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 first national mental health survey carried out in India, 2015-2016, suggested that one in 10 Indians had a diagnosable psychiatric disorder.

Following the COVID-19 pandemic, there was a surge in common mental disorders (particularly anxiety and depression). Worldwide, the age of onset of substance use disorders is reducing, and there has been an increase in synthetic and pharmaceutical drug misuse.

Digital addiction is a growing problem, particularly among young people. Suicide is a major global concern, and in India, there were more than two lakh suicides in 2025. Rising suicides in urban areas and among students have been growing concerns.

Improving Mental Health Literacy

Just like people recognize physical disorders, it is important to improve mental health literacy so that people can recognize symptoms of a mental or psychiatric disorder in themselves or others. It is also important that they reach out for timely help, without a sense of feeling stigmatized.

Often, physical and mental disorders occur together and worsen each other, so addressing both is important to improve health outcomes.

How Government Is Tackling Mental Health Burden

The Government of India has initiated the Tele MANAS (14416) to provide telephonic mental health counselling and to link people up to other services. The National Mental Health Program of India seeks to provide decentralized mental health care at the District levels and below.

The Ayushman Arogya Mandirs also offer basic mental health support. NIMHANS, apart from providing quality institution-based services, has also been closely involved in developing community models of mental health care, working with non-governmental organizations and with community stakeholders. It has also been focusing on expanding human resources through its digital academy.

A second NIMHANS in northern India, strengthening some of the other institutions providing mental health care to expand infrastructure, human resources, and networking to develop a continuum of care from primary to tertiary care settings, is a recent step taken by the Union government.

Urological cancer cases are surging at an alarming rate in India. Yet, many patients continue to seek medical help only when the disease has reached an advanced stage. Doctors highlight that cancers affecting the urinary system are often silent during the initial stages and are ignored by people owing to a lack of awareness and hesitation in consulting an expert. It is important to remember that timely urology screening can help detect cancer early, reduce complications, and improve survival rates. Many people ignore symptoms and seek help only during the advanced stages, when the risk of complications also increases. Experts are urging people, especially those at higher risk, to seek early screening and intervention without delay.

What are urological cancers?

“People should prioritise their well-being and seek timely help,” said Dr Pradeep Rao, Head of Department – Urology Oncoscience, Gleneagles Hospital, Mumbai.

Diagnosis and treatment of urological cancers

Dr Pradeep Rao further explained how early-stage urological cancers are often treatable with less aggressive procedures, while advanced cancers require complex treatment and carry higher risks. Diagnosis is carried out through urine examination, ultrasound, and prostate-specific antigen (PSA) testing to detect cancer early. Timely screening and intervention can not only save lives but also preserve organ function. Advanced techniques such as robotic-assisted surgery are now widely used to provide relief to patients. Robotics has made diagnosis, treatment, and the healing journey much smoother for both patients and doctors.

What are the symptoms of urological cancers?

“Urological cancers such as prostate, bladder, and kidney cancer are rising across age groups, yet many patients seek medical help only when symptoms become severe. Each month, two to three patients in the age group of 30–65 consult me when symptoms worsen and the cancer progresses, which takes a toll on their overall well-being. Moreover, signs and symptoms such as blood in the urine, difficulty in urination, pelvic pain, or unexplained weight loss are often ignored, leading to advanced-stage disease that can cause anxiety and panic among patients. Delayed diagnosis can result in serious complications such as kidney damage, the spread of cancer, and reduced quality of life. Early screening and treatment are life-saving. Currently, a combination of robotic surgery, chemotherapy, radiation therapy, and targeted treatments offers better outcomes, but early diagnosis remains the most critical factor for successful recovery,” concluded Dr Anil Bradoo, Consultant Urologist, Zen Annexe, Zen Multispeciality Hospital, Chembur, Mumbai.

What are the benefits of robotic surgeries?

Dr Pradeep Rao also explained the benefits of robotic surgeries. Robotic-assisted prostatectomy for prostate cancer helps with the accurate removal of the prostate while protecting vital nerves, thereby reducing the risk of incontinence and erectile dysfunction. Robotic partial nephrectomy is performed for kidney cancer and helps remove diseased kidney tissue while preserving the kidney, with minimal blood loss and quicker healing. The advantages of robotic surgery include precise tumour removal with minimal blood loss, reduced pain and complications, shorter hospital stays, and faster recovery. Early-stage patients benefit the most from these modern treatments, which is why awareness and screening are so important.

Insulin resistance is a condition in which the body cannot effectively use insulin. Shockingly, this condition is now being linked to first-trimester miscarriages, especially in women with PCOS, with lab markers such as HbA1c and fasting insulin offering early clues. Therefore, it is essential for women to take charge of their health and maintain their blood sugar levels within the recommended range, as per Dr Sushruta Mokadam, Senior Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Kharadi, Pune. The expert went on to talk about other aspects of the same, detailing just how first trimester miscarriages could be a consequence of ignoring high blood sugar or insulin resistance.

Why are miscarriages in the first trimester rising?

Currently, there is a surge in cases of miscarriages during the first trimester, which is raising concern among experts. This may be due to undiagnosed insulin resistance. Yes, that’s right—miscarriage is not only caused by infections, hormonal imbalance, or blood clotting disorders, but also by insulin resistance. Many women fail to pay attention to insulin resistance, which affects how the body processes sugar and plays a major role in causing hormonal imbalance. Women with Polycystic Ovary Syndrome (PCOS) are at a higher risk, as metabolic dysfunction can lead to miscarriage. Many women are experiencing repeated early pregnancy loss but are not screened for insulin resistance, leading to missed opportunities for early intervention.

How are miscarriages and insulin resistance linked?

Miscarriage and insulin resistance link: Insulin resistance occurs when the body’s cells do not respond properly to insulin, leading to higher blood sugar and insulin levels. This imbalance can impact ovulation and egg quality and interfere with the implantation of the embryo. In early pregnancy, it may affect placental development, increasing the risk of miscarriage in the first trimester. In women with PCOS, insulin resistance is commonly present, even in those who are not overweight.

The impact of insulin resistance on reproductive health

High insulin levels can lead to increased androgen (male hormone) production, further affecting reproductive health. This hormonal imbalance can make it difficult for a pregnancy to be sustained, especially in the early weeks, which may result in miscarriage. Lab tests such as HbA1c (which reflects average blood sugar levels over time) and fasting insulin levels can help identify at-risk women. Even subtle elevations in these markers, including those within the upper-normal range, can indicate underlying metabolic dysfunction that may increase the chances of miscarriage.

What to do?

Pregnant women should opt for regular screening, manage blood sugar levels, eat a balanced diet, and exercise daily before planning pregnancy. Even during pregnancy, they should stay in touch with an expert who can guide them throughout the process.