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!

In a breakthrough investigation published in Nature Medicine found that GLP-1 medicines are not just weight loss drugs, but actually brain reprogramming drugs. The study highlighted how deeply GLP-1 medications influence our brain's reward circuits, cravings, and the electrical rhythm.

Case Study

The study took a 60-year-old woman who had a lifelong "food noise", and underwent deep-brain stimulation that targeted the nucleus accumbens, which is brain's craving centre. The woman was also to start tirzepatide, an antidiabetic medication used to treat type 2 diabetes and for weight loss, which is an active ingredient in Mounjaro. As she reached her full dose, her compulsive food thoughts went silent, however, five to seven months later, the neutral signal returned before her cravings did, while she was still on the medication.

How Was The Study Conducted?

Scientists from the University of Pennsylvania, monitored brain activity directly from the nucleus accumbens in people using tirzepatide.

The research followed three patients with severe food preoccupation and uncontrolled eating. Two underwent deep-brain stimulation, while the third received tirzepatide and also had electrodes implanted around the same time. When cravings or intense food thoughts occurred, researchers observed strong delta-theta waves in the nucleus accumbens. These slow brain signals are linked to reward, motivation, and compulsive eating.

Once the patient on Mounjaro reached the full therapeutic dose, the changes were dramatic: for nearly four months, they reported almost no episodes of “severe food preoccupation.” Their delta-theta activity also fell to very low levels, even during moments when cravings typically occurred. However, while initially there was a suppression in the brain activity that triggered cravings, the cravings returned over time.

Why Does This Matter?

This is the first time scientists have been able to directly record craving-related brain activity in real time and compare it before and after using a medication like Mounjaro. Although the study involved only three people, the findings help explain why medications in this class appear to influence more than just appetite. They may also reshape how the brain processes reward and desire around food.

The researchers say larger studies are needed, but early signs point to a clearer understanding of how obesity drugs change both behavior and brain biology.

What To Keep In Mind?

Dr Simon Cork, senior lecturer in Physiology, Angila Ruskin University said that there must be some caution that should be applied while looking at the findings of the study.

Dr Cork says, "This study specifically looked at a marker of brain activity associated with periods of “binge eating” in patients with obesity associated with food preoccupation. This is important because this is a specific (and rare) condition associated with obesity. They found that in three patients, periods of intense preoccupation with food was associated with a characteristic change in brain activity in a region of the brain associated with reward...While this study is methodologically very interesting, it has to be clear that this is only one patient with a very specific condition that is associated with obesity and so shouldn’t necessarily be generalised to the entire population.”

The Supreme Court of India has directed a Noida hospital to form a medical board to assess whether life-sustaining treatment can be legally withdrawn for a 31-year-old man who has been in a vegetative state for more than a decade.

This has come from the bench of Justices JB Pardiwala and KV Vishwanathan who noted the young man's condition that deteriorated over the years, despite care. The medical evaluation is now also required to be presented before the court to decide the plea. The hospital has also been told to submit its report within two weeks.

Also Read: 'Facing Breathing Issues After Morning Walk' Says CJI Surya Kant As Delhi's Toxic Air Worsens

The bench said, "We want the primary board to give us a report that life-sustaining treatment can be withheld. Once it is before us, we shall proceed to pass further orders."

What Made The Court Consider Passive Euthanasia?

This is the case of Harish Rana, whose life changed in 2013 when he suffered severe head injuries after he fell from the fourth floor from his PG accommodation while he was studying at Panjab University. He had been bedridden ever since, and survived on feeding tube. His father filed a petition seeking passive euthanasia under the guidelines Supreme Court had laid down in 2018 under Common Cause judgment. This is the second time the parents have approached the apex court.

Last year, the court also suggested that Rana could receive home-based care with support from the Uttar Pradesh government. The home-based care includes periodic visits by doctors and physiotherapists. The court suggested that in case home care was not feasible, he could be moved to Noida's district hospital. However, his parents have noted that his condition continued to worsen. Family advocate Rashmi Nandakumar also informed the bench that "nothing seems to be working out".

Also Read: Tini Younger Reveals Losing Baby Girl To Placental Abruption—What Is This Condition?

"He is falling ill quite often and is repeatedly admitted to hospital," she said. The advocate further added that the family only sought passive euthanasia, which is withdrawal of treatment, and not any active intervention.

Justice Pardiwala also read medical reports and observed, "Just look at the condition of the boy. It's pathetic."

What Is The Common Cause Ruling?

The Common Cause ruling refers to a landmark Indian Supreme Court judgment that involves the NGO Common Cause. This is a 2018 case that recognized 'right to die with dignity' and legalized passive euthanasia and living will.

Under the ruling, a request for passive euthanasia must be evaluated by a primary medical board and if the board concludes that treatment could be withdrawn, a secondary board will be constituted to verify the decision before taking a final call.

The registry has been instructed to send Thursday’s order to the Noida hospital and to the office of Additional Solicitor General Aishwarya Bhati.

