I have not been to China (other than passing through Hong Kong) since the early '90s. I was with a group of 6 that toured Yunnan on motorcycles, and dipped into Szechuan. We were accompanied by a support vehicle and a young but moderately high ranking police officer. The reason for this is that we had obtained permission to entry areas previously prohibited to foreigners. We also had a local guide on each stage because to the differences in local dialects.
In some villages and towns people had not seen a European in living memory. The result was that we attracted huge crowds in these places. It was almost as though we had landed from Mars.
We stayed in some interesting places, including a matriarchal villa. The worst was when we underestimated the time to arrive at a certain point and had to stay for the night in an old government hotel. It was absolutely disgusting.
Certainly, in those days, I could not recommend the use of country public toilets. The contrast with always clean Japan, where they are even likely to have flowers in vases near the wash basins, couldn't be greater.
I can only hope that there have been some improvements in sanitary arrangements.