I live in India most of the year and unfortunately seeing someone take a dump or urinate in the open is a normal day thing as you drive through some of the outer elements of the city (sometimes internal as well).
A number of years ago the Indian government spend a small fortune installing toilets for the poorer classes in the remote areas of India to realize sometime later that no one was using them. They simply prefer to do it outside by squatting on the side of the road.
Unfortunately the longer you get here the more you get used to it.
A couple of years ago a maid who we hired to work in one of our houses asked if she could use our toilet. She went into our wet room and instead of using the porcelain.....she simply did what she had to do on the floor, and used the shower to wash it down the drain. When my wife sacked her, she genuinely had no idea that what she was doing was grim.
The number one problem is the lack of education in India, and its the number one reason it will never catch up to the developed world however much it tries.
Two steps forward, and one back.