A few years ago I visited the Ecuadorian Amazon as a guest of the Rainforest Alliance, and was surprised by the washroom facilities that were often built next to many of the houses. They were little concrete block rooms with tiled interiors, a toilet, sink and shower. They are all built by the Government of Rafael Correa, who was trying to bring modern facilities to the people. I wrote in a slideshow at the time:This is odd; in the first world, dependable water supplies came first, then the toilet evolved to take advantage of the water supply, and then the sewer was invented to cope with the explosion in contaminated water. Water flush toilets were a response to available infrastructure and there is no chicken/egg question; infrastructure came before toilets.