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!

Joint pain in your 30s and 40s can stem from sports injuries, obesity, a sedentary lifestyle, muscle weakness, or repetitive strain. It can also signal arthritis, including rheumatoid arthritis and osteoarthritis, which can affect younger adults.

On World Arthritis Day, experts warned that joint pain that persists, keeps returning, or occurs with swelling, prolonged morning stiffness, or restricted movement should not be ignored. Sudden, severe pain in a hot, swollen joint—especially with fever—requires urgent medical evaluation.

Dr. Atul Shrivastava, Consultant, Orthopedics and Joint Replacement Surgery, Narayana Hospital, Howrah, told HealthandMe that chronic joint pain should not be dismissed as fatigue or the result of a sedentary lifestyle.

“Prolonged sitting, a sedentary lifestyle, weakened muscle tone, and sudden leaps in physical activity can all contribute to musculoskeletal pain without necessarily indicating the presence of arthritis.”

Dr. Rakesh Rajput, Head of Orthopedics, CK Birla Hospitals, CMRI, Kolkata, said, “Sedentary lifestyles, obesity, poor posture, sports injuries, nutritional deficiencies, and repetitive strain from daily activities can contribute to joint problems.”

Morning Stiffness Or Arthritis? Signs To Watch For

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Occasional stiffness after waking up or sitting for long periods may result from inactivity or muscle strain. However, recurring morning stiffness accompanied by swelling, tenderness, or restricted movement warrants medical attention.

“Occasional stiffness after waking up or remaining in one position for a long time may result from inactivity or muscle and joint strain. However, recurring morning stiffness, especially when accompanied by joint swelling, tenderness or restricted movement, deserves attention,” Dr. Shrivastava said.

Morning stiffness lasting 30–60 minutes or longer may be associated with inflammatory conditions such as rheumatoid arthritis. Osteoarthritis can also cause stiffness after rest, which often improves with gentle movement. However, these patterns alone cannot confirm a diagnosis.

Other warning signs include:

• Persistent joint swelling or warmth
• Difficulty performing routine activities
• Pain or stiffness affecting multiple joints
• Reduced joint movement or persistent tenderness

Rheumatoid arthritis can affect the same joints on both sides of the body, particularly the hands and wrists, although symptoms vary. Persistent symptoms warrant medical assessment rather than reliance on painkillers or home remedies.

A suddenly hot, swollen, and severely painful joint, particularly when accompanied by fever, requires urgent medical evaluation to rule out a serious condition such as a joint infection.

Knee Pain In Your 30s And 40s: What's Behind It?

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Knee pain can result from sports injuries, ligament or meniscal problems, kneecap-related conditions, muscle weakness, overuse, or early osteoarthritis.

Dr. Shrivastava said, “Knee pain in the 30s and 40s can have several causes, and arthritis is only one possibility. Pain may arise from sports injuries, meniscal or ligament problems, kneecap-related conditions, muscle weakness, overuse or early osteoarthritis. Identifying the cause is essential because treatment differs depending on the underlying problem.”

Excess body weight increases stress on the knees, while weak supporting muscles and sudden increases in exercise intensity can aggravate symptoms. However, appropriately selected, progressive exercise can improve muscle strength and joint function.

Persistent pain, recurrent swelling, locking, or instability should be assessed by an orthopedic specialist. Sudden severe pain, an inability to bear weight, or a hot, swollen knee requires prompt medical attention.

Treatment depends on the underlying cause and may include physical therapy, activity modification, weight management, and medication when appropriate.

Can You Prevent Joint Problems?

Maintaining a healthy weight, strengthening the muscles that support the joints, staying physically active, and preventing injuries can help maintain joint health. Gradually increasing exercise intensity and avoiding prolonged inactivity may also help reduce strain on the joints.

Not all forms of arthritis are preventable. Persistent pain, swelling, or stiffness should prompt medical evaluation rather than self-diagnosis.

As Delhi gears up for another season of air pollution, cancer experts are raising concerns about long-term exposure to pollutants and whether it could contribute to gastrointestinal (GI) cancers.

Doctors at Sir Ganga Ram Hospital have reported seeing GI cancer patients as young as 15, raising questions about the environmental factors that could affect cancer risk among young population.

The discussion took place at a joint international conference organised by Sir Ganga Ram Hospital, New Delhi, and The Christie NHS Foundation Trust, UK, on October 10 and 11, 2026.

The conference focused on advancements in colorectal and other gastrointestinal cancers, where experts highlighted the need for stronger prevention efforts, earlier diagnosis and India-based research.

However, although many studies have linked long-term air pollution with cancer risk, the evidence does not establish that Delhi’s pollution is causing GI cancers in younger patients directly or that ground-level ozone is driving a surge.

GI Cancer Patients As Young As 15

Also read: Delhi Smog: Can You Really Tackle Pollution Season With An N95 Mask And Air Purifier?

Dr. Shyam Aggarwal, Organising Chairperson of the conference and Chairperson of the Department of Medical Oncology at Sir Ganga Ram Hospital, said the age of some patients presenting with GI cancers had prompted concern.

