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 all major diseases, early detection is key to improving treatment outcomes. However, when it comes to rare diseases, it is unpredictable, making it more challenging to diagnose. In such a scenario, Artificial Intelligence (AI) is playing a major role -- from early diagnosis to treatment, said health experts on Rare Disease Day.

Rare Disease Day is annually observed on February 28 to raise awareness about the lesser-known conditions and the underlying challenges for people suffering from them.

While many of the rare disorders are genetic, they often also surface without any prior family history. In some cases, they are diagnosed in infancy, while in others the manifestation is years late.

The advanced AI technology is, however, now enabling clinicians to better understand the patients’ genetic profiles and patterns that were not clearer earlier. The technology is also paving the way for earlier and more accurate diagnoses, bringing hope to thousands of patients worldwide.

“AI is revolutionizing the fight against rare diseases by speeding up diagnosis, research, and development of treatments. Rare diseases often take years to diagnose because of the lack of data, overlapping symptoms, and unclear diagnosis,” Dr. Vinit Banga, Director, Neurology, Fortis Escorts Hospital, Faridabad, told HealthandMe.

“AI algorithms can process medical records, genetic information, and images to identify patterns that may escape human detection, allowing for earlier and more accurate diagnoses,” he added.

AI Simplifying Rare Disease Diagnoses, Drug development

In a February paper published in the journal Nature, researchers from the Shanghai Jiao Tong University in China presented an AI system called DeepRare -- a multi-agent system for rare disease differential diagnosis decision support, powered by large language models, integrating more than 40 specialized tools.

Using the specialized tools and knowledge sources, the agentic AI system generates ranked diagnostic hypotheses for rare diseases. Each of the tools was also accompanied by reasoning that links the conclusions to verifiable medical evidence.

Similarly, Harvard University-based researchers in a paper also published in the Nature journal in 2025 described an AI tool called PopEVE, which can identify genetic variants most likely to cause severe disease or death.

The model was able to identify more than 100 novel alterations responsible for undiagnosed, rare genetic diseases.

"AI is cutting short the diagnostic odyssey from years to weeks. Large-scale genomic projects help create a vital reference architecture for India and the global community,” Dr. Sudheendra Rao N R, MBBS, PhD, Scientific Advisor, Organization for Rare Diseases India, told HealthandMe.

By integrating deep phenotyping with AI, clinicians can decipher unknown genetic variants and accelerate the development of both repurposed and next-generation precision-therapies, the expert added.

AI can also help researchers identify new drug targets for the treatment of rare conditions.

Dr. Banga said that AI is also instrumental in accelerating drug development by processing enormous amounts of biomedical data to discover new targets for drugs and repurpose existing ones. Importantly, AI is cutting down on time and expenses.

“Machine learning algorithms enable the prediction of patient responses to particular treatments, making it possible to develop personalized treatment strategies,” the expert said.

Further, AI-enabled infrastructure is helping to achieve geographic neutrality, delivering the same caliber of healthcare screening to rural villages and Tier-3 cities as to Tier-1 hubs, ensuring a high-quality healthcare gateway that is no longer defined by where the patient lives.

Moreover, AI-based platforms bring together researchers from across the globe, making it easier to share data.

What Is A Rare Disease

The World Health Organization (WHO) defines a rare disease as an often debilitating, chronic, or degenerative condition affecting 1 or fewer per 1,000 population.

Rare diseases do not have epidemiological data, are at high risk of misdiagnosis, and often also lack effective treatments.

According to the WHO ICD-11 (International Classification of Diseases), there are over 5,500 rare diseases. It also assigns unique identifiers (URIs) to them for better tracking.

There are estimated to be over 7,000 distinct rare diseases affecting more than 300 million people globally.

Do you know that congenital hypothyroidism, a rare disability, affects about 1 in 2,500–3,000 newborns globally, but in India, the incidence is higher -- approximately 1 in 1,000 births.

India records nearly 26 million births annually, with an estimated 10,000 babies born each year with Congenital Hypothyroidism.

This means 27 babies are born every day in India, with the condition that more than one is born every hour. Early treatment within the first 2 weeks of life can ensure normal brain development, while delayed treatment can reduce IQ by 30–50 points.

Congenital Hypothyroidism (CH) is a condition present at birth in which a baby’s thyroid gland does not produce enough thyroid hormone.

The thyroid is a small gland located in the neck. It produces a hormone called thyroxine (T4), which is essential for brain development, growth, and overall body metabolism. The thyroid hormone is especially important in the first few weeks of life.

The thyroid hormone helps in:

• Brain development
• Physical growth
• Bone development
• Muscle strength
• Energy regulation

If a baby does not receive enough thyroid hormones soon after birth, it can lead to permanent intellectual disability and growth problems.

The good news is that congenital hypothyroidism is easily detectable and completely treatable if identified early.

What Causes Congenital Hypothyroidism? What Are The Symptoms?

Congenital Hypothyroidism may occur because:

• The thyroid gland is completely absent
• The thyroid gland is underdeveloped
• The gland is present but does not function properly
• Rarely, the baby cannot produce or use the thyroid hormone correctly

One of the biggest challenges with Congenital Hypothyroidism is that most babies look completely normal at birth.

However, over time, some signs may appear:

• Excessive sleepiness
• Poor feeding
• Constipation
• Prolonged jaundice (yellowing of skin and eyes)
• Hoarse cry
• Large tongue
• Puffy face
• Cold or dry skin
• Slow growth

How Is Congenital Hypothyroidism Detected?

