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!

The monsoon season brings a respite from scorching heat, but it also increases the risk of contracting various diseases and infections. Apart from common illnesses like dengue, malaria, and typhoid fever, states and cities in India also face the risk of specific infections based on climate, geography, infrastructure, parasites, and sanitation.

Prevention Of Gut Infections During Monsoon

In a conversation with Health and Me, Dr Aabha Nagral, Director of Gastroenterology, Chief Hepatologist and Liver Transplant Physician at Jaslok Hospital and Research Centre, explained how rains can lead to contamination of water sources, increasing the spread of fecal-oral infections.

As the monsoon has set in, several states in India, including Maharashtra, Kerala, Karnataka, and Tamil Nadu are facing an alarming rise of gastrointestinal infections. Heavy rains are one of the reasons behind contamination of drinking water and food supplies.

Bacteria, viruses, and parasites in food and drinking water often result in a spike in diarrhea, vomiting, food poisoning, and gastroenteritis. Increased bacterial growth in warm and humid conditions, combined with poor food hygiene and subpar sanitation facilities, contributes to the rise of gut infections in urban areas like Mumbai.

Recent research and seasonal trends also support the increase in these infections. A 2025 review published in Frontiers in Tropical Diseases found that tropical infections like cholera, giardiasis, and enterotoxigenic E. coli infections disrupt the gut microbiome by reducing beneficial bacteria and increasing harmful microbes.

Faecal-oral diseases and infections like hepatitis A and E mainly cause jaundice, whereas gastroenteritis presents with diarrhea. On the other hand, typhoid can present with high fevers.

Dr Nagral says, “You can have various other diseases during the rains by what we call faecal-oral contamination of water. So, we know that during the rainy season, the water gets contaminated more easily. So, make sure that you are boiling your water for at least 10 minutes, or if you are using RO or any other means of sterilising the water. Also, make sure your systems are well serviced regularly so that the water you drink is well filtered and sterile.”

The water source is among the first to get contaminated during the monsoon. Dr Nagral suggests these tips to prevent gut infections.

• Avoid foods and drinks that contain water in different forms

• Avoid street-side juices during monsoons to prevent gut infections

• Avoid any drink that contains ice or that has been sitting out for a long time

Dr Aabha Nagral also spoke about avoiding consuming street foods as they are more likely to be contaminated during the monsoon.

She explains, “Also, I would say avoid all street food because that’s how diseases spread. They spread through flies which sit on the faeces, which are often unfortunately there on our roadside, and then onto your food or drinks.”

Common Monsoon Diseases

Monsoon diseases can vary across India depending on rainfall, flooding situation, sanitation, and local mosquito populations. Some of the most common ones include dengue, malaria, typhoid, and diarrheal diseases. These infections affect nearly every state during the rainy season.

Specifically, Kerala, Maharashtra, Karnataka, and Tamil Nadu have seen a higher likelihood of leptospirosis following floods.

Odisha, Chhattisgarh, and Jharkhand continue to record high malaria cases, while flood-prone states like Odisha, Assam, and Bihar are vulnerable to water-borne illnesses, including cholera and gastroenteritis.

A recent study has found proof that an autoimmune reaction is triggering certain neurological symptoms seen in some long COVID patients. The study, conducted in healthy mice, found that the mice exhibited symptoms mirroring those of affected patients to some extent.

What is Long COVID?

While it has been a long time since the end of the COVID pandemic, its effects continue to linger even today. Several patients who contracted COVID continue to suffer.

Autoantibodies Behind Long COVID Symptoms?

A US NIH-funded research group, directed by Drs. Akiko Iwasaki and Tamas L. Horvath of the Yale University School of Medicine and Dr. David Putrino of the Icahn School of Medicine at Mount Sinai recently found that autoantibodies could be triggering these neurological symptoms in some long COVID patients.

Antibodies, in a healthy person, help fight infections. In patients with autoimmune diseases, these antibodies target the body’s own tissues. They are called autoantibodies.

The study also discovered that patients who had these autoantibodies are more likely to experience similar symptoms. For example, people with autoantibodies are more likely to face symptoms like loss of taste and smell. They are also more likely to experience nausea and joint pain.

