I wonder if the OP has used toilets in China (outside of nicer hotels and such).
The problem there is not so much the fact that they are often holes that you squat over (which I have seen in Switzerland and Italy as well), but that "flushing" is often just a small ineffective trickle of water that makes you wonder why they even bothered to have a water supply to the toilet. The sights and smells can be rather crappy.
Yup. The worst I saw: A bus station that served other purposes as well. The men's consisted of a "room" made up of basically 3 1/2 concrete walls--a doorway, no door. Once you passed through the doorway you found an area built purely out of concrete--the space on the right meant to walk, a raised bit of concrete rather like a curb and the area to the left of it where the waste went. I saw no flush mechanism of any kind and it was obvious that there was no meaningful flush mechanism (although I suspect it was hosed down at the end of the day.) Anyone standing in front got a side view of what anyone inside was doing, to take a dump you would have to squat with your feet on the curb-like bit--and note that if you pee in this position it's going to go out into the walk area. A few people had taken a dump anyway--obviously urgent ones they couldn't wait to find a better toilet. I believe the women's was the same but I was never in a position to see.
Competing with that would be the village in Indonesia where there were ditches that were obviously an open sewer--and which people used for the purpose.