1. Newborn Screening Test (Heel-Prick Test)

• This is the most important test.
• A few drops of blood are taken from the baby’s heel.
• It is usually done 48–72 hours after birth, but can be done soon after birth on the cord blood, too.
• Test measures Thyroid Stimulating Hormone (TSH).
• If TSH levels are high, it suggests that the thyroid is not functioning properly.
• This test is simple, safe, quick, and affordable

2. Confirmatory Blood Tests

If the screening test is abnormal, the doctor will order:

• Serum TSH test
• Free T4 (thyroxine) level
• High TSH and low T4 confirm the diagnosis

3. Thyroid Scan

In some cases, imaging tests are needed. The ultrasound of the neck (less accurate) and Nuclear Medicine Thyroid scan (more accurate) may be done to check whether the gland is absent, small, or misplaced. However, treatment should not be delayed while waiting for imaging.

When Should Treatment Start?

Treatment should begin as early as possible -- ideally within the first 14 days of life. Starting treatment within the first two weeks allows normal brain development.

Delaying treatment increases the risk of permanent intellectual disability.

Doctors will monitor:

• TSH levels
• T4 levels
• Baby’s growth and development

Initially, blood tests are done every 2–4 weeks, then less frequently as the child grows. Proper follow-up ensures the dose remains correct. Some babies may need treatment for life.

In certain cases, doctors may reassess thyroid function after 3 years of age to see whether the condition is temporary or permanent. Most children who receive early and proper treatment grow up with completely normal intelligence and physical development.

Can Congenital Hypothyroidism Be Prevented? Why Early Screening Is So Important

Most cases cannot be prevented. However:

• Universal newborn screening can prevent intellectual disability
• Ensuring adequate iodine intake during pregnancy helps reduce risk
• The key is early detection—not prevention

A baby with Congenital Hypothyroidism may look perfectly healthy. Without screening, diagnosis may be delayed until symptoms appear—by then, brain development may already be affected.

With early testing the diagnosis is simple; treatment is affordable; and outcome is excellent. But without testing:

• Intellectual disability can occur
• Growth may be affected
• The child may require lifelong support

Congenital Hypothyroidism is one of the most preventable causes of intellectual disability in children. A small heel-prick test in the first few days of life can protect your baby’s brain forever.

If you are expecting a baby or have a newborn, speak to your doctor about newborn thyroid screening.

Early diagnosis. Simple treatment. Normal life.

Prime Minister Narendra Modi today launched the nationwide Human Papillomavirus (HPV) vaccination campaign for girls aged 14 years from Rajasthan's Ajmer.

The initiative marks a decisive step towards eliminating cervical cancer through timely HPV vaccination. Cervical cancer remains the second most common cancer among women in India. Nearly 80,000 new cases and over 42,000 deaths are reported annually in the country.

"Today, I have had the opportunity to launch the HPV vaccine campaign from Ajmer. This campaign is an important step towards empowering women and daughters of this country,” PM Modi said.

“For us, this was a sensitive issue tied to the insult of our sisters and daughters, one that made them ill. That is why we resolved it at a crucial turning point in their mission,” he added.

The World Health Organization has also lauded India's mission to launch the HPV vaccine and prevent the risk of cervical cancer.

“We are leaving no stone unturned to ensure that the daughters of the country are healthy and prosperous. The objective of this initiative is the prevention of cervical cancer," the Prime Minister, earlier wrote in a post on social media platform X.

The HPV Vaccination Campaign

The nationwide program, based on expert recommendations of the National Technical Advisory Group on Immunization (NTAGI), will target girls aged 14 years.

At 14, the HPV vaccine offers maximum preventive benefit, well before potential exposure to the virus.

"By prioritizing prevention at the right age, the program is expected to provide lifelong protection and significantly reduce the future burden of cervical cancer in the country," the government said.

“The HPV vaccine works best at 9-14 years, before exposure, and when the immune response is strongest. Studies show effectiveness is highest in younger age groups and decreases with age,” Dr. Parmod Kumar, Associate Professor in Medical Oncology, AIIMS Jodhpur, shared on X.

Vaccination under the national program will be voluntary and free of cost.

The HPV vaccination will be conducted exclusively at designated government health facilities, including Ayushman Arogya Mandirs (Primary Health Centers), Community Health Centers, Sub-District and District Hospitals, and Government Medical Colleges.

Cervical Cancer Burden In South East Asia

Despite being preventable, cervical cancer continues to claim the life of a woman every two minutes globally, and the WHO South-East Asia Region bears nearly one-quarter of the global burden.

Dr. Catharina Boehme, Officer-in-Charge, WHO South-East Asia, stated that the introduction of HPV vaccination at a national scale in India "will have a far-reaching impact". It will accelerate progress not only for the country, but for the region and the world, she said.

“This landmark step, led at the highest level of government, reflects India’s strong commitment to protecting adolescent girls from cervical cancer," said Dr. Boehme.

With today’s milestone, nine of the 10 countries in the Region now include HPV vaccination in their national immunization programs.

The WHO global targets for 2030 include vaccinating 90 percent of girls by age 15, screening 70 percent of women by ages 35 and 45, and ensuring 90 percent of women with pre-cancer and invasive cancer receive appropriate treatment.