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?

Just a few weeks back, I was travelling to Himachal Pradesh on a bus. While I was excited to explore the state for the first time, anxiousness gripped me. “What if I have to dehydrate myself again on the journey?” I thought.

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

Holding your pee for too long can lead to many health risks. But peeing on a dirty seat may lead to infections.

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?

I learned my lesson from Udaipur and for this trip, I did not want to be sick. So, there are a few essentials that I carried this time with me, that you can too. Because not drinking water or holding your pee is not the solution.

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

I now carry a stand and pee device. With this device, you no longer must sit on the dirty toilet seat. It is a slanted funnel-like device, which can be placed between your legs when you urinate. Once you are done, you can dispose of it and throw the device in the dustbin.

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?

Countries like South Korea, Japan, and China have incorporated technologies in their toilet to provide a safe experience. They have different water modes, and a button that will wipe your seat when pushed. There are buttons that change your toilet seat covers too.

However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!

Alpha-gal syndrome (AGS) is a potentially life-threatening allergy to red meat and other products derived from mammals. Unlike typical food allergies that cause immediate reactions, AGS symptoms can appear several hours after consumption. These range from hives and nausea to anaphylaxis and, in rare cases, heart attacks. The syndrome is triggered by a sugar molecule called galactose-α-1,3-galactose (or alpha-gal), which is introduced into the human body through the bite of a lone star tick.

Why are lone star ticks spreading?

Lone star ticks, named for the white dot found on the backs of females, have long been native to the southeastern United States. But in recent years, their range has expanded dramatically — now reaching as far north as Maine and westwards toward the central US. Experts say this is largely due to the warming climate, which has made previously inhospitable regions more suitable for tick survival and reproduction.

This spread is also helped by other factors such as:

• Increased deer populations (which host ticks)
• Urban development that pushes human dwellings closer to wild habitats
• Lack of natural barriers, such as mountain ranges, in some regions

How common is AGS?

The true number of alpha-gal syndrome cases is difficult to determine due to inconsistent data collection and lack of awareness. The Centers for Disease Control and Prevention (CDC) has documented about 110,000 cases since 2010, but estimates suggest the actual number could be as high as 450,000. Many people may never realise their allergic reactions are linked to a tick bite.

What makes these ticks dangerous?

Lone star ticks are notoriously aggressive. They are capable of detecting humans by sensing heat and carbon dioxide and will actively pursue a host. They can even move quickly over short distances, increasing the chances of biting.

The concept of a “tick bomb” — a cluster of tiny juvenile ticks that swarm over anything they encounter — adds another terrifying element to their behavior.

Living with alpha-gal

For those diagnosed with AGS, life can change dramatically. Aside from cutting out red meat (beef, pork, lamb), many patients also have to avoid dairy, gelatin, and even some medications, toothpaste, and medical products derived from mammals. Food choices become limited and dining out risky. In severe cases, even airborne particles from cooking meat can trigger a reaction.

Support groups are growing rapidly, especially in affected regions like Virginia, where community members share coping strategies and advocate for clearer food labelling.

What’s next?

As the climate warms and tick populations expand, AGS may affect millions more. Other tick-borne illnesses like Lyme disease, Babesia, and the deadly Powassan virus are also on the rise.

Yet, despite this growing threat, researchers warn that US funding for tick-borne disease research is shrinking. Experts stress the urgent need for better surveillance, education, and treatment options to confront what could become a nationwide health crisis.

The choice of quitting oral contraceptives is a personal one, usually related to shifting life priorities—whether it's switching to another type of birth control, getting pregnant, or just needing a break from hormone synthetics. But for many women, going off the pill isn't only about changing periods. For some, it can also mean the return of unwanted acne—sometimes more stubborn and long-lasting than the breakouts of your teenage years.

If you assumed your days of fighting breakouts were over, stopping the pill can be a rude shock. Why does this occur, and how can you prevent it? As a health editor to a worldwide audience, I've spoken to dermatologists and sifted through the most recent evidence to give you an in-depth guide to managing post-pill acne.

Why Does Acne Suddenly Break Out After Stopping the Pill?

The birth-control pill is not only a pregnancy-prevention tool—it's also a hormone controller that has a major impact on skin health. Some women are put on the pill simply to manage acne due to its effect of inhibiting androgens (male hormones) and sebum (skin oil) production. When you discontinue the pill, your body needs to re-balance its hormones, which often means a short spike in androgens. This hormonal storm can put the oil glands in your skin into overdrive, producing clogged pores and breakouts.

The transition phase has been likened to "hormonal chaos." Your ovaries, which had been maintained with artificial estrogen and progesterone, suddenly take over their natural role, sometimes compensating by producing more androgens than previously. This rush of oil production sets the stage for the acne-causing bacteria to thrive.

The birth control pill, particularly combination pills containing estrogen and progestin, inhibits this androgen activity. When the pill is discontinued, the body's natural hormonal cycles return, including the production of androgens, which can overburden the skin's oil-controlling systems—especially if your body is genetically predisposed to be sensitive to these hormones.

Not necessarily. How your skin reacts after coming off the pill depends heavily on your genetics and any underlying hormonal imbalances. For instance, some women start the pill in their teens before acne ever truly develops. In these cases, the pill may be silently suppressing a genetic predisposition to acne, which becomes apparent only after discontinuation.

In some women, the recurrence of acne can indicate a pre-existing covered-up hormonal issue, such as polycystic ovary syndrome (PCOS)—a prevalent endocrine disorder that involves high levels of androgens. In these women, the pill corrects PCOS's evident signs, but when it is withdrawn, the underlying imbalance reappears.

Where and How Does Post-Pill Acne Appear?

