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!

Thyroid disorders don’t just affect women — it also affects men and raise fertility risks, said experts today on World Thyroid Day.

While thyroid disorders are commonly linked to symptoms such as weight gain, fatigue, mood swings, and hair loss, experts highlighted a lesser-known impact of thyroid imbalance — its effect on male fertility and reproductive health.

Dr. Piyush Lodha, Endocrinologist at Ruby Hall Clinic, Pune, told HealthandMe that both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can negatively affect sperm health and reproductive function in men.

“The thyroid regulates several important body functions, including metabolism and hormone balance. Even slight thyroid dysfunction can influence fertility because thyroid hormones are closely connected to reproductive hormones,” he explained.

How Thyroid Imbalance Affects Male Fertility

The doctors noted that thyroid hormones play an important role in sperm production, sperm maturation, libido, and sexual performance.

In hypothyroidism, reproductive processes may slow down significantly. Men may experience low testosterone levels, reduced libido, erectile dysfunction, and poor sperm quality.

Dr. Lodha noted that hypothyroidism can negatively affect sperm count, sperm motility, and sperm morphology, lowering the chances of successful conception. Fatigue, depression, and weight gain associated with thyroid disorders may further impact sexual health and self-esteem.

Hyperthyroidism can also affect fertility. Excess thyroid hormone may disturb the hormonal balance required for normal sperm production.

“In men, hyperthyroidism can lead to premature ejaculation, increased oxidative stress, and damage to sperm cells. In some cases, sperm concentration and semen volume may also decrease,” he said.

The expert warned that thyroid-related fertility issues often remain undiagnosed because symptoms develop gradually or are mistaken for stress and lifestyle-related problems.

Early Diagnosis Can Improve Outcomes

The expert stressed that timely diagnosis and treatment can significantly improve reproductive health.

“With hormonal therapy, dietary modifications, and regular monitoring, sperm health and reproductive function can improve over time,” Dr. Lodha explained.

He advised men experiencing unexplained infertility, sexual dysfunction, or persistent fatigue to undergo comprehensive reproductive health evaluations, including thyroid function tests.

Lifestyle Reasons Behind Surging Thyroid Disorders

Dr. Anu Mathew, Consultant Endocrinology, Fortis Hospital, Manesar, told HealthandMe that while women are more at risk, thyroid disorders can also affect men and children, and a lack of awareness often delays diagnosis.

She added that thyroid disorders are increasingly being linked to lifestyle-related factors, despite autoimmune disease remaining the most common cause.

Also read: Heatwaves And Toxic Air Create A Growing Health Crisis In Delhi

Dr. Anu pointed out that subclinical hypothyroidism (SCH) — characterized by elevated thyroid-stimulating hormone (TSH) with normal T3 and T4 levels — has shown strong associations with lifestyle factors in several studies.

“Both iodine deficiency and iodine excess have been associated with thyroid disorders. Lack of sleep, poor sleep quality, chronic stress, smoking, and sedentary lifestyles may also contribute to thyroid dysfunction,” she said.

According to experts, subclinical hypothyroidism has also been associated with increased risks of cardiovascular disease, insulin resistance, and metabolic syndrome.

The doctors, thus, stressed the importance of healthy lifestyle changes to prevent thyroid dysfunction and related complications.

When Thyroid Disorders Become Cancerous

Read More: Ebola Cases Cross 900, Death Toll Tops 200; 10 Countries On High Alert

Dr. Manjunath NML, Senior Consultant – Surgical Oncology and Robotic & Laparoscopic Surgeon at HCG Cancer Hospital, Bengaluru, told HealthandMe thyroid cancer is often difficult to detect early because it grows slowly and may initially cause painless or nonspecific symptoms.

“Small thyroid nodules may go unnoticed because they are not always visible or palpable during routine examinations,” he explained.

Detection may become even more challenging in obese patients, where larger nodules can remain hidden.

Doctors also highlighted that cancerous nodules may sometimes be concealed within multinodular goitre, a condition commonly associated with iodine deficiency and more frequently seen among women in endemic regions.

Other reasons for delayed diagnosis include lack of awareness, socioeconomic barriers, and limited access to specialists and diagnostic technologies such as ultrasound and FNAC (fine needle aspiration cytology).

Experts noted that imaging tools like the TIRADS (Thyroid Imaging Reporting and Data System) scoring system play an important role in classifying thyroid nodules as benign, suspicious, or malignant, helping guide appropriate treatment decisions.

When people gain weight, the first thought often revolves around poor eating habits or a lack of physical activity in their daily routine. While that may be true, the cause of weight gain may be more than what meets the eye. One could have gained weight gradually despite the lack of significant changes in his/her lifestyle. In such cases, an underlying health condition such as a thyroid disorder could be contributing.

What Does The Thyroid Actually Do?

The thyroid is a small gland found in the neck region. But it plays a huge part in the body’s activities. This gland secretes hormones that control metabolism, i.e., the body’s capability to convert food into energy. The hormones released by the thyroid control many other body functions, including heart rate, body temperature, etc.

When the thyroid gland becomes underactive, a condition called hypothyroidism occurs, and it causes bodily functions to slow down. In turn, metabolism may be reduced, causing some alterations in people's well-being.

Weight Gain Is Often Not The Only Symptom

People suffering from hypothyroidism may experience other common symptoms besides weight gain, such as fatigue, lack of energy, constipation, dry skin, hair loss, mood swings, and intolerance to cold temperatures. However, thyroid-related weight gain is often misunderstood. It is usually gradual and may not always be dramatic. In many cases, the change can happen because of slowed metabolism and fluid retention.

