That washroom is in a sense a microcosm of what is happening in Hyderabad. The city is modernizing at a rapid pace, but the development is not even. Hyderabad has become a hot location for high tech companies looking for cheaper alternatives to hire highly skilled employees. This has, in recent years, moved beyond basic outsourcing (i.e., hiring the services of an independent company located in India and subcontracting the work) to companies like mine opening full-fledged R&D divisions. The city itself is rapidly modernizing and expanding due to the influx of capital and flood of people moving there to fill the growing job market.
The Old City is -- to put it bluntly -- old, and seems to fall below the standard level of city maintenance that an American would be used to. There are a fair number of elaborate and beautiful monuments and buildings interspersed throughout the Old City, however; due to the strong Muslim influence on design, this area of town has a very interesting feel to it.
Cell phone usage is common, although widespread use of data streaming capabilities is just coming online (3G is widely available but higher speeds are not). Network accessibility in hotels are also widely available but speed and reliability are not quite as good as you find in the U.S. Both the old and new parts of the city are affected by daily power outages, which typically will only last for between 10 and 30 seconds.
One of the most immediate and visceral differences between India and the U.S. is the traffic. If you want to get an idea of what this is, search for 'Hyderbad Traffic' on YouTube. Basically, you can imagine an intersection with cars, motorbikes, and pedestrians moving full speed in every direction at once, somehow impossibly managing to avoid collisions. It is madness. Even watching the video can't prepare you for the experience of actually travelling in that traffic. A few hints: don't sit in the front seat of a car, don't bother accepting that bike ride from your Hyderbadi friend, and definitely don't try crossing the street on your own! Cars are becoming more and more popular, and it is becoming quite common to see some quite expensive cars driving on the streets. The motor bike is has been the preferred method of travel because you can weave in and out of traffic much more easily than you could in a car. However, the car has a higher prestige level, which is becoming more of a factor in peoples' choice of transportation as the ranks of the middle class increases. This has the effect of creating three tiers of simultaneous traffic speed (including the pedestrians), seemingly increasing the chaos level. Taxis in Hyderabad are essentially passenger cabins built on top of motorbikes. It all seems to work, however; I saw more accidents during the two hours driving from San Diego to LAX than I saw during my entire two week trip in Hyderabad!
Although I was initially shocked by my experience in the Hyderabad washroom, in the end I decided that the experience was actually much better than many other questionable washrooms I've visited in Asia. It was not quite what I was expecting, but like Hyderabad itself, was definitely interesting!
A few random India travel notes:
The first thing to realize when writing about a trip to India, is that it is far. The time zone difference from Pacific Standard Time is twelve and a half hours; traveling to India from Los Angeles is about the farthest place you can go on the planet. This means that if you are writing about a fictional character visiting India, your character will have to travel between twenty to twenty-eight hours by plane, and possibly more if he or she has to go to an outlying region by car or train from the metropolitan center. So having your character do anything significant immediately after arriving in India is not really plausible due to the travel fatigue he or she will be experiencing.
Although India is large enough to contain multiple time zones, the government there decided to have a unified time zone for the entire country (India Standard Time or IST). In order to accommodate this, and not have either of the two halves of the country have days that end too early or too late, they elected to have a time zone that falls between the official two hourly GMT offsets; hence the aforementioned twelve and a half hour difference. This is unusual (but not unique to India) as most countries are offset at hourly increments from GMT. Also, India does not observe Daylight Savings Time.
Language is not an issue for a native English speaker visiting any of the major metropolitan areas in India. Although Hindi is the official national language, in southern regions such as Hyderabad, it is not normally used (Telugu is the common spoken language). Typically, when a Northern Indian and a Southern Indian communicate with each other, they will use the other national language, English.