“Cancer prevention can no longer be discussed only in terms of tobacco, diet and lifestyle. In our OPD we are now seeing new GI cancer patients as young as 15 years old which was uncommon 5 years ago. We must also pay attention to the environment in which people live,” he said.

Aggarwal also called for closer attention to ground-level ozone, a pollutant that receives less public attention than particulate should also be studied.

“The latest international studies have strengthened the case for investigating the relationship between air pollution and cancer. Ozone deserves particular attention because public awareness largely focuses on PM2.5 and PM10, while ground-level ozone is a less familiar threat. We need more India-specific evidence to understand the contribution of these pollutants, particularly in cities with persistently poor air quality.”

The question of environmental exposure comes amid wider concerns about changing cancer patterns and diagnoses among younger adults. An observation by Aggarwal examining birth-cohort trends in gastrointestinal cancers in England and India highlights differences between the two countries.

In England, bowel cancer incidence among people under 50 rose from 3.9 per 100,000 in 2001 to 8.4 per 100,000 in 2023, more than doubling during the period. In comparison, India’s early-onset colorectal cancer rate remains relatively low, at 3.5 per 100,000 among people aged 25 to 49.

However, Indian urban cancer registries show an increase in colorectal cancer, while hospital studies have reported younger patients presenting with advanced disease.

Link Between Air Pollution And GI Cancer

Also read: Left Delhi To Escape Air Pollution? Why Health Effects May Linger For A Long Time

A 2026 review published in Epidemiologic Reviews examined 70 studies investigating associations between air pollution and gastrointestinal diseases.

Researchers reported that long-term exposure to fine particulate matter, or PM2.5, was associated with higher mortality from GI cancers, especially colorectal cancer.

PM2.5 consists of fine airborne particles small enough to penetrate deep into the lungs. Its health effects are not limited to the respiratory system, with research also examining its links to cardiovascular disease and other long-term health outcomes.

The review suggests that prolonged exposure to air pollution may be relevant to cancer prevention. But, an association between exposure and cancer mortality does not, on its own, prove that the pollutant caused cancer.

Other Risk Factors

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

GI cancers include cancers of the colon and rectum, stomach, oesophagus, liver, pancreas and other organs of the digestive system. Their causes and established risk factors vary according to the type of cancer. Environmental exposures are only one possible area of investigation. Family history, genetic susceptibility, diet, lifestyle, and infections can also influence cancer risk, depending on the malignancy.

Dr. Saumitra Rawat, Chairman of the Department of Surgical Gastroenterology, GI and HPB Onco-Surgery and Liver Transplantation at Sir Ganga Ram Hospital, spoke about the need to examine these factors together.

“The diagnosis of gastrointestinal cancer in younger patients is a serious concern and calls for a comprehensive investigation into the factors that may influence disease development. Family history, genetic susceptibility, diet, lifestyle, infections and possible environmental exposures all deserve appropriate consideration. We must strengthen Indian research to understand these factors rather than draw conclusions from associations alone. Equally important are awareness of persistent digestive symptoms, timely medical consultation and access to multidisciplinary cancer care.”

Delhi’s persistent air-quality crisis makes it important to investigate the long-term health consequences of exposure to a mixture of pollutants. But determining whether pollution contributes to GI cancer will require more than observing that both problems exist in the same population.

Stronger air-quality monitoring, improved cancer registries and Indian studies linking exposure data with clinical outcomes could help researchers assess whether pollutants are associated with specific cancer types.

Studies would also need to account for other risk factors and differences in exposure across populations. This would help establish whether observed associations persist after other relevant factors are considered.

D. S. Rana, Chairman of the Trust Society at Sir Ganga Ram Hospital, said, “The international collaboration between Sir Ganga Ram Hospital and The Christie NHS Foundation Trust represents an important step towards strengthening medical knowledge and cooperation in cancer care. Cancer is a complex challenge that requires coordinated efforts across institutions, specialities and countries. By bringing experts together and encouraging the exchange of experience, we can create new opportunities to advance cancer research, improve early diagnosis and work towards better outcomes for patients.”

Mr. Selvasekar Chelliah, Consultant Colorectal and Laparoscopic Surgeon at The Christie NHS Foundation Trust, UK, also highlighted the role of collaboration in improving cancer care and research.

“International collaboration enables specialists to exchange clinical experience and examine new evidence that can improve the management of colorectal and other gastrointestinal cancers. Bringing together expertise in medical oncology, surgical oncology and other disciplines helps strengthen multidisciplinary decision-making and supports continuous improvement in patient care. Such partnerships can also encourage further research into prevention, early diagnosis and the environmental factors that may influence long-term health.”

Prevention And Early Diagnosis

Alongside research into environmental risks, experts emphasised the importance of established cancer prevention measures, awareness of persistent symptoms, timely medical consultation and access to appropriate diagnosis and treatment.

