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!

Arthritis is sometimes treated like a normal part of getting older. Yet it can show up in many age groups. It can also limit how freely someone moves. That can affect daily independence and overall comfort.

Some people think arthritis care always means an operation, like joint replacement. In reality, the path to care is wider. What happens next depends on symptoms, which joint is affected, a person’s age, how active they are, and their general health.

Early-Stage Arthritis: Why Physiotherapy And Exercise Matter

Where the disease is in its early stages or is perceived to be mild, treatment will begin in a very low-key manner. This will involve physiotherapy and exercise. Where necessary, losing excess body weight can be beneficial. Minor changes in daily activities will decrease stress. Doctors will prescribe medication depending on the situation. Here, the main objective is to alleviate symptoms and maintain function. It will not be the initial step and will only be considered where appropriate.

In case arthritis is severe, pain and stiffness will persist for a long period of time. Performing simple activities becomes difficult. Even walking will become challenging. Sleep may also be affected. When this happens, it helps to check again. Doctors can use exam findings and imaging to see how much the joint has changed. They can also review whether non-surgical care is working as expected.

Also read: Arthritis Day: Stanford Researchers Explore Possibility To Treat Osteoarthritis Without Knee Replacement Surgery

How Doctors Decide On The Right Treatment

Good arthritis care is about choosing the right path for the right person. Timing matters too. It begins with a close look at symptoms and a clear diagnosis. Sometimes it also means getting scans when they are needed. After that, the plan should rely on what the best research shows.

Treatment should be set up with rehab in mind. The aim is to fit the person, not just the label on the chart. One person may do well with physical therapy and simple habit shifts. Another person may need a procedure, mainly when a joint is badly worn.

Why Early Arthritis Management Matters

The main goal is easier daily comfort and better movement. Just as important, it should help someone keep their independence. It is also not only about chasing the newest option.

People should not wait until pain makes normal life hard. When they seek help early, it can be easier to see what is driving the joint pain. It can also help show how far the arthritis has gone. With that in hand, a care plan can be built with more clarity.

When care starts early and matches the person, many can stay active longer. They may also better protect joint function and keep it working well for more time.

As pollution levels rise in October, doctors warn that exposure to particulate matter can affect lung and heart health, aggravate existing respiratory conditions, and cause symptoms even in otherwise healthy individuals, particularly as winter approaches.

PM2.5 and PM10 can irritate the respiratory tract, while fine particles such as PM2.5 can penetrate deep into the lungs, with some entering the bloodstream.

Delhi woke up to poor air quality on Thursday, with the Commission for Air Quality Management’s (CAQM) AQI dashboard recording an Air Quality Index (AQI) of 226 across Delhi-NCR at 7 am.

As per the CAQM’s dashboard, some areas of the national capital recorded very poor air quality, with an average AQI of 307.

The Commission for Air Quality Management (CAQM) on Wednesday imposed Stage I of the Graded Response Action Plan (GRAP) across Delhi-NCR after the capital's air quality slipped into the 'poor' category.

According to the Air Quality Early Warning System, Delhi's air quality is likely to remain in the 'poor' category until October 23. The forecast for the following six days also indicates that pollution levels are likely to remain in the same category.

Also read: Delhi Air Pollution Is Back: What Days Of Poor AQI Can Do to Your Lungs

How Air Pollution Affects Lung And Heart Health

Dr. Amit Kumar Mandal, Senior Director - Pulmonology, Paras Health Panchkula, told HealthandMe that air pollution can cause inflammation in the airways and worsen asthma, chronic obstructive pulmonary disease (COPD) and other respiratory conditions. It can also increase the risk of cardiovascular complications.

The effects may not always be immediately noticeable. People may experience persistent coughing, throat irritation, wheezing or breathlessness. Repeated exposure over time can contribute to more serious health problems, even in people without pre-existing conditions.

Dr. A.S. Sandhya, Consultant, Pulmonary & Sleep Medicine, Kailash Hospital & Neuro Institute, told HealthandMe that October can mark the beginning of a prolonged period of poor air quality in Delhi-NCR.

When pollution combines with changing weather conditions, people with asthma, bronchitis and COPD may experience more frequent symptoms. However, healthy individuals can also develop eye irritation, coughing, throat discomfort and reduced exercise tolerance after exposure to polluted air.

How To Protect Yourself From Rising Pollution

Read More: Can Delhi’s Air Pollution Increase GI Cancer Risk? Doctors Report Patients As Young As 15

Doctors recommend monitoring daily AQI levels and limiting exposure when air quality is poor.

Dr. Mandal advises reducing prolonged outdoor activity and avoiding exercise near busy roads during high-pollution periods. Children, older adults, pregnant women and people with respiratory or heart conditions should take extra precautions.

Dr. Sandhya recommends limiting strenuous outdoor exercise when pollution levels are high and using a well-fitted N95 mask when outdoor exposure cannot be avoided.

