Public toilets in Asia are a mix of various designs. They range from a simple hole in the floor and move up from there. This particular model has the added danger of falling. A person would step up and place their feet on the ribbed portion on each side. Once you are properly positioned you bend your knees and squat over the opening and proceed with the task at hand. Wearing some form of trousers? Take them off and hang them on the wall hook after entering the stall. Toilet paper? Maybe or maybe not- but if it does the soiled paper goes in the waste basket. Some only provide a source of water for clean up. This particular model actually flushes and there was toilet paper available. Areas that see a number of tourists are usually equipped with squatters as well as the more familiar (to Westerners) porcelain thrones.