This is the first in a series on differing cultural standards around bathrooms, cleanliness, and hygiene practices.

Everyone expects culture shock when leaving home, but not everyone expects it to occur in the bathroom. The well-known difference between Chinese and Western toilets is that it is common to squat, rather than sit in a public restroom, but there are many more differences we felt it would be best to share. There is a saying in Chinese 百闻不如一见 (Hearing a hundred times is not the same as seeing once). To fully experience a Chinese restroom, you will have to make the trek yourself. But for those who will not, here is what to expect.

Public bathrooms in China are abundant and free. There are at least twelve public restrooms within five hundred meters of our Hopkins campus in Nanjing. However, public restrooms in China may not have all the amenities of a typical American restroom. Squat toilets, a lack of toilet paper (which is not flushable), and no soap for handwashing define most regular Chinese bathrooms outside Westernized tourist areas.

Squat toilets can provide a lot of benefits. You don’t have to touch a potentially dirty toilet seat. They take up less space in confined areas like trains and, because they are flush to the ground, you won’t accidentally brush against them opening or closing the stall door. If you are lucky enough to be in a stall with a door, that is. However, you risk standing on or contributing to a dirty floor.

While some public bathrooms in China provide toilet paper, many do not. In those that do, the toilet paper is often located outside the stall or available through purchase by scanning a QR code with a Chinese mobile payment app. To be a savvy China traveler, you should always carry your packet of tissues for emergency bathroom stops. Remember to throw them into the trash can and not the toilet itself.

With your emergency toilet paper, carry a bottle of hand sanitizer or wet wipes. While almost every public bathroom has running water, few have hand soap, paper towels, or a hand dryer.

Despite the differences between China and the US, some attributes are universal. Everyone appreciates a clean bathroom. Like in America, restrooms in China come equipped with trash cans. But trash is not the only sanitary issue. Accuracy remains a problem. In China, to ensure male bathroom users remember their social obligation to keep the place tidy, most urinals have signs above them reminding users to take a step forward.

Like Neil Armstrong said: One small step for man, one giant leap for mankind.

This is not to say all bathrooms in China are offensive to Western sensibilities. A short subway ride from our Hopkins-Nanjing home are some of the nicest public restrooms we have ever seen. The Deji shopping mall in the bustling city center of Xinjiekou is home to five floors of luxurious public bathrooms, each fancier than the next. These bathrooms not only provide soap, toilet paper, and paper towels, but each has a lounge with seating, charging locations, a room for nursing mothers, and an emergency first aid room. One public restroom even has a piano.

No country is a monolith, even on the bathroom front. Living in China allows us to see all parts of the country, from glam to grime, and even the ones that are less than suitable for polite conversation.