In Africa, pay toilets are particularly common in informal settlements lacking sewage systems. Of all countries, Ghana has the greatest reliance on public toilets. In Accra, lack of space makes private toilets unrealistic in low-income neighbourhoods. In Kumasi, it has been estimated that 36% of residents use pay toilets, and that "once-daily use of a public toilet by a family of four would cost between US$3.60 and $18 per month depending on the fee charged by the operator of the toilet they use." Some of the earliest documented pay toilets were built around 74 AD in Rome. Emperor Titus Flavius Vespasianus created this method to ease the financial hardships resulting from the many wars that had been fought. This was not a popular choice with his people, and he was ridiculed for the decision, to which he reacted with the famous quote, "Pecunia non olet", "Money does not stink". The Greco-Roman city of Ephesus was important in ancient times, becoming the trade centre and commercial hub of the ancient world. The Scholastica Baths were built in the 1st century AD, and contained all of the modern amenities for hygiene, including advanced public toilets with marble seats. One had to pay to enter these luxury conveniences, where one could enjoy the use of a pool, use the toilet or socialize. John Nevil Maskelyne, an English stage magician, invented the first modern pay toilet in the late 19th century. His door lock for London toilets required the insertion of a penny coin to operate it, hence the euphemism to "spend a penny". The first pay toilet in the United States was installed in 1910 in Terre Haute, Indiana. Whether or not public toilets should require payment is a plot point in Noël Coward's 1949 play "South Sea Bubble". Pay toilets are key to the 2001 American musical "Urinetown". People on low incomes, for instance in Accra, often choose to defecate in the open rather than pay to use toilets. Or they may limit the number of times per day that they use a pay toilet. Thus pay toilets have damaging public health consequences. Some landlords also use the existence of nearby pay toilets as an excuse for not installing private toilets in the homes of their tenants. American activist Richard Stallman argues on his website that pay toilets are discriminatory against the poor: