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 during winter after Diwali, much of India finds itself wrapped in a grey blanket of smoke and smog. The festival of lights, which should bring joy surrounded by family and friends, is now characterised by hazy mornings, stinging eyes, and a lingering cough that many have come to accept as ‘normal’ for the season. Firecrackers, vehicle fumes, construction dust, and crop burning together also push the air quality indices up in many cities like Delhi NCR and Patna to alarmingly unsafe levels.

In clinics we see sick people walk in every November with the same symptoms as the previous years—children wheezing, grandparents struggling to breathe, and adults who have smoked for years ignoring a cough that deserves attention. As a pulmonologist, I want to explain in simple terms how smoke, smog and tobacco affect our lungs and what each of us, from the youngest child to the oldest grandparent, can do to protect them.

Why the Lungs Are So Vulnerable

With every breath our lungs are in contact with the outside world, inhaling the air around. Millions of tiny air sacs pass oxygen into the blood, while microscopic hairs lining the airways sweep out dust and germs.

This natural defence works remarkably well, but years of exposure to smoke or polluted air can wear it down. Once the airways are inflamed and the cleaning system weakens, the lungs become more prone to infection, chronic respiratory disease, and in some people, even cancer.

Also read: Is It Just A Persistent Cough Or Is Your Body Telling You Something Else?

Tobacco: The Leading Preventable Cause

Tobacco smoke contains many carcinogens, which are chemicals that can even damage DNA (deoxyribonucleic acid) in our cells. Recent research shows that cigarette smoke reduces the ability of the cells to repair this damage, leaving them unstable and likely to turn cancerous. Another study found that smoking leaves a distinct signature in our DNA and disrupts proteins that normally stop tumours from growing.

The risk is substantial, and reports indicate that the risk of lung cancer in smokers rises by 24 to 36 times more than non-smokers. Smoking also harms those around the smoker, because children and elderly family members who breathe second-hand smoke at home carry a very real risk even though they never made that choice to inhale smoke.

Smoking continues to affect a patient’s outcome even after lung cancer has been diagnosed. A large international analysis of nearly 49,000 patients across 25 countries found that a patient’s smoking status can influence survival as strongly as the traditional factors doctors use to stage the disease, such as the size of the tumour and whether it has spread to nearby lymph nodes.

In fact, among patients with early-stage disease, smoking history had a greater impact on prognosis than whether the cancer had spread to nearby lymph nodes. A parallel study found that quitting smoking within six months of diagnosis improved median survival by about four years across cancer types. In other words, stopping smoking remains one of the most powerful steps a patient can take at any stage of the disease.

Air Pollution: A Growing Concern

The threat to our lungs does not come from smoking alone. Many cities see air quality worsen sharply in the weeks around Diwali and early winter, as construction dust, vehicle emissions, crop burning, and firecrackers add fine particles to the air. These particles are small enough to travel deep into the lungs and enter the bloodstream.

Polluted air worsens asthma, bronchitis and COPD, and long-term exposure is also linked to lung cancer, including in people who have never smoked. Some city administrations have started responding to this grave health issue with work-from-home advisories and curbs on construction activity during certain hours. But there is more to be done.

Children and Older Adults Need Extra Care

Children and older adults are the two groups I worry about most. Children breathe faster relative to their body size as their lungs are still developing.

So they absorb more pollutants than adults do in the same environment. Older adults often have reduced lung reserve if they have other conditions such as diabetes, heart disease, or old tuberculosis scarring. This means, even one bad air day can affect them more severely.

Also read: Sperm Under Heat: Traffic, AQI, and the Dual Thermal Trap

Symptoms That Need Attention

Lung cancer often causes no symptoms in its early stages, which makes awareness all the more important.

Please consult a doctor if you or a family member has a cough lasting more than three weeks, blood in the sputum, persistent chest pain or breathlessness, wheezing or hoarseness that does not settle, or unexplained weight loss and fatigue. Many of these have simple and treatable causes, but only an examination can tell. An early visit can save a life.

Practical Steps and Advice

For families with children, I recommend keeping them indoors on severely polluted days, allowing outdoor play only when the air is clear. Avoid smoking around them or in closed rooms. A cracker-free Diwali is one of the kindest gifts we can give young lungs, choosing instead to celebrate with diyas and rangoli which are just as beautiful.

