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!

Water remains the most reliable and effective way to keep the body hydrated during hot weather. However, many people increasingly turn to energy drinks during long workdays or busy schedules, hoping to stay refreshed or energized.

Experts warn that relying on these drinks instead of water can create several health risks, particularly when temperatures are high.

Energy drinks are typically marketed as quick solutions for fatigue and low energy. They often contain high levels of caffeine, added sugars and stimulants that may temporarily increase alertness.

While this short term boost may seem appealing, experts say these drinks are not designed to support proper hydration. When consumed frequently, especially during summer, they can place extra strain on the body rather than helping it stay cool and hydrated.

Dr Arun Sachdeva, an Internal Medicine Specialist at Felix Healthcare in Bengaluru, explains that replacing water with energy drinks during hot weather can interfere with the body’s natural hydration balance.

According to him, excessive consumption of these beverages may contribute to both immediate and long term health concerns, particularly when the body is already losing fluids through sweating.

Higher Risk Of Dehydration

During summer, when sweating already causes significant water loss, this effect may make it harder for the body to maintain proper hydration.

When energy drinks replace water intake, the risk of dehydration increases. Common symptoms of dehydration include fatigue, dizziness, headaches and dry mouth. In more severe cases, dehydration can also affect concentration, physical performance and overall wellbeing.

Excessive Stress On The Heart

For people who already have high blood pressure or existing heart conditions, excessive intake of energy drinks could increase the risk of heart palpitations or irregular heart rhythms. Experts therefore recommend limiting the consumption of these beverages, particularly during periods of intense heat.

High Sugar And Empty Calories

Frequent spikes in blood sugar levels may gradually increase the risk of metabolic disorders. Over time, consistently high sugar consumption can contribute to health problems such as obesity and type 2 diabetes.

Therefore, doctors advise paying attention to sugar content in beverages, especially during hot weather when people tend to drink more fluids throughout the day.

Sleep Disruption And Energy Crashes

Instead of providing sustained energy, regular consumption of energy drinks may lead to temporary stimulation followed by sudden drops in energy levels.

This cycle can leave individuals feeling even more tired later in the day, creating a pattern where they rely on more caffeinated drinks to stay alert.

Kidney Health And Hydration

When the body does not receive enough water, the kidneys may struggle to function efficiently. Over time, poor hydration can increase the risk of kidney related problems and may affect the body’s ability to regulate fluid levels effectively.

Why Water Remains The Best Choice

Doctors emphasize that water remains the safest and most effective drink for maintaining hydration during summer. It helps regulate body temperature, supports organ function and replaces fluids lost through sweating without introducing excess caffeine, sugar or stimulants.

Energy drinks may occasionally provide a quick boost of alertness, but they should not be used as a substitute for water. Maintaining regular water intake throughout the day remains one of the simplest and most effective ways to support overall health during hot weather.

Late nights at the office, quick dinners made from instant noodles or packaged snacks and constant deadline pressure are often treated as normal parts of professional life, but doctors say these habits may gradually affect kidney health.

Nephrologists report that routine health screenings are increasingly detecting early signs of kidney stress in people in their late 20s to 30s, even among those without traditional risk factors such as diabetes, smoking or a family history of kidney disease.

According to nephrologist Dr Kristin George, some patients show warning indicators such as elevated creatinine levels, high blood pressure or traces of protein in the urine.

Creatinine is a waste product filtered out by the kidneys and rising levels may indicate that the organs are not removing waste as efficiently as they should.

Doctors say that when lifestyle patterns are examined more closely, prolonged work stress, sedentary routines, irregular meals and frequent late-night snacking often emerge as common factors.

Kidney Disease Is A Growing Global Concern

Chronic kidney disease, or CKD, involves the gradual loss of kidney function over time and can eventually lead to kidney failure if it is not detected early.

Health experts warn that CKD could become one of the leading causes of death globally in the coming decades. Diabetes and hypertension account for a large proportion of cases and according to the International Society of Nephrology these two conditions combined contribute to nearly two-thirds of chronic kidney disease cases worldwide.

Doctors also note that prolonged stress may indirectly increase these risks because long-term elevations in stress hormones such as cortisol can raise blood pressure and disrupt metabolic balance.

