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!

The National Medical Commission (NMC) has issued an advisory mandating strict adherence to safe injection practices. The directive aims to curb preventable outbreaks of HIV, Hepatitis B (HBV), and Hepatitis C (HCV) caused by the unsafe reuse of syringes, needles, and other single-use medical devices.

Despite decades of evidence and repeated warnings from the World Health Organization (WHO), unsafe injection practices continue in India, often under the guise of cost-saving. This has led to avoidable infections, lifelong treatment costs, and a loss of public trust in healthcare systems.

What the NMC Advisory Says

The advisory mandates:

• Single-use devices must never be reused:Reuse of syringes, dialyzers, or vials is a direct breach of patient safety.
• Progressive adoption of safety-engineered auto-disable syringes: These devices prevent reuse and help protect healthcare workers from needle-stick injuries.
• Strict enforcement of the Biomedical Waste Management Rules, 2016: Proper segregation and disposal of sharps is mandatory.
• Mandatory training and audits: Healthcare workers must undergo regular competency assessments, and institutions must conduct strict monitoring.

Why Action Is Important

“India has the manufacturing capacity to supply safety-engineered syringes at scale. The barrier is not technology, it is willpower. Procurement administrators must prioritize patient safety over short-term cost-cutting,” said Rajiv Nath, Forum Coordinator of the Association of Indian Medical Device Industry.

“Single-use devices like syringes, dialyzers, and AV (Arteriovenous) fistula needles must not be reused. Unsafe injection practices are entirely preventable, and continuing them is indefensible,” he added.

The expert urged policymakers to act now because it is affecting

• Public Health : Treating HIV, HBV, and HCV infections acquired through unsafe injections costs far more than investing in safe injection devices.

• Global Credibility: As one of the world’s largest users of injectable medicines and vaccines, India’s leadership in safe injection, drug delivery, and blood management practices is critical to global health security.

• Patient Trust: Every reused syringe erodes confidence in healthcare institutions and undermines national health programs.

Read More: Ebola Alert In India: Rajasthan, Hyderabad Report Suspected Cases of Deadly Virus

Call to Action

The AiMeD stated that the NMC's advisory must be treated as a binding mandate, not a suggestion. Procurement administrators, hospital authorities, and policymakers should:

• Enforce zero tolerance for device reuse across all healthcare facilities.
• Allocate budgets for safety-engineered syringes, including auto-disable syringes and sharps injury-prevention devices, as a public health investment rather than a discretionary expense.
• Establish accountability mechanisms through accreditation schemes, including audits, reporting of needle-stick injuries, and penalties for non-compliance.
• Launch patient awareness campaigns to empower communities to demand safe injection practices.

"Unsafe injection practices are not a matter of affordability but of accountability. India has the capacity, technology, and cost-effectiveness evidence through Health Technology Assessment (HTA). What is needed now is decisive action to protect patients and healthcare workers alike," the AiMeD said.

Survival rates among patients with high-grade gliomas — one of the most aggressive forms of brain cancer — have improved by up to 50 per cent in India, according to leading oncologists ahead of World Brain Tumour Day 2026.

Doctors say a growing number of patients are now living significantly longer after diagnosis, with some surviving for more than a decade.

Advances Boost Survival Outcomes

Dr. Tejinder Kataria, Chairperson of Radiation Oncology at Medanta, said median survival for many high-grade glioma patients has increased from around 9–12 months to 14–18 months.

She noted that some centers are "reporting nearly 40 per cent two-year survival rates among patients with Grade III and Grade IV gliomas. In addition, about 5 per cent of patients in certain high-grade glioma groups are now surviving for more than 10 years".

Experts attribute these improvements to advances in molecular diagnostics, comprehensive genomic profiling, neuronavigation-assisted surgery, precision radiation therapy, and targeted treatments.

“Radiation oncology has evolved from open beams in the cobalt era to highly precise beam configurations using modern technologies. We are now able to deliver tumoricidal doses more accurately while also preserving quality of life,” Dr. Kataria said.

Personalized Treatment Changing Care

Also read: Ebola Alert In India: Rajasthan, Hyderabad Report Suspected Cases of Deadly Virus

Dr. R. Ranga Rao, Chairman of Medical Oncology at Paras Health, said brain tumor treatment is no longer limited to surgery and radiation.

A deeper understanding of tumor biology is enabling doctors to tailor treatment according to the molecular profile of each patient’s cancer.

“Although high-grade gliomas remain challenging to treat, the combination of precision diagnostics, modern therapies, and multidisciplinary specialist care is helping more patients live longer and maintain a better quality of life than was possible even a few years ago,” Dr. Rao said.

He also highlighted the growing role of whole genomic sequencing, which helps clinicians understand a tumor’s genetic makeup and select more personalized treatment strategies that may improve survival.