For older adults, it can help to check the air quality before a morning walk, opting to exercise indoors on bad days, and wearing a well-fitted N95 mask in heavy smog. They should also carry with them inhalers and medicines as prescribed by their doctor. Ask about flu and pneumonia vaccination and take them if advised. The most important rule is to avoid tobacco in all forms, including beedis, hookah and chewing tobacco, practice daily slow breathing exercises with gentle physical activity, and keep indoor air free of dust and smoke.

Quitting Is Worthwhile

Many long-term smokers feel it may be late to quit. On the contrary, quitting the habit reduces the risk of lung cancer, even after many years of smoking. Nicotine replacement, medication and counselling all improve the chance of success when a decision to quit is made, and the support of family members makes a great difference to the outcome. For people at high risk, such as long-term heavy smokers over the age of 50, annual screening with a low-dose CT scan may be advised as it can detect cancer at a stage when treatment is most effective. Do discuss with a pulmonologist on whether it is the right approach for you.

We may not be able to control the air outside on our own, but we can control what we inhale into our lungs and how we respond to bad air on high-pollution days. Small, consistent habits protect the lungs for a lifetime. If you have persistent symptoms or concerns regarding your respiratory health, do not wait beyond a couple of weeks; an early consultation can make all the difference between cancer diagnosis and good health.

By Dr. Prahalad Elamarthi, Consultant, Medical Oncology, Narayana Health City, Bengaluru

Once recognised primarily as a cause of respiratory problems, air pollution is increasingly being linked to cardiovascular and metabolic health concerns, among others. Emerging evidence suggests that long-term exposure to fine particulate matter (PM2.5) may also increase the risk of Type 2 diabetes.

With India facing high pollution levels and a growing diabetes burden, experts on the occasion of World Diabetes Day 2026 stressed that cleaner air must become part of the wider conversation on diabetes prevention.

Air Pollution And Diabetes: What's The Link?

"Fine particulate air pollution (PM2.5) may contribute to insulin resistance by triggering inflammation and oxidative stress in the body. These processes can affect the liver, muscles and fat tissue, potentially interfering with insulin action," Dr Anoop Misra, Executive Chairman and Director, Diabetes and Endocrinology, Fortis C-DOC Hospital, told HealthandMe.

A recent review of 13 systematic reviews, covering over 200 million cumulative participant observations, led by Dr Misra's team, found that long-term PM2.5 exposure was associated with a 10–16% higher relative risk of developing Type 2 diabetes for every 10 μg/m³ increase in exposure.

This is particularly concerning for India, where pollution levels and diabetes prevalence are both high.

Since nearly everyone is exposed to outdoor air pollution, even relatively small increases in individual risk could translate into millions of additional diabetes cases.

Also read: Why Some Diabetes Patients May Not Be Suitable For GLP-1 Treatment, Experts Explain

Dr Misra stated that pollution may also add to the effects of genetic susceptibility, abdominal obesity, unhealthy diets and physical inactivity. However, its role in the rising incidence of diabetes among younger people remains uncertain. Evidence that pollution directly worsens glucose control in people who already have diabetes is also limited.

Dr V Mohan, Chairman of Dr. Mohan's Diabetes Specialities Centre, told HealthandMe that PM2.5 pollutants can trigger inflammation and oxidative stress, potentially affecting insulin function. He added that lifestyle changes, unhealthy diets, physical inactivity, stress, obesity and genetic factors also play important roles in the rising incidence of diabetes among younger Indians.

Can Cleaner Air Help Prevent Diabetes?

Dr Mohan said diabetes prevention should go beyond healthy eating, exercise and weight management to consider environmental factors.

People can check daily AQI levels, avoid exercising near busy roads, use well-fitted N95 masks when exposure is unavoidable and consider HEPA air purifiers indoors.

Dr Misra also emphasised that reducing exposure through cleaner air, better urban planning and effective pollution control should be part of India's diabetes-prevention strategy.

The experts highlighted the need for collective action to identify and address the major contributors to air pollution. Individuals can also avoid strenuous outdoor activity on highly polluted days, while indoor HEPA filtration may help reduce exposure.

Read More: HbA1c Test May Not Be Accurate For Everyone: Who Should Not Rely On It?

Does Pollution Mean Earlier Diabetes Screening?

People living in polluted cities should be more conscious of their metabolic health. However, there is currently insufficient evidence to recommend additional screening solely based on air pollution exposure, Dr Mohan said.

India's screening recommendations advise testing adults from the age of 30, with earlier screening for those with additional risk factors such as obesity, family history and high blood pressure.

Current guidelines do not specifically consider air pollution as an independent screening criterion. Dr Misra also noted that pollution exposure alone does not justify a separate, earlier diabetes screening schedule.