Processed Foods And Late-Night Eating

Late-night meals frequently include instant noodles, chips, processed meats or packaged snacks, many of which contain significant amounts of sodium.

Sodium helps regulate fluid balance, but excessive intake forces the kidneys to work harder to maintain stable blood pressure. The World Health Organization estimates that most adults consume nearly twice the recommended daily sodium intake, largely because of processed foods.

Doctors say that consistently high salt intake can gradually increase blood pressure and place additional strain on kidney function.

Sedentary Work And Poor Hydration

Hydration habits and prolonged sitting are additional concerns among office workers. Many professionals rely heavily on coffee, energy drinks or sugary beverages during long workdays, often replacing plain water as the main source of fluid intake.

While moderate caffeine consumption is generally considered safe, relying mainly on caffeinated drinks can contribute to mild dehydration, which may affect blood circulation through the kidneys and increase the likelihood of kidney stones.

At the same time, many corporate jobs require employees to remain seated for extended periods. Sedentary routines have been linked to obesity, impaired glucose metabolism and high blood pressure, all of which are major contributors to kidney disease.

Early Signs Often Go Unnoticed

Kidney disease often develops silently in its early stages, which means many people remain unaware of the problem until significant damage has occurred.

Early kidney dysfunction may progress quietly for years before symptoms appear, and by the time signs such as swelling, fatigue or changes in urination become noticeable, kidney function may already be reduced.

Doctors therefore recommend periodic screening tests, including serum creatinine measurements, estimated glomerular filtration rate (eGFR) tests and urine albumin tests, which can detect early signs of kidney damage.

Small Changes Can Make A Difference

Health experts say that protecting kidney health often begins with small lifestyle changes. Reducing processed food consumption, limiting excessive salt intake, staying adequately hydrated and maintaining regular sleep schedules can all support kidney function.

Taking short movement breaks during long work hours and managing stress through regular physical activity or relaxation techniques may also help reduce the long-term strain that modern work routines place on the body.

Doctors emphasise that kidney disease usually develops gradually, which means recognising and adjusting everyday habits early may help many young professionals protect their kidney health.

Heart disease remains the leading cause of death in India, often affecting people nearly a decade earlier than in Western populations.

Recent cholesterol management recommendations from the American Heart Association (AHA) and related global guidelines emphasize aggressive control of LDL cholesterol — the so-called “bad cholesterol.” For Indians, these recommendations carry particular importance.

Studies consistently show that South Asians have a higher tendency for premature coronary artery disease. Even individuals who appear relatively lean may have underlying metabolic risk factors such as insulin resistance, abdominal obesity, and elevated triglycerides. Because of this inherent susceptibility, the same cholesterol levels that may appear “borderline” in Western populations can translate into a significantly higher cardiovascular risk in Indians.

What Does The New Guidelines Say

The newer guidelines shift the focus away from merely treating cholesterol numbers to assessing an individual’s overall cardiovascular risk.

Factors such as diabetes, smoking, blood pressure, family history of early heart disease, and age are considered together. If a person falls into a higher-risk category, doctors now recommend lowering LDL cholesterol more aggressively than before.

For people who already have established heart disease, the goal is particularly strict. LDL cholesterol is ideally reduced to levels below 55 mg/dL. Achieving such targets often requires not only lifestyle changes but also medications such as statins, and in some cases, newer therapies that further lower cholesterol levels.

How Indians Can Prevent Heart Disease

For Indians without diagnosed heart disease, prevention becomes the key message. Regular screening after the age of 30–35 years is increasingly advisable, especially if there is a family history of heart disease or diabetes. Diet also plays a central role: reducing trans fats, limiting refined carbohydrates, increasing fibre intake, and maintaining a healthy body weight can significantly influence cholesterol levels.

Equally important is regular physical activity. Even 30 minutes of brisk walking most days of the week can improve lipid profiles and reduce cardiovascular risk.

The key takeaway is simple: Indians develop heart disease earlier and often at lower cholesterol levels.

The newer AHA recommendations reinforce the need for earlier screening, individualized risk assessment, and more proactive cholesterol management to prevent future heart attacks.