When visiting Dr, I find it hard to use a small trash can in the bathroom, but visitors down there find it hard to throw it in the toilet, because I have found used paper behind my toilet. Now the toilet systems or sewer systems in the US are designed for the paper to go in the toilet with some areas and modern developements having two sets of pipes in the ground, one for waste and the other for rain water and in some of the foreign restaurants, Mexican, Vietnamies, Columbian etc. , provide a waste basket next to the toilet, which is probably unknown to local government or possibly ignored. But even though I explain it to my foreign friends here, they find it hard to accept, the same as I find it hard to accept there. Here in Phila. I repair and replace sewer systems from the house into the main street.