Early screening, healthy lifestyles and a cleaner environment can together help reduce India's diabetes burden. Clean air must be recognised as an important component of a healthy metabolic environment.

With public health experts raising concerns about ultra-processed foods (UPFs), food brands are increasingly using health-focused claims such as ‘natural’, ‘multigrain’ and ‘immune-boosting’ to appeal to health-conscious consumers. But do these labels actually mean the products are healthy, particularly for children?

Research has linked diets high in ultra-processed foods, processed meat and sugar-sweetened beverages to several health concerns. This is particularly concerning amid rising childhood obesity, which can increase the risk of conditions such as diabetes and hypertension. Children's food choices and eating habits can also influence their health later in life.

So, how can parents distinguish genuine nutritional value from clever food marketing? To understand how we may be mistaking food marketing for healthy eating, HealthandMe spoke to experts.

Are ‘Natural’ And ‘Multigrain’ Packaged Foods Really Healthy?

Also read: High Sugar, Salt Or Fat? India May Mandate Red Hexagon Labels On Food Packs

Food marketing requires critical evaluation before a product is considered genuinely healthy, experts said. Terms such as ‘natural’, ‘superfood’, ‘immune-boosting’ and ‘low-fat’ are often marketing claims and do not necessarily reflect a product's overall nutritional value.

Beyond individual food products, experts emphasise the importance of overall dietary patterns in determining long-term health. From a cancer perspective, large cohort studies and the World Cancer Research Fund have linked diets high in processed meat, sugar-sweetened beverages and ultra-processed foods to an increased risk of cancer. Diets rich in whole grains, vegetables, fruits, legumes and fibre, on the other hand, are associated with a lower risk.

No single food prevents cancer; the overall dietary pattern matters.

"The main myth about packaged foods is that generic terms like 'organic', 'natural' and 'multigrain' automatically label the product as healthy. These look at the surface and tell us nothing of the overall food picture," Dr Narendra BS, Lead Consultant, Endocrinology, Aster Whitefield Hospital, told HealthandMe.

He explained that parents should look beyond these claims and examine what has been added to a product and whether it is replacing healthier foods in a child's diet. For example, replacing a whole fruit with a packaged fruit drink can decrease fibre intake and increase free sugars.

How Can Ultra-Processed Foods Affect Children's Health?

Read More: Every Extra 100g Ultra-Processed Food Linked To 14% Higher Heart Risk, 11% Higher BP Risk

Consuming large quantities of sugar-laden drinks and energy-dense foods can increase calorie intake and contribute to weight gain. In children, this can also increase the risk of insulin resistance and other metabolic abnormalities from an early age, Dr Narendra said.

Dr Smitha Saldanha, Senior Consultant, Medical Oncology, HCG Cancer Hospital, KR Unit, Bangalore, said excess body fat is a risk factor for cancer. Sugar-sweetened beverages and other foods associated with weight gain can contribute to this risk over a person's lifetime.

"We know that excess body fat is a risk factor for cancer, and sugar-sweetened beverages and other foods tied to weight gain are one of them in terms of lifetime risk. That is, most people who eat a bad diet at the beginning of their life with high amounts of ultra-processed foods and refined carbs tend to do the same later in life," she told HealthandMe.

READ: Exclusive: From IPL To Olympics — How Sport Became A Marketing Tool For Junk Food And Sugary Drinks

She added that the focus should be on maintaining a balanced diet and avoiding excessive consumption of ultra-processed foods and refined carbohydrates.

"Sugar in and of itself, any ultra-processed food, for that matter, should not be the focus of cancer. It's about eating in a balanced manner, balanced portions, and avoiding excess consumption of ultra-processed, refined carbohydrate-heavy foods every day or multiple times a week."

How Can Parents Identify Healthier Packaged Foods?

Rather than relying on claims printed on the front of a package, parents should examine the nutrition information and ingredients, the experts advised.

Dr Narendra urged parents to compare nutrition labels, particularly serving sizes, and prioritise whole or minimally processed foods.

"I would challenge all parents to start comparing the nutrition label, in particular the serving sizes, and never underestimate the power of whole or minimally processed foods. Not to scare them against all packaged foods, but to make sure that convenience doesn't overtake nutrition."

Dr Smitha also advised consumers to turn the package over and check its nutritional information.

"Flip it over, read the label, scan for sodium and added sugars, and ask: is this label talking about the product or just marketing it? And you be the judge: is this really a healthy choice?"