Knowing When To Pay Attention

Not every person who gains weight has a thyroid problem, and not every thyroid patient experiences noticeable weight changes. Weight is influenced by many factors, including sleep, stress, age, and overall health.

However, if weight gain feels unexplained and is accompanied by other persistent symptoms, it may be worth seeking medical advice. Simple tests can help assess thyroid function and identify problems early. Sometimes, understanding the reason behind weight changes can be the first step toward better health.

Understanding Treatment And Management

The good thing here is that thyroid-related conditions are easily manageable after proper diagnosis. Treatment for hypothyroidism entails administering medications that help normalize hormonal levels in the body. Such therapy helps in balancing metabolic processes naturally.

Along with medical treatment, lifestyle measures remain important. Maintaining a balanced diet, regular physical activity, adequate sleep, and stress management can support overall metabolic health and help improve quality of life. However, people should avoid self-medicating with supplements or relying on unverified remedies claiming to “boost” thyroid function.

As awareness around metabolic health grows, World Thyroid Day is an opportunity to move beyond assumptions. Understanding the connection between thyroid function and metabolism can help people recognize symptoms early and seek timely care. Sometimes, the body may be signaling that there is more to the story than lifestyle alone.

The ongoing Ebola outbreak in Africa, with nearly 1,000 cases and over 200 deaths, has sparked concerns among people, bringing back memories of the COVID-19 pandemic. With every new outbreak, fears about viruses becoming airborne like SARS-CoV-2, the virus behind COVID-19, tend to rise.

However, experts have clarified that Ebola is not airborne and does not spread like COVID-19.

Why Ebola Spread Is Not Like COVID

“Ebola is a serious viral hemorrhagic disease,” said Dr. Ishwar Gilada, Secretary General, People’s Health Organisation (India).

“Ebola does NOT spread through casual airborne exposure like influenza or COVID-19. Individuals become infectious only after symptoms begin, not during the incubation period. The incubation period ranges from 2 to 21 days,” he added.

Former AIIMS Director Dr. Randeep Guleria told PTI that Ebola is “a zoonotic infection, mainly originating in bats.”

“Ebola does not spread through air like respiratory viruses. It spreads only through direct contact with infected body fluids,” he added.

Experts further explained that Ebola is far more difficult to spread than airborne respiratory viruses such as influenza, COVID-19, measles, and even the Andes strain of hantavirus, which recently caused an outbreak on a cruise ship.

“Ebola is not airborne. There's no evidence of that at all. To be infected, you've got to have body fluid contact with someone who is quite ill,” said Michael T. Osterholm, Director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota.

According to Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine, people with Ebola do not spread the virus before developing symptoms.

The experts reiterated that during Ebola’s incubation period, which ranges from 2–21 days, an infected person is generally not contagious, unlike COVID-19, where transmission can occur before symptoms appear.

Moreover, even early Ebola symptoms such as fever, sore throat, headache, and body aches are less likely to spread the virus compared to respiratory infections.

Ebola does not spread through coughing, sneezing, or casual contact like shaking hands.

“You cannot get Ebola from passing someone in an airport, sitting near someone freely, or through other casual contacts,” explained Captain Satish K. Pillai, Incident Manager for Ebola Response at the US Centers for Disease Control and Prevention (CDC).

Also read: Ebola Cases Cross 900, Death Toll Tops 200; 10 Countries On High Alert

How Ebola Spreads

Ebola spreads through:

• Direct contact with infected blood or bodily fluids
• Contact with contaminated surfaces or medical equipment
• Unsafe caregiving exposure
• Traditional burial practices involving direct contact
• Certain zoonotic animal exposures

Common Symptoms Of Ebola

Common symptoms include:

• Sudden fever
• Severe weakness and fatigue
• Headache
• Muscle and body pain
• Sore throat
• Abdominal pain
• Vomiting and diarrhoea
• Rash

Severe illness may involve:

• Bleeding manifestations
• Shock
• Multi-organ dysfunction

Historical case fatality rates have ranged from 25% to 90%, depending on the virus strain, outbreak conditions, and access to timely medical care.

Ebola: How You Can Stay Safe

• Washing your hands often
• Avoiding contact with bodily fluids
• Avoiding contact with individuals who appear ill or who have a fever
• Avoiding objects that have come in contact with an infected individual, such as bedding, clothing or medical equipment
• Not handling someone who has died from Ebola
• Avoiding contact with bats and nonhuman primates, and raw meat from these animals
• Avoiding seeking medical care at hospitals where patients are being treated for Ebola
• Paying attention to your health for 21 days after returning from a country where Ebola has been found
• Seeking medical attention immediately if you experience any Ebola symptoms

How To Prepare Healthcare Systems

Dr Gilada stressed the importance of:

• Immediate isolation protocols for suspected cases
• PPE readiness across designated hospitals
• Emergency infection control drills and refresher training for healthcare workers
• Laboratory diagnostic preparedness with safe specimen handling
• Contact tracing systems
• Central and state public health coordination

The expert also urged authorities to strengthen “science, surveillance, preparedness, and infection control” to curb the spread of the disease.

Dr Guleria called for stricter infection control, timely isolation, and avoiding direct contact with infected persons remain key preventive measures. They also noted that Ebola outbreaks have largely remained confined to Africa due to effective containment efforts.