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 2022, there were around 19,976,499 cancer cases diagnosed from around the world, notes the World Cancer Research Fund. Out of them, 10,311,610 were men, and 9,664,889 were women. In 2024, several reports say that there were over 19 million new global cases in that year. The cases of cancer are rising, so is there any way one can stay one step ahead of it?

While it is important to get screenings done frequently, especially if one has a family history of cancer, there could be certain red flags, one must look out for to book an appointment with oncology.

Here are the cancer red flag one must keep a look out for:

Persistent Fatigue

Persistent fatigue remains one of the most overlooked symptoms of oncology. This is not like a routine tiredness, this is a kind of exertion that stays despite rest, balanced meals, and time off. Data from 2022-24 shows that over 30% of early stage cancer patients reported unexplained fatigue prior to diagnosis.

Unexplained Weight Loss

Oncologists explain that over 40% of newly diagnosed gastrointestinal and lung cancer patients experienced weight loss. This could happen due to metabolic changes caused by tumors, which can alter energy absorption and consumption, often suppressing appetite and leading to a rapid loss of body fat.

When to see a doctor? If you have lost more than 5% of your body weight in under 6 to 8 weeks, it is important that you seek immediate medical attention.

Chronic Pain

If there is a pain that does not go away, it could be because of cancer. Many patients have complained of persistent pain as one of the fist symptoms of their cancers. This is particularly true for back pain, which is common in pancreatic or ovarian cancer. Bone pain too is common in metastasis, and pelvic pain is common in uterine or colorectal cancer.

Skin Changes

Not all cancers start inside the body, some also show up on the skin. These changes could be new moles, non-healing wounds, or changes in pigmentation. In fact, unusual rashes also signal changes like skin cancer.

Changes In Bowel And Bladder Habits

If you experiences changes in your bowel and bladder habits and find blood in your stool or urine, it is best to see a doctor. Colorectal, bladder and prostate cancers often start subtly. Before it becomes serious, keeping a track of your bowel and bladder habits could prevent the cancer from spreading.

Lump Or Thickening Of Body

While lumps could be benign, they are also one of earliest signs cancer. For instance, the early detection of breast cancer and testicular cancer are from lumps, which are observed while self examination. In fact, the early detection, thanks to self examination, has even increased by 22%.

Persistent Cough

While this may be a season of virus and flu, but if your cough does not go away, it may be a serious sign. If you find blood in your cough, see a doctor, take scans. If you are a smoker, you may be more prone to early stage throat cancer.

Headache That Does Not Go Away

There could be certain neurological issues, including a stubborn headache that does not go away. This may be an indication of a tumor in the brain.

If you have any of these stubborn symptoms, it is best to book a doctor's appointment and go for a screening.

Note: Health and Me is not a substitute for doctor's advice, please consult a registered doctor, if you face any of these symptoms.

Delhi's AQI on Tuesday morning seemed to be doing somewhat better than Monday morning. The AQI has brought some relief to the residents who had been dealing with 'severe' pollution levels, with visibility being hit. As per Tuesday's AQI, according to Central Pollution Control Board (CPCB), Delhi's air pollution stood at 381 AQI as of 6.30 am. This has placed the air quality in the 'very poor' category.

While it has become a habit of many to check AQI before stepping out of the house, how many of us actually understand what AQI really means?

Recently, Delhi's Chief Minister Rekha Gupta claimed that AQI and temperature are the same. At a summit hosted by a news channel, Delhi CM Gupta referred to AQI as "temperature".

Such statements could further lead to misconceptions, and add to everyday confusions. Health and Me is breaking down what AQI really means and why is it not the same as temperature.

How Air Quality Index Work And What It Means

As the Delhi CM claimed that AQI is like temperature and could be "measured using any instrument", is not true. Though it is understandable why such comparisons may have been drawn as you can easily check the AQI report on your phones, like we do with temperature.

However, in real sense, AQI or the air quality index is a tool used for communicating outdoor air quality and health. The AQI includes six-color coded categories, each of which corresponds to a range of index values. The higher the AQI value, the greater the level of air pollution and the greater the health concern.