Patients Should Not Lose Hope

Dr. Shyam Agarwal, Senior Consultant in Medical Oncology at Sir Ganga Ram Hospital, said many patients fear the worst when diagnosed with a brain tumor.

“People often feel that nothing can be done once they hear the word tumor in the brain. But brain tumors are of many different types — benign and malignant — and even malignant tumors vary widely in behavior,” he said.

According to Dr. Agarwal, modern treatment options, including surgery, radiation, targeted therapies, and newer drugs, can control many brain cancers for extended periods and may even offer a cure in selected cases.

He also stressed the importance of molecular testing and comprehensive genomic profiling to identify patients who may benefit from precision medicines.

Late Diagnosis Remains a Major Challenge

Despite advances in treatment, experts say delayed diagnosis remains a significant problem in India.

“The biggest blind spot in our country is that many patients reach specialists at a late stage. Symptoms may masquerade as routine headaches, hearing deficits, or visual disturbances. We need greater awareness,” Dr. Kataria said.

Dr. Agarwal added that delayed diagnosis is due to symptoms such as persistent headaches, hearing problems, or vision disturbances which are often mistaken for stress, migraine, or other common conditions, leading to late referrals.

What Is Glioma?

As per the Johns Hopkins Medicine, glioma is a common type of tumor originating in the brain. About 33 per cent of all brain tumors are gliomas, which originate n the glial cells that surround and support neurons in the brains, including astrocytes, oligodendrocytes and ependymal cells.

Gliomas are called intra-axial brain tumors because they grow within the substance of the brain and often mix with normal brain tissue. Symptoms include

• Headaches
• Seizures
• Personality changes
• Weakness in the arms, face or legs
• Numbness
• Problems with speech
• Nausea and vomiting
• Vision loss
• Dizziness.

With advancements in medical technology, hip replacement surgery has evolved significantly over the years. One of the most promising innovations in this field is the Direct Anterior Approach (DAA) Total Hip Replacement, a modern technique that offers patients a safer procedure, reduced pain, and faster recovery.

Unlike traditional hip replacement surgeries, the DAA technique allows surgeons to access the hip joint from the front through a small incision. The biggest advantage of this approach is that muscles are not cut during the surgery. Instead, they are gently separated, which helps minimize tissue damage and reduces post-operative pain considerably.

This muscle-sparing approach has transformed patient recovery experiences. Most patients are able to stand and walk on the same day of surgery, and hospital stays are generally shorter. Recovery is smoother, allowing individuals to return to their normal routine within three to four weeks in most cases.

The DAA technique is especially beneficial for patients suffering from chronic hip pain, restricted movement, or severe joint damage. Common conditions that may require hip replacement include osteoarthritis, avascular necrosis (AVN), rheumatoid arthritis, old hip fractures, and long-standing degenerative joint conditions. When medications, physiotherapy, and injections fail to provide lasting relief, hip replacement surgery can significantly improve mobility and quality of life.

Compared to conventional hip replacement procedures, DAA offers several advantages. The surgery involves a smaller incision, less blood loss, minimal muscle damage, and lower post-surgical discomfort. Patients are able to regain movement faster and often experience greater confidence during rehabilitation.

One of the most common concerns among patients is the fear of severe pain after surgery. However, with modern pain management techniques and advanced surgical methods, discomfort after DAA hip replacement is usually minimal and manageable. Patients today recover much more comfortably than they did in the past.

Another important factor is the durability of modern implants. Advances in implant technology have significantly improved their lifespan, with many implants lasting more than 25 years. Maintaining a healthy body weight, staying physically active, and following medical advice can further improve the longevity and effectiveness of the implant.

After successful recovery, patients are generally able to resume a normal and active lifestyle. They can return to work, perform household activities independently, and participate in light exercises such as yoga, swimming, and stationary cycling. The primary goal of hip replacement surgery is not just pain relief, but restoring confidence, mobility, and independence.

Preparation before surgery also plays an important role in achieving better outcomes. Patients are advised to maintain controlled blood sugar levels, blood pressure, and overall heart health. Informing doctors about ongoing medications, performing basic physiotherapy exercises before surgery, and preparing a comfortable recovery environment at home can contribute to a smoother rehabilitation process.

Hip pain should never be ignored, especially when it begins affecting daily life and mobility. Timely treatment and the right surgical approach can make a remarkable difference. The Direct Anterior Approach has made hip replacement surgery simpler, safer, and more patient-friendly, helping individuals return to an active and pain-free life much faster than before.

Dr. Ishwar Bohra is Senior Director and Senior Joint Replacement Surgeon at BLK-Max Super Speciality Hospital, New Delhi.