A Legal Journey To Die With Dignity

Rana’s parents have been navigating an incredibly tough journey, caught between differing medical opinions and strict legal requirements. In July 2023, the Delhi High Court declined their request for a medical board, saying Rana did not fall under the criteria for passive euthanasia because he was not on mechanical life support.

The Supreme Court later agreed that he wasn’t being kept alive by machines since he could breathe on his own and was being fed through a tube. But the judges also recognized the overwhelming strain on his elderly parents, who have even sold their home to keep his care going.

By November 2023, the court again suggested that he could be cared for at home, but still did not allow treatment to be withdrawn.

Now, as Rana’s condition worsens and his parents struggle to manage, the court has taken a more urgent stance. It has ordered a thorough medical evaluation to understand whether continuing treatment is simply prolonging his suffering rather than helping him recover.

What Does India Say About Passive Euthanasia?

India permits passive euthanasia under strict guidelines, and legalizes only the withdrawal of life support for terminally ill patients. One of the key cases also includes the Aruna Shanbaug Case (2011).

Shanbaug was an Indian nurse who was attacked and strangled in 1973. This attack left her in a persistent vegetative condition for 42 years until her death in 2015. She was admitted in the same hospital she worked as a nurse, at KEM Hospital in Mumbai. The case was brought by her friend, who petitioned the Supreme Court of India to end her life through passive euthanasia. The court, in a landmark judgment, allowed passive euthanasia, and also set new guidelines for the legality of euthanasia in India.

At least 55 people have lost their lives and 279 remain missing after Hong Kong’s most severe fire in more than a century swept through several high-rise towers on Wednesday afternoon, officials said. Fire crews are still trying to put out the blaze in the Tai Po area and reach those who are trapped inside. By early Thursday, authorities said they had managed to control the fire in four buildings, though teams were still working on three others more than 16 hours after the flames first appeared.

What Happened in Hong Kong?

A residential complex in the Tai Po district caught fire at around 2:51pm local time on Wednesday. The flames started on the bamboo scaffolding fixed to the outside of one of the buildings. This scaffolding, made of bamboo poles used by workers during repairs, burns very easily. Once it caught fire, the flames moved quickly up the outside of the building, spread into the apartments, and then reached nearby towers.

The blocks were also covered in green construction netting from the ground to the roof because renovation work was taking place. This netting caught fire as well and helped the flames advance at a faster pace. Local reports noted that the fire grew at incredible speed. By 3:34pm, it had reached a level four alarm, and by 6:22pm, it had been raised to a level five alarm, the highest alert in Hong Kong. It is now the deadliest fire the city has seen in more than 100 years.

Hong Kong Fire: How Did The Fire Start?

The blaze spread in minutes because it began on the bamboo scaffolding around the building and moved to the green netting covering the towers. Both materials burn very easily. Once they ignited, the flames climbed the outside of the tower and reached many floors above. Burning fragments then dropped to the ground and set nearby buildings on fire within minutes. Wind and the open gaps created during the renovation work likely pushed the flames even faster. While officials are still examining the exact cause, they said that the flammable scaffolding, the construction materials, and the tall buildings standing close together all played a part in letting the fire grow out of control, according to Al Jazeera.

Hong Kong Fire: Essential Safety Tips To Keep In Mind During A Fire Emergency

As per The American Red Cross society, here are some essential safety tips you should follow during incase a fire emergency strucks.

Smoke Alarms:

• Make sure your home is fitted with working smoke alarms.
• Place an alarm on every level of your home including inside each bedroom and outside every sleeping area. Connect the alarms so that they all sound together.
• Install alarms and alert tools to help family members who are deaf or hard of hearing.
• Alert tools such as strobe lights flash when the alarm rings. Pillow or bed shakers can help wake someone who is sleeping. These devices are triggered by the sound of the smoke alarm and shake the bed to warn the person about the fire.
• Test each alarm at least once a month. Press the test button to check that it works.
• Visit the Consumer Product Safety Commission website for details on smoke alarms that may have been recalled.

Home Escape Plan

• Create a home escape plan that includes two ways out of every room. Share this plan with all family members and guests.
• The plan should show two clear exits from each room and a meeting point outside the home.
• Make sure everyone in the house knows the plan.
• Practice your fire drill regularly.
• Ensure that children, older adults, and people with disabilities have the help they need during an escape.
• Keep stairways well lit to prevent falls.
• Clear clutter so no one trips while trying to leave quickly.
• Add handrails along both sides of staircases.
• If you live in an apartment, know where all exit staircases are located on your floor in case the nearest one is blocked by smoke or flames. Always use the stairs to leave the building. Do not use the elevator unless the fire department says you can.

Fire Response

• If there is a fire, get out quickly and stay outside. Then call 9-1-1.
• If you cannot leave the building, call 9-1-1 and tell the fire department you are unable to get out. Wave a light coloured cloth or a flashlight near the window to signal for help, but keep the window closed.
• If you see smoke, use your second escape route. If you must move through smoke, stay low and crawl under it.