Hormonal acne tends to appear in the lower third of the face—jowl, chin, neck—and sometimes the shoulders, chest, or back. It tends to be made up of cysts or inflamed, painful pimples that are deep, not blackheads or whiteheads you may have experienced in puberty.

This pattern is related to sites of increased androgen receptor concentration and oil gland function. But everyone's experience is different: some people have solo flare-ups, others experience more widespread outbreaks.

Women with a history of acne in their families or those with naturally higher androgen levels are at increased risk. Stress, food intake, and even gut health can also determine the intensity and longevity of post-pill breakouts.

What Does Post-Pill Acne Look Like?

Hormonal acne tends to appear on the lower third of the face—chinion and jawline, basically—but can crop up on the chest, shoulders, or back. The eruptions can be as mild as blackheads and whiteheads, or as severe and painful as cystic acne. For some, the flare-up fades in a few months; for others, it can last for a year or more, particularly if there are strong genetic components involved.

The timeline is different. Most women see their acne flaring two to six months after stopping the pill. In some, it could improve a few months later as the hormones balance out. But for others—particularly those with a strong genetic inclination toward acne—it might continue for up to a year or even longer.

In the opinion of dermatologists, your acne's severity and duration will usually reflect your body's sensitivity to hormones. If your body responds strongly to even minor hormonal changes, post-pill acne can be more serious and persist for a longer period.

Can Skincare Alone Treat It?

Here's the bad news: skincare can't change your hormones or your genetic sensitivity to androgens. Although regular skincare can help maintain healthy skin, prevent breakouts, and downsize inflammation, in most cases, it is seldom sufficient to treat post-pill acne in moderate to severe forms.

Over-the-counter remedies such as salicylic acid, benzoyl peroxide, and retinoids might provide relief. But dermatologists sometimes prescribe stronger medications, such as:

• Topical antibiotics or retinoids to decrease bacteria and inflammation
• Oral antibiotics in moderate to severe cases
• Hormonal treatments such as spironolactone, which blocks androgen receptors
• Isotretinoin (Accutane) for severe, cystic acne that is nonresponsive to other treatment

Could This Be a Sign of a Bigger Hormonal Imbalance?

Yes. In many cases, post-pill acne acts as a window into your natural hormonal landscape. If your acne is accompanied by other symptoms—like irregular periods, excess facial hair, or unexplained weight gain—it might be worth exploring conditions like PCOS or insulin resistance with your healthcare provider.

Coming off the pill can reveal long-standing imbalances that were previously being managed rather than resolved.

When to See a Dermatologist?

If your acne is bad, ongoing, or emotionally distressing, see a dermatologist. They can diagnose underlying hormonal imbalances, provide effective treatments, and offer advice specific to your needs. Women with symptoms of PCOS—irregular menstruation, excessive hair, or weight gain—may need a referral to an endocrinologist.

Post-pill acne isn't your fault, and it's not permanent. Although it can be an infuriating obstacle, particularly if you thought you could put acne behind you after adolescence, it's also a chance to learn more about your body's individual hormonal map.

If you’re thinking of coming off the pill, talk to your healthcare provider about what to expect and how to prepare. Remember, you’re not alone—and with the right support, clearer skin is within reach.

Falling asleep to the gentle hum of white noise might seem like a good idea, but a brain doctor warns it could actually cause problems later on, especially if you make one big mistake. This expert, Dr. Baibing Chen (known as Dr. Bing online), suggests that trying to sleep better with loud white noise could raise your risk of getting dementia in the future. He personally avoids three things before bed, and making white noise too loud is one of them.

Hidden Danger of Loud White Noise

Dr. Bing explains that many people use white noise machines to block out annoying sounds like traffic, a partner's snoring, or even a dog licking its paw in the middle of the night. But he warns that if the machine is too loud, it can slowly damage your hearing. He highlights that losing your hearing is one of the biggest risk factors for dementia when you get older. While there's no strong proof that white noise itself directly causes dementia, some studies do suggest that being exposed to a lot of noise over time, including very loud white noise, might be linked to a higher chance of developing dementia.

What Exactly Is White Noise and Does It Help You Sleep?

The Sleep Foundation describes white noise as a type of "broadband noise" that includes all sounds our ears can hear. Think of the static hiss from an untuned radio or the gentle hum of a fan – these are common examples of white noise. Studies on whether white noise actually helps you sleep have shown mixed results.

Some research found that white noise helped newborn babies fall asleep faster, and also helped adults living in noisy parts of New York City drift off more quickly and get better sleep. However, in some cases, white noise actually made it harder for people to fall asleep. This suggests that whether it helps or not really depends on each person and their specific situation.

How to Use White Noise Safely

You can buy special white noise machines from stores, or you can use cheaper options like smartphone apps, which you can find in app stores. If you enjoy nature sounds, pink noise might be a better choice for you, as it includes calming sounds like rain, waterfalls, and flowing rivers. The Sleep Foundation says that some therapists often use pink noise to help treat hearing problems or ringing in the ears (like tinnitus). Here are some safety tips for listening to white noise.

Keep the volume low

Dr. Bing advises setting your white noise machine to a maximum of 50 decibels. This is similar to the quiet hum of a refrigerator.

Maintain a safe distance

Place the machine at least 30 centimeters (about a foot) away from your bed, especially for children.

Address hearing loss

Untreated hearing problems can lead to loneliness and a decline in thinking abilities, both of which increase dementia risk.

Get your hearing checked

The Alzheimer's Society recommends regular hearing tests, especially if you're between 40 and 65, as hearing loss can be an early sign of dementia or increase your risk.

Consider hearing aids

There's evidence that using hearing aids might help slow down thinking problems related to dementia.