adoor said sleep is often the first thing people sacrifice during their busiest years, but the brain pays the price.

Irregular sleep schedules, untreated sleep apnea, and repeated nights of poor-quality sleep can lead to mental fatigue, difficulty concentrating, and persistent brain fog. If brain fog continues, he said, it should not be ignored, as it may indicate an underlying health issue that requires attention.

Dr. Bhushan Joshi, Consultant Neurologist, Manipal Hospital, Kharadi, Pune, told HealthandMe that he is "seeing more professionals in their 30s and 40s complaining of brain fog than ever before". According to him, hormonal changes and chronic inflammation are among the common but often overlooked causes.

Hormonal Changes Can Affect Cognitive Function

Dr. Joshi noted that hormonal fluctuations can significantly influence brain function. Women entering perimenopause may experience difficulty concentrating, while others may notice "word retrieval and short-term memory due to changing estrogen levels that influence brain function."

He added that it is not limited to women. Men also undergo age-related hormonal changes that can affect energy levels and cognitive performance. While these changes are often temporary, they can still be distressing.

Read More: Aspartame, Saccharin, Erythritol Linked To Faster Brain Ageing: Study

Chronic Inflammation May Reduce Mental Clarity

Dr. Joshi explained that chronic low-grade inflammation can also contribute to brain fog. Conditions such as obesity, diabetes, autoimmune diseases, and persistent infections can trigger inflammatory responses that interfere with the brain's ability to process information efficiently. In some people, inflammation has been linked to reduced attention, poor memory, and diminished mental clarity.

Small Lifestyle Changes Key

The good news: Simple daily habits can support long-term brain health. Regular physical activity—whether it's walking, cycling, dancing, or strength training several times a week—improves blood flow to the brain, boosts mood, and supports healthy ageing.

Dr. Adoor also recommends limiting unnecessary screen time, taking regular breaks from phones and digital devices, and focusing on one task at a time to reduce mental overload.

When Should You See A Doctor?

Occasionally feeling mentally sluggish is common, but worsening memory problems or cognitive changes that begin interfering with work or daily life should not be ignored, Dr. Joshi said.

He added that these symptoms may stem from treatable conditions such as thyroid disorders, vitamin deficiencies, anxiety, or depression, making timely medical evaluation important.