would go to the toilet in sewers, barrels or in alleys. Once Hong Kong opened up for trade (1856-1880), the British Hong Kong government determined that the appalling hygiene situation in Hong Kong was becoming critical. Thus, the government set up public toilets (squat toilets) for people in 1867. But these toilets needed to cleaned and emptied manually every day and were not popular. In 1894, plague broke out in Hong Kong and 2,500 people died, especially public toilet cleaners. The government decided to act, setting up underground toilet facilities to improve this situation, though these toilets also had to be cleaned and emptied manually. Early in 1940, the colonial government built the first public flush toilet. In 1953, a fire broke out in Shek Kip Mei. After that, the government embarked on a major public housing project in Hong Kong including public toilets for residents. More than ten people shared each toilet and they used them for bathing, doing their laundry as well as going to the toilet. Finally, in the 1970s, the government decided that one toilet for four or five families was insufficient and renovated all public housing providing separate flush pedestal toilets for all residents. United States In the United States, concerns over public health and sanitation spurred the sanitarian movement during the late 1800s. Reforms to standardize plumbing codes and household plumbing were advocated for; the intersection of advancements in technology and desire for cleanliness and disease-free spaces spurred the development of public toilets. Facilities for women sometimes had a wider emphasis, providing a safe and comfortable private space in the public sphere. The Ladies Rest Room is one example of the non-euphemistic use of the term: literally, a place to rest. Historically such rooms pre-dated the washroom and washrooms were added afterwards. Subsequent integrated designs resulted in the "women's restroom lounge". A notable early example of a public toilet in the United States is the Old School Privy. The American architect Frank Lloyd Wright claimed to have "invented the hung wall for the w.c. (easier to clean under)" when he designed the Larkin Administration Building in Buffalo, New York in 1904. According to a 2021 study by QS Supplies, the United States has just 8 public toilets for every 100,000 people, a rate that ties the country with Botswana in terms of access to toilet facilities. In the 1970s there were 50,000 coin-operated public