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 many women, the last day of treatment feels like crossing a finish line they have been running toward for months. There is relief, there is gratitude, and there is often a quiet sense of disbelief that it is actually behind them. But finishing treatment is not really the end of the journey. It is the start of a new chapter—one we call survivorship—and it deserves just as much care and attention as everything that came before. Understanding what lies ahead can make all the difference between living in fear and living well.

Follow-Up Care Must Continue

Recovery does not mean walking away from the hospital. In the first few years after treatment, survivors are usually asked to return for follow-ups. The reason behind this is simple: if cancer ever returns, catching it early gives the best chance of treating it successfully. Or in many cases it a good habit to keep a check and boost confidence to the survivors.

Impact of treatment

What often surprises many women is that the impact of cancer treatment may continue even after active treatment ends. Recovery is a gradual process, and experiences can vary significantly from one individual to another depending on the type of cancer, treatment approach, and overall health. In terms of breast cancer, some women may continue to face physical, emotional, or lifestyle-related challenges during survivorship, while others may require ongoing therapies or follow-up care to reduce the risk of recurrence. What must always be remembered is that these issues cannot be addressed in silence. Open communication between the woman and her treatment team may allow problems to be sorted out in time, with the proper support being provided.

Emotional Health Deserves Equal Attention

Healing is not only physical. Many survivors carry a constant worry about whether the cancer will come back, while others feel strangely lost once the busy routine of treatment falls away. These emotions are completely natural and nothing to be ashamed of. Speaking to a counsellor, joining a support group, or simply being honest with the care team can lighten the burden enormously.

Healthy Habits Support Recovery

The choices made every day genuinely shape long-term health. Eating plenty of vegetables, fruits, and whole grains, and staying active with something as simple as a thirty-minute walk most days, makes a real difference. Keeping to a healthy weight is especially important, because carrying excess weight is linked to a higher chance of the cancer returningi. Cutting back on alcohol and staying away from tobacco add further protection.

Adjusting to Physical Changes

The body changes after cancer and coming to terms with this takes time. Worries about appearance and intimacy are entirely understandable, and they are worth raising during clinic visits, because often there are practical ways to help.

Be an Informed Advocate

No one understands a patient's body better than the patient herself, which is why every survivor should feel empowered to ask questions. Before treatment ends, it is wise to request a survivorship care plan. This is a summary of the treatment received, together with a clear schedule for future check-ups. Such a document becomes an invaluable guide, both for the survivor and for any doctor she may see in the years ahead.

Looking Ahead

Survivorship is rarely a straight line. There will be good days and harder ones, moments of confidence and moments of doubt. With regular check-ups, a few sensible habits, and the support of people who care, life after breast cancer can be every bit as rich and full as before—sometimes even more so. Because in the end, the goal of cancer treatment was never just to help women survive. It was always to help them truly live.

More than 57 million people worldwide are living with dementia, a number expected to triple to over 152 million by 2050. While there is still no cure, growing evidence suggests that healthy lifestyle changes can help improve brain health and preserve cognitive function in older adults at risk of dementia.

A major study published in The Lancet suggests that adopting healthy lifestyle habits can significantly improve memory and thinking skills in older adults at risk of dementia.

The study found that a culturally adapted, structured lifestyle program delivered across 11 Latin American countries produced meaningful improvements in cognitive function over two years. Participants in the intensive program showed 55 per cent greater improvement in overall cognition than those who received general health advice.

Lead author Lucia Crivelli, principal investigator at Fleni, a neurological institute in Buenos Aires, Argentina, said culturally adapted lifestyle interventions can be successfully implemented across diverse communities and "deliver cognitive benefits" for people at risk of dementia.

"Addressing multiple lifestyle factors can positively impact brain health and may eventually be combined with emerging drug therapies to reduce cognitive decline and dementia risk," added Heather M. Snyder, senior vice president of medical and scientific relations at the Alzheimer's Association.

What Did The Study Find?

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The clinical trial enrolled 1,065 adults aged 60 to 77 years at increased risk of cognitive decline across 12 sites in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Ecuador, Mexico, Peru and Uruguay.

Participants were randomly assigned to one of two groups. The Systematic Lifestyle Intervention (SLI) group received ongoing coaching, supervised exercise, personalized nutrition counselling, cognitive training and regular monitoring of cardiovascular risk factors. The Flexible Lifestyle Intervention (FLI) group received general lifestyle recommendations through periodic health education sessions without continuous coaching or supervision.

The structured program combined supervised exercise, a brain-healthy MIND diet, computer-based cognitive training, regular monitoring of blood pressure, blood sugar and weight, and social engagement activities designed to encourage accountability and interaction.