Ms. Punya Salila Srivastava, IAS, Secretary of the Ministry of Health and Family Welfare, Government of India, said, “Addressing the cancer burden requires a strong focus on prevention, early diagnosis, public awareness and access to quality healthcare. Collaborative efforts between leading medical institutions and evidence-based research are essential to strengthening cancer care and improving health outcomes across the country.”

Reducing emissions and improving air quality remain important public health priorities. At the same time, cancer prevention and care must continue to address known risk factors, screening and timely diagnosis.

When a child struggles with anxiety, loneliness or a personal problem, turning to a trusted adult can offer reassurance, perspective and human connection. But today, children are increasingly seeking advice from an AI chatbot on their phones, often without adult supervision.

Young people are increasingly turning to AI chatbots, not just for homework help but also for relationship advice and emotional support, raising questions about how these tools could shape the way children seek help.

A study of nearly 40,000 students in Canada, published in JAMA Pediatrics, found that more than one in five reported using generative AI for affective purposes, including emotional support or advice. The students were in grades 4 through 12, with an average age of nearly 13 years.

Among those who used AI for emotional support or advice, 57.7% had emotional problem scores above a clinical threshold, compared with 29.2% of those who did not report such use. The findings do not establish that AI use causes emotional problems, but suggest that young people already experiencing distress may be more likely to turn to chatbots.

So what does this mean for children's help-seeking behavior, and are adequate safeguards in place?

Why Children Are Turning To AI For Emotional Support

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Child and adolescent psychiatrist Dr. Kavita Arora of the India Mental Health Alliance (IMHA) told HealthandMe that children may turn to chatbots when they feel anxious or are dealing with issues they are uncomfortable sharing with others. They may eventually begin treating a chatbot almost like a person with whom they have a relationship.

While a trusted adult can offer human connection and perspective, a chatbot provides immediate, seemingly personal responses that children can accept or act on without supervision.

“The concern is that there is currently no way to measure the impact these AI tools are having on children or their development or mental health, because there is no mechanism to collect data on how they are being used or the responses children are receiving,” Dr. Arora said.

She warned that these products lack adequate monitoring mechanisms and established child-oriented safeguards, raising the possibility that their effects may become clear only after harm has occurred. She compared this to the early years of social media, when safeguards were largely absent.

Could AI Change How Children Seek Professional Help?

Children generally need to involve a parent, teacher or another concerned adult to access a mental health professional. Open-access AI chatbots, however, offer a private and readily available alternative without equivalent, transparent safeguarding arrangements.

Dr. Arora warned that children could begin to see professional mental health services as difficult to access while viewing chatbots as an easier option. The potential implications for children experiencing anxiety, loneliness or suicidal thoughts remain insufficiently understood.

Can AI Chatbots Reinforce Anxiety Or Unhealthy Beliefs?

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Researchers and parents do not necessarily know what children share with chatbots or how these systems respond.

A child might say, “I am scared of the monster under my bed,” or ask, “Do you think I look good?” Neither statement automatically indicates an underlying mental health or body image problem. The chatbot must interpret what the child is trying to communicate, and that interpretation may not capture the full context.

Dr. Arora also raised concerns about how chatbots respond when children show signs of distress. Simply directing a child to an adult may not be an adequate safety mechanism.

Mental health professionals working with children operate within ethical and safeguarding frameworks, with requirements relating to competence and supervision. AI systems need safeguards that account for children's particular vulnerabilities, she said.

Dr. Mimansa Singh Tanwar, head of the Fortis School National Mental Health Program at Adayu and Fortis Healthcare, cautioned that AI responses can reinforce anxiety or unhealthy beliefs. Because chatbots respond to the context users provide, they may struggle to offer a different perspective, potentially creating an echo chamber.

What Safeguards Should AI Companies Put In Place?

Dr. Arora said AI companies must build child-safety safeguards into products before release. Personalization can make chatbots particularly engaging for teenagers, while monitoring their interactions raises privacy concerns, making oversight and audits essential.

Commercial interests must not outweigh child health, and schools and communities should teach children about AI's limitations and responsible use to avoid repeating the social media experience.

Who Is Responsible When Children Need Human Help?

READ: Women Turning to AI for Health Detection: Helpful Tool or Risky Trend?

AI companies bear primary responsibility, Dr. Arora said, though parents, teachers, caregivers and policymakers also play a role in ensuring children receive appropriate support.

“At the very least, when an interaction moves beyond a genuine educational or learning need, it should be redirected towards appropriate human support,” she said.

Why Human Support Still Matters

Dr. Tanwar told HealthandMe that AI chatbots can appeal to children because they are easily accessible and often designed to respond empathetically. They may help users reflect on concerns and consider possible solutions, but they do not necessarily replace the support provided by mental health professionals, family members or friends.

She warned that increased chatbot use could lead to emotional dependence, particularly among children. Parents, teachers and mentors should maintain regular conversations with young people and encourage real-world relationships.

The goal, she said, should be to ensure AI complements rather than replaces human interaction and support.