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!

Every year, as the monsoon rolls in, hospitals and clinics across India see a familiar pattern: a sharp uptick in children and elderly patients presenting with vomiting, diarrhoea, and dehydration.

Doctors attribute this seasonal surge to a combination of contaminated water supplies, deteriorating food hygiene, and warm, humid conditions that favour the spread of viruses like rotavirus and norovirus.

Why Monsoon Fuels Gut Infections

Heavy rains and flooding routinely compromise municipal water lines, allowing sewage to mix with drinking water. Street food and produce are more prone to contamination during this period, and the humidity itself accelerates bacterial and viral growth.

Acute gastroenteritis, an inflammation of the stomach and intestines, is consistently one of the fastest rising monsoon health conditions, with rotavirus being a leading cause in children and norovirus a common culprit across age groups.

Understanding Rotavirus

Rotavirus is a highly contagious, wheel shaped virus and remains the leading cause of severe diarrhoeal illness and death in children under five worldwide. It spreads through the faecal oral route via contaminated water, food, surfaces, or close contact with an infected person, and can cause several days of intense vomiting and watery diarrhoea, putting young children at real risk of rapid dehydration.

The good news: Rotavirus vaccines, given orally in a series of doses before 8 months of age, are highly effective at preventing severe disease and are recommended as part of national immunisation programmes.

Also read: Climate Change And Progressive Urbanization Call For An Integrated Approach To Infectious Disease Surveillance

Expert Recommended Prevention Measures

1. Water safety first

Boil or filter all drinking water during the monsoon months. Avoid ice and beverages of uncertain origin, especially from street vendors.

2. Food hygiene

Steer clear of cut fruits, chaat, and other street food that has been sitting exposed. Cook food thoroughly and eat it hot. Avoid reheated leftovers stored without refrigeration.

Also read: Dengue & Guillain-Barré Syndrome: Can A Common Monsoon Illness Trigger A Serious Nerve Disorder?

3. Hand hygiene

Frequent handwashing with soap before eating, after using the toilet, and after changing diapers remains one of the single most effective, low cost interventions against faecal oral transmission.

4. Vaccination

Ensure infants complete their full rotavirus vaccine schedule on time. Vaccination substantially reduces hospitalisations and severe outcomes, even though it does not eliminate all seasonal transmission.

5. Isolate and disinfect

Because these viruses spread easily within households and childcare settings, keep infected individuals' utensils and linens separate, and disinfect surfaces regularly during an active infection.

Recognising The Warning Signs

Most cases of viral gastroenteritis are self limiting, but caregivers should watch for signs of dehydration that require urgent medical attention:

• Sunken eyes, dry mouth, or reduced tears when crying (in infants)
• Little or no urination for 6+ hours
• Lethargy or unusual drowsiness
• Persistent vomiting that prevents fluid intake
• High fever or blood in the stool

Also read: Beware! Common Mistakes New Parents Make During Their Baby’s First Monsoon

Treatment: What Actually Helps

Oral Rehydration Solution (ORS) is the cornerstone of management.

A simple homemade version consists of 1 litre of boiled and cooled water, 6 teaspoons of sugar, and half a teaspoon of salt. It can be lifesaving when commercial ORS packets are not available, though pre mixed WHO formula ORS is preferable when accessible.

Zinc supplementation (around 20 mg daily for 10 to 14 days) is recommended for children under five, as it has been shown to reduce the duration and severity of diarrhoeal episodes.

Antibiotics are not effective against viral gastroenteritis and should only be used if a bacterial cause, such as cholera, is confirmed by a doctor. Inappropriate antibiotic use can do more harm than good.

Continue feeding. For breastfed infants, continue breastfeeding throughout the illness. For older children and adults, small, frequent sips of fluids and bland, easily digestible food are better tolerated than large meals.

When to See a Doctor

Seek medical care promptly if there is persistent high fever, visible blood in the stool or vomit, signs of moderate to severe dehydration, or if symptoms do not improve within 2 to 3 days, particularly in infants, the elderly, or anyone with underlying health conditions.

By Dr. Geeta Malkan Billa, Director of Gastroenterology & Hepatology at Dr. L. H. Hiranandani Hospital

Urinary tract infections are common. A lot of people get them every year. When you have a tract infection you might feel a burning sensation when you go to the bathroom you might have to go to the bathroom a lot and your lower belly might hurt. These symptoms can get in the way of your life. You might want to try to make the pain go away on your own. Taking medicine without prescription is not a good idea.

Taking antibiotics when you do not need them can be bad for you. Urinary tract infections can become harder to cure when the bacteria get used to the medicine. This is called resistance and it is a big problem for everyone’s health. When this happens, you might get tract infections repeatedly and you might have fewer choices, for treatment. That is why it is so important to go seek medical attention at the earliest.

Causes Of UTIs

Most Urinary Tract Infections are caused by bacteria that are usually in the digestive tract and then get into the urethra. Things like not having water, not keeping yourself clean having something wrong with the urinary system or having a weak immune system can make it more likely for bacteria to grow.

If you take the medicine or stop taking it too soon the strong bacteria will live and get stronger. Over time these bacteria will not be affected by the medicines, which makes them very hard to treat. This is what happens when you have a Urinary Tract Infection that is resistant to drugs. Urinary Tract Infections, like these are very tough to deal with.