Air quality is made of dust and small particles like PM2.5 and PM10, along with gases like nitrogen dioxide from car exhaust, sulphur dioxide from factories, and carbon monoxide from vehicles. The levels are measured through specialized machines. In India, the standard of the machines are carried out by the Central Pollution Control Board or CPCB.

What Makes Delhi So Polluted?

As per a review of Delhi's air quality from 1990 to 2022, published in Sustainability (MDPI), an open access journal, these are the following sources of Delhi's Air Pollution:

• Transports emit around 10 to 30% of pollution. This includes all road, rail, and aviation modes and combustion of petrol, diesel, and gas.

• Dust make up another 10 to 30% of pollution. Dust from resuspension on the roads and construction activities.

• All industries, including small, medium, and large industries, including power plants and brick kilns lead to 10 to 30% of pollution.

• In summers, all residential activities, including cooking, lighting, and heating activities lead to 10% of pollution, whereas in winter, it makes up for 30%.

• Waste burning, including residential sides and landfills leads to 5 to 15% of pollution.

Power plants from outside the city leads to less than 7% of pollution. Dust storms contribute to less than 5% of pollution. Agricultural residue burning, which is a seasonal source of pollution leads to less than 3% of pollution, whereas firecrackers, another seasonal source, leads to less than 1% of pollution.

Earlier in November, the Public Health Ontario's (PHO) data revealed that Ontario and Canada as a whole could be in a "very tough" flu season this year, thanks to the Influenza A or the flu A. The PHO data revealed a 1.8% rise in influenza cases in the last week of October. Now, amid the influenza A outbreak, 3 children have died from the same in Ottawa and Eastern Ontario region.

Influenza A: Can Flu Kill People?

As per the infectious physician at the Johns Hopkins University Center for Health Security, as reported in Scientific American, "Dying from the flu is not like dying from a bullet or a black widow spider bite. The presence of the virus itself isn't going to be what kills you. An infectious disease always has a complex interaction with its host.”

Once the virus enters someone's body usually via their eyes, nose, or mouth, the influenza virus begins hijacking human cells in the nose and throat to make copies of itself. This triggers a strong response from the immune system, and sends battalions of white blood cells, antibodies and inflammatory molecules to eliminate the threat.

T cells work by targeting and destroying virus-infected tissue, especially in the respiratory tract and lungs where the infection usually settles. In most healthy adults, this response clears the virus and leads to recovery within days or weeks. In some cases, however, the immune reaction becomes excessive, damaging large areas of lung tissue and impairing oxygen delivery to the blood, which can cause hypoxia and, in severe cases, death.

What Is Influenza A?

As per the National Institutes of Health, US, influenza viruses that contains single-stranded RNA that are classified into three types: A, B, and C. Type A and B cause annual epidemics and even pandemics, while type C is a less common disease.

As per the Centers for Disease Control and Prevention (CDC), Influenza A viruses are descendants of the 2009 H1N1 pandemic virus that emerged in the spring of 2009 and caused a flu pandemic. These viruses, scientifically called the "A(H1N1)pdm09 virus," and more generally called "2009 H1N1," have continued to circulate seasonally since 2009 and have undergone genetic and antigenic changes.

Influenza A(H3N2) viruses also change genetically and antigenically. Influenza A(H3N2) viruses have formed many separate, genetically different clades in recent years that continue to co-circulate.

It is a fast-spreading respiratory virus responsible for seasonal flu outbreaks and, at times, global pandemics. It changes quickly through genetic shifts, which makes new strains harder to predict and control. The virus is grouped based on surface proteins called hemagglutinin and neuraminidase, with H1N1 and H3N2 among the most common strains in circulation. It spreads mainly through coughs, sneezes, or close contact and often comes on suddenly, causing fever, cough, body pain, and extreme tiredness. In some cases, it can lead to serious complications, especially in vulnerable groups.

Influenza A: Common Signs And Symptoms

• Fever or chills
• Dry cough
• Sore throat
• Headache
• Fatigue
• Some people could also get symptoms like diarrhea or vomiting, especially kids.

The symptoms usually appear 1 to 4 days after exposure and could linger for a week.