The Mouse Experiment

The researchers conducted the study by transferring purified antibodies from long COVID patients into healthy mice. It was discovered that the mice developed the following changes that resembled the donors' symptoms:

• Antibodies from patients with chronic pain caused increased pain sensitivity

• Antibodies from patients with dizziness caused balance problems

• Antibodies from fatigued patients reduced treadmill endurance

The recent breakthrough in long COVID research has brought the healthcare industry one step closer to personalizing care for those affected.

Dr. Putrino says, “Our study now shows that if you are in a subgroup of Long COVID patients who have autoantibodies circulating in your body, this is a quantifiable sign that you may be a good candidate for these drugs.”

Long COVID Patients More Likely To Develop Heart Diseases

The study finds that cardiovascular diseases were more common among long COVID patients. It concluded that 11.9% of those with long COVID have CVD compared to 6.8% without this condition.

Specifically, it further revealed that long COVID was associated with a higher risk of chest pain and heart attack, but not coronary heart disease and stroke.

There is a growing belief that ‘sugar feeds cancer.’ Because of this, many people think that stopping sugar and carbohydrates completely can starve cancer cells and help defeat the disease. However, the trend may have side effects. This half-truth is becoming dangerous for many patients. This trend is making it even more difficult for patients to cope with the side effects of chemotherapy.

This fact is not entirely unscientific, but it is incomplete. In 1924, the German scientist Otto Warburg found that cancer cells consume more glucose than normal cells. This phenomenon is known as the Warburg Effect.

This finding has subsequently been validated in numerous studies. This is also the reason why cancer cells appear clearly in PET-CT scans. They absorb glucose-like substances more aggressively than normal cells. But this does not mean cancer can be “starved” by reducing sugar in food.

Why The Body Still Needs Glucose?

Glucose is an essential fuel for the human body. The brain, heart, red blood cells, and immune system all depend on it.

If a person completely stops eating carbohydrates, the body starts producing glucose on its own. It breaks down muscles and proteins to make energy. This process is known as gluconeogenesis. This means the cancer cells still receive fuel, but the patient’s body becomes weaker day by day. This condition is described as ‘cancer cachexia.’

In this condition, body weight and muscle mass reduce rapidly. Such patients often cannot tolerate chemotherapy and surgery properly. In some cases, their protein levels and white blood cell counts had dropped too much.

As a result, doctors had to delay treatment, reduce medicine doses, or even stop some treatment cycles. Irony is painful. In trying to starve cancer, patients sometimes end up weakening their own bodies so much that proper treatment becomes difficult.

In my clinic, I see it almost every week. In such a case, a cancer patient walks in visibly frail. She almost had lost several kilograms over the past month. When I asked about her diet, her IT professional son said that she has cut out sugar entirely. The reason behind this was the same reel-based knowledge about sugar and cancer cells. His son strictly follows this half-truth. Due to her weakness, we had to push back her treatment for a few weeks.

What Cancer Patients Should Eat

We simply suggest avoiding foods that rapidly increase blood sugar levels. These include refined sugar, sweets, soft drinks, maida, and highly processed foods. We advise cancer patients to eat complex carbohydrates, whole grains, pulses, vegetables, healthy fats, and enough protein. The best way is not to cut sugar entirely, but to lower the glycemic load.

Will Fasting help?

Some animal studies have shown the benefits of fasting during cancer treatment. However, there is still not enough evidence in humans. For patients who are already weak or losing weight rapidly, long fasting can become harmful.

The Goal Is to Stay Strong During Treatment

Cancer cells use more glucose, but starving the body cannot stop cancer. If you want to help your body, then avoid refined sugar and junk food, but continue eating balanced meals. Because sufficient protein and calories are extremely important. Practising long fasting without medical advice is harmful. The goal should be to keep the body stable and strong, not weak.

The purpose of cancer nutrition is to nourish the patient, not to starve them. Proper nutrition helps the body tolerate treatment and fight disease more effectively. What is needed is to reduce the intake of refined sugar and foods with a high glycemic index, not to declare every carbohydrate an enemy. After all, one cannot win the battle against disease by weakening the body.