We detached this subthread from https://news.ycombinator.com/item?id=18494646 and marked it off-topic.
To your point about plastic bags, many many people are cognizant of the ill-effects of plastic bags in India. Many of my friends actively try to avoid it. It's just that when you're a developing nation or minority everyone talks in blanket statements than nuanced views like "rural India" or "10% of Northern India", it has to be all "Indians shitting on streets". Whereas, some flaw in the developed countries is always attributed to the actual states where there is a problem rather than all of the population.
Any problem, including education about safe hygiene practices, is massively difficult at scale. Educating people in the rural areas will solve this problem, but when it's many millions it can be slow so more innovative methods need to be thought of.
Even in the US there is a rise in the "anti-vaccine" crowd. A topic that is supposedly so-obvious that everyone should be against it. Yet, education at scale is an important solution to protecting kids against anti-vax parents.
I have two toilets at home, I haven't waited for the government to build them for me.
Americans always underestimate the amount of effort and wealth it takes for the infrastructure that maintains their normalcy.
Functioning septic systems are also not paid for by the government and a large portion of the non urban U.S. still uses them. A much smaller portion of the non urban U.S. is still on well water. Perhaps most importantly, federal and state governments don't pay sewer and water systems in most cases.
(Though Hookworm is resurfacing because people don't realize that they have to invest in their septic systems)