To improve participation, the intervention was adapted to local cultures. Exercise sessions incorporated familiar activities such as salsa and tango, while nutrition counselling focused on regionally available foods including avocado, quinoa, açaí, chia seeds, pumpkin seeds and aguaymanto.

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After two years, participants in the structured intervention experienced:

• 55 per cent greater improvement in overall cognitive performance than those in the flexible intervention group.

• The largest gains in memory.

• Significant improvements in executive function, including planning and decision-making.

• Faster processing speed.

The cognitive benefits were consistent regardless of participants' age, education level, ethnicity or genetic risk for Alzheimer's disease.

The authors noted that while the program improved performance on cognitive tests, it did not determine whether the intervention prevents dementia. They said longer-term follow-up is needed to establish whether these cognitive improvements ultimately reduce the risk of developing the disease.

What Is Dementia?

Dementia is an umbrella term used to describe a significant decline in mental function that is serious enough to affect everyday life. It commonly impacts memory, thinking, and reasoning skills. Dementia itself is not a single disease but a collection of symptoms caused by underlying conditions such as Alzheimer’s disease or vascular dementia.

Common signs include

• memory problems,
• confusion,
• difficulty finding words,
• changes in mood or behavior,
• trouble completing familiar tasks.

Nearly one in five women aged 50 and older in the United States has osteoporosis, a bone disease that weakens bones and increases the risk of fractures. Yet many women remain undiagnosed because the condition often develops without noticeable symptoms in its early stages.

To improve early detection, the updated recommendations from the US Preventive Services Task Force (USPSTF) advise routine osteoporosis screening for women aged 65 years and older.

The task force also recommends that postmenopausal women younger than 65 undergo a risk assessment to determine whether they should receive a bone density scan.

Updated USPSTF Screening Recommendations

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The USPSTF recommends:

• Women aged 65 years and older should undergo routine screening with a bone density scan.
• Postmenopausal women younger than 65 should first complete a risk assessment questionnaire to determine whether a bone density scan is needed.

Women under 65 may need screening if they have one or more risk factors, including:

• Low body weight
• Family history of hip fractures
• Cigarette smoking
• Excessive alcohol consumption

"Screening is important because osteoporosis causes bones to become weaker and fracture more easily, leading to disability, chronic pain, loss of independence, and even death,” said Task Force member Dr. Esa Davis, professor of family and community medicine at the University of Maryland, Baltimore, NBC reported.

Why Osteoporosis Often Goes Undetected

Osteoporosis is often called a "silent disease" because it usually causes no symptoms until a bone breaks. Many people only discover they have osteoporosis after experiencing a fracture. The most common fracture sites include the:

• Hip
• Wrist
• Spine

Why Osteoporosis Is More Common In Women

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According to the US Centers for Disease Control and Prevention (CDC), data from 2017-2018, published in 2021, showed that:

• 19.6 per cent of women aged 50 and older had osteoporosis in the femur or lower spine.
• In comparison, 4.4 per cent of men had osteoporosis.

The study also found that osteopenia—a condition of lower-than-normal bone density that often precedes osteoporosis—was more common in women than men. While osteopenia affected 51.5 per cent of women, it affected 33.5 per cent of men.

In women, osteoporosis is commonly linked to the hormonal changes that occur after menopause.

Estrogen plays an essential role in building and maintaining strong bones. After menopause, estrogen levels decline significantly, accelerating bone loss and increasing the risk of osteoporosis.

People who do not build strong bones during childhood and early adulthood are also at greater risk later in life. Factors such as lack of physical activity, eating disorders, and certain health conditions can prevent the body from achieving optimal bone mass during the younger years.

What Is Osteoporosis Screening?

Doctors use imaging tests to measure bone density and diagnose osteoporosis. A DXA (dual-energy X-ray absorptiometry) scan is the standard diagnostic test and measures bone density in the spine, hip, and wrist using a very small amount of radiation.

Ultrasound can also assess bone quality, but it is not used alone to diagnose osteoporosis. If ultrasound findings suggest bone loss, a DXA scan is still required to confirm the diagnosis.

Is Osteoporosis Treatable?

There is currently no cure for osteoporosis, but treatment and lifestyle changes can help slow bone loss and reduce the risk of fractures.

Experts recommend:

• Stay physically active and do weight-bearing exercises such as walking.
• Do not smoke.
• Limit alcohol consumption.
• Get enough calcium and vitamin D through your diet. Your healthcare provider may also recommend calcium and vitamin D supplements if needed