Also read: Kidney Stones In Urban India: Causes, Prevention, And Modern Treatment

Signs And Symptoms To Watch Out For:

Recognizing the early warning signs helps prevent the infection from spreading deeper into the body. Common signs of a UTI include:

• A strong, continuous urge to urinate, even immediately after emptying the bladder

• A burning or painful sensation during urination

• Passing small amounts of cloudy, dark, or unusual-smelling urine

• Visible blood in the urine, giving it a pink or reddish tint

• Pelvic pain or pressure in the lower abdomen

• Fever, chills, lower back pain, or nausea, which often signal that the infection has reached the kidneys

Also read: Prostate Cancer: NHS England's New Precision Radiotherapy Offers Hope In Just 5 Sessions

Tips For Prevention:

Preventing tract infections is always better than treating them especially now that we have a lot of antibiotic resistance. If you do simple things every day you can reduce the risk of bacteria getting into your urinary system.

Here are some things that can help:

1. Stay well hydrated: Drinking water is very important for urinary health. When you drink fluids during the day it helps wash away bacteria from the urinary system. This lowers the chance of getting an infection.

2. Prioritize good personal hygiene: Doing things to stay clean can help lower the chance of a UTI. It is best to wipe from front to back after going to the bathroom. This keeps bacteria from the stomach area from moving into the system.

3. Don’t delay urination: Going to the bathroom regularly helps stop bacteria from growing. If you hold your urine for long it can create a place where bacteria grow faster. This makes it more likely to get an infection.

4. Be cautious with intimate hygiene products: Products that have smells, like sprays or douches can hurt sensitive areas. They can also change the balance of bacteria that protect the body. This might make UTIs more likely.

5. Wear breathable fabrics: Choosing cotton underwear and clothes that're not tight helps keep the area dry. A dry and cool place is not a home, for bacteria. This lowers the chance of getting an infection.

Also read: Can You Flush Out A UTI By Drinking More Water?

Diagnosis And Proper Medical Evaluation

Accurate diagnosis is essential before starting any medication. Diagnosis start with an evaluation and a simple urine test called a urinalysis to check for bacteria white blood cells and red blood cells.

In cases a urine culture is also done. This test finds the strain of bacteria causing the infection and tests it against different medications to find out which antibiotic will work best. For people who have recurring UTIs imaging tests, like ultrasound or CT scans might be used to look at the structure of the urinary tract and find any blockages or problems that are there.

Treatment Options

Also read: Turns Out, Peeing In The Shower Could Have Unexpected Dangers

Urinary tract infections or Urinary Tract Infections can usually be treated with antibiotics. You must take all the antibiotics even if you start to feel better so that you can be sure the Urinary Tract Infection is gone and you do not get sick again.

Medicines also help with the pain and discomfort you feel when you urinate, such as burning or feeling like you must go to the bathroom all the time.

In some cases, Urinary Tract Infections may recur due to underlying conditions such as kidney stones, urinary tract blockages, an enlarged prostate or structural abnormalities of the system. When these factors are identified, treating the root cause becomes essential.

Procedures such as kidney stone removal, stent placement or corrective surgery for urinary tract abnormalities may be recommended to prevent repeated Urinary Tract Infections.

Prevention and early intervention remain the effective strategies, in managing Urinary Tract Infections. Being aware of the warning signs and getting care at the onset of symptoms and avoiding unnecessary antibiotic use can significantly reduce the risk of recurrent Urinary Tract Infections and serious complications.

With diagnosis and appropriate treatment most Urinary Tract Infections can be successfully managed, safeguarding both urinary health and overall well-being.

By Dr. Arif Akhtar, Principal Consultant - Urology, Robotics and Renal Transplant, Manipal Hospital, Gurugram

By the time we enter our 40s, the lungs begin to undergo gradual changes that can affect breathing capacity and respiratory reserve. While some changes are a normal part of ageing, persistent cough, breathlessness or recurrent chest infections should not simply be dismissed as getting older.

Experts explain why lung health deserves greater attention after 40, which everyday habits can help protect the lungs, and when screening or medical evaluation may be needed.

As we enter our 40s, what natural changes occur in our lungs, and why does lung health become more important at this stage of life?

As we age lung tissue elasticity declines and chest wall mechanics stiffen. From an oncology standpoint, age-related cellular damage and long-term exposure to cancer causing agents like tobacco increase cancer risk. Looking after lung health from young age builds the respiratory reserve needed to tolerate advanced medical or surgical interventions if required as you get older.

What everyday lifestyle habits can help keep our lungs healthy after 40?

Engage in regular aerobic conditioning exercises to maintain full breathing capacity. Reduce carcinogen exposure by avoiding active and passive tobacco smoke, and ensuring proper ventilation while cooking. using HEPA air purifiers may help to an extent. Maintain an antioxidant-rich diet to combat cellular oxidative stress.

Also read: Dream Of Becoming A Footballer Or Cricketer? Cardiologists Reveal Heart-Healthy Habits For Young Athletes

What are some early signs of declining lung health that people often dismiss as 'just ageing' but should actually get checked?

2 to 3 week cut off is applicable here. A persistent cough lasting over three weeks, progressive exertional breathlessness, recurrent chest infections, coughing up blood, or unexplained weight loss are red flags. This is for both smokers and nonsmokers. Early-stage lung cancers are frequently asymptomatic or subtle; ignoring these signs delays diagnosis. These symptoms are that of TB as well. So, that should be ruled out.

Are there any health screenings, vaccinations, or routine check-ups that adults over 40 should consider to protect their lung health?

Annual flu and once in lifetime pneumococcal vaccine prevents severe pulmonary infections. For high-risk individuals—such as heavy past or present smokers—a annual Low-Dose CT (LDCT) scan is the gold standard for early lung cancer detection, finding lesions when they are most curable. Eliminating tobacco, mitigating indoor air pollution, exercising, and maintaining balanced nutrition significantly lower cancer risk and improve overall survival outcomes.

By Dr. Sandeep Nayak, Chairman of Oncology, MACS-Renova Oncology Institute, KIMS Hospital, Bangaluru