Indoor air quality also matters, particularly for children and older adults who spend extended periods at home. Air purifiers with suitable filtration may help reduce indoor particulate matter, although they do not eliminate all pollutants.

When To Seek Medical Advice

People should not ignore persistent coughing, wheezing or unusual breathlessness. Those experiencing persistent breathing difficulties, chest discomfort or worsening respiratory symptoms should consult a doctor.

People with existing medical conditions should follow their treatment plans and seek medical advice if their symptoms worsen.

Taking preventive measures now, rather than waiting for pollution to peak in winter, can help reduce exposure and the risk of avoidable health complications in the months ahead.

Climate change is not just raising temperatures and intensifying extreme weather. It may also affect digestive health by disrupting food production, threatening water security and changing the spread of gastrointestinal infections, according to two leading gastroenterology experts from the World Gastroenterology Organization (WGO).

Climate change can contribute to heat-related illnesses and influence the geographic spread of infectious diseases, especially in countries like India.

A February 2025 review in The Lancet Planetary Health outlines how the combined effects of climate change could affect the human gut microbiome, including through food insecurity, malnutrition and exposure to disease-causing pathogens. These challenges could alter the composition of gut microbial communities worldwide.

Research suggests that heat stress may alter gut microbes, digestion and immune function. It may also increase intestinal permeability, potentially allowing toxins and pathogens to enter the bloodstream.

Climate-related drought can disrupt food production and reduce access to nutritious food, potentially affecting the gut microbiome. Environmental changes may also influence food- and waterborne pathogens, increasing infection risks where access to safe water and sanitation is limited.

Speaking to HealthandMe, Professor Geoffrey Metz, professor of medicine at the University of Melbourne, said climate change was becoming an increasing concern for gastrointestinal health.

“Certainly, with global warming, we're seeing a lot more infectious diseases in the gastrointestinal tract,” Metz said.

How Climate Change Can Affect Digestive Health

Also read: 'Humanity Can Still Act': Lancet Warns Of 17 Global Health Threats By 2100

Climate change can affect digestive health through several interconnected pathways, including water availability, food production and infectious diseases.

Metz said the consequences of global warming extend beyond rising temperatures.

“The other thing, of course, with global warming—and this is a major interest of the World Gastroenterology Organisation—is that it's not just making us hot, but it's also creating more drought, which interacts with food production. So there's less food available, impacting our nutrition.”

Drought can disrupt food production and reduce food availability, raising concerns about nutrition. Changes in water availability can also make safe food preparation and hygiene more difficult.

However, the extent to which these environmental changes contribute to specific gastrointestinal diseases requires further investigation.

Safe Water And Food Hygiene Remain Essential

Professor Carolina Olano, professor of gastroenterology in Montevideo, Uruguay, and president of the WGO, highlighted the role of environmental factors in digestive diseases.

“Well, I think it's a combination of many factors. You know that there are some things related to genetics, and we have genetic predispositions to some diseases. But there are also environmental factors related to different diseases, and climate change has an impact too. We are working very hard at the World Gastroenterology Organisation to understand how climate change is affecting different diseases.”

Olano also emphasised the importance of safe drinking water and food hygiene in preventing infections.

“It's also important to have a varied diet and to drink safe, clean water, making sure that the water we drink is safe. Food hygiene is also extremely important.”

She told HealthandMe that handwashing was another simple preventive measure.

“We learned from the COVID pandemic that handwashing before eating is extremely important. These are things we can do every day without spending anything, and they can help prevent many important diseases, especially those related to infections.”

Climate Change Has Wider Health Consequences

Read More: Climate Change Is Affecting Skin Health Worldwide, Warns Study

The effects of climate change may extend beyond the digestive system, affecting multiple aspects of health.

“Global warming is not just affecting how we feel; it's also having an effect on heart disease, lung disease, gastrointestinal disease, obstetrics and gynaecology,” said Metz, who is also the former president of the WGO.

Olano also pointed to population movements as a factor to consider when assessing environmental and health risks.

“As you know, it's not only about weather and climate change. It's also about how populations move from one country to another and what the impact of these movements is when people move from one region to another.”

“Because, as you know, it's not only about weather and climate change. It's also how populations move from one country to another and what the impact of these movements is when people move from one region to another.”

Understanding these connections is important as researchers investigate how climate-related environmental changes may influence disease patterns across regions.

What Can People Do To Protect Their Digestive Health?

While individuals cannot control climate-related changes, Olano highlighted everyday measures that can help prevent infections and support digestive health:

• Drink safe, clean water.
• Maintain food hygiene and handle food safely.
• Wash hands before eating.
• Follow a varied diet.
• Stay physically active.

She also stressed the importance of seeking medical advice about hepatitis prevention, vaccination and testing where appropriate, as well as colorectal cancer screening.

Climate change presents a broader public health challenge, but safe water, food hygiene and infection prevention remain important measures for reducing avoidable digestive health risks.