Unfortunately Ive experience some very, very uncivilized and vile bathroom facilities right here in the US in my travels that unless they involve a Coke bottle, a pit in the ground and a square of dirty of newspaper, probably rival anything youd find in the third world. In fact squatting over a pit in the ground, or peeing into a Coke bottle and using newspaper for tissue would probably be preferable to some of public restrooms Ive encountered. Most recently my niece and I went to a local McDonalds here in PA with her young kids and took one of her small children into the restroom and immediately walked out, preferring to have her daughter pee in the small potty my niece kept in their minivan for long trips. It was gross to such an extreme that I wanted to throw up and I have a pretty strong constitution. We wiped her kid and me with sanitary wipes just for having gone into that filthy bathroom.