Common-use toilets in India can often be badly maintained, but it's also worth pointing out that there is also a cultural relativism in approaches to cleanliness in the bathroom.

- For Indians, water & sunlight are the best cleansing/disinfecting agents. A bathroom that has been rinsed thoroughly with water+soap, and then dried in sunlight is the cleanest it could ever be. Indian bathrooms typically have windows allowing ample sunlight, and are almost completely covered in stone/tiles to make this whole process easy.

- For this reason, Indian visitors have a hard time adjusting to apartment bathrooms in the US -- which are almost always designed to never have any wetness outside the bath tub / shower area. These bathrooms can never ever be rinsed clean (there is no outlet to drain water!) or dried in the sunlight (because there is no window! just the way apartment layouts are optimized).

- This also means that American bathrooms need an active ventilation system -- which works with varying levels of effectiveness -- and has a bunch of corollaries such as incidences of mold, etc. Residual humidity in American bathrooms is a significant problem, complicated by the use of wood/drywall/carpet in apartments.

- For Americans, the bathroom space being dry is one of the most important symptoms of cleanliness. Wet somehow means soiled/used/disgusting -- even if it is just clean water on the bathroom floor. American bathrooms & processes -- both home and public/shared -- are designed to optimize for this experience.

- The traditional style Indian toilets involve squatting. Being contact-free, this is way more hygenic in comparison to the "western" style toilets -- where the excretory areas of different people come into secondary contact through a common surface. When this does get addressed, the western solution to this again hinges on dryness -- using a sheet of paper (or just unrolled toilet paper) as a disposable seat cover.

- Western style (seated) toilets have become increasingly common in India though (because sitting is more comfortable than squatting), but they typically have a small hand-held shower and are unlikely to feature any toilet paper.

- The same principle of washed -vs- dry as "clean" reflects again in how the two cultures choose to clean themselves after going to the loo. In India it is traditional to thoroughly rinse one's behind with soap and water (as OP mentioned in the experience at the Doha airport) and then dry it in various ways, while American toilets are designed for wiping with dry paper and sometimes even just using a hand sanitizer afterwards (not always rinsing hands with water/soap).

- Glossing over the comparison of what cleanliness means in each of these cases, I'm given to understand that the operating pattern of repeatedly rubbing dry paper on sensitive areas while trying to get them clean makes anal hemorrhoids far more common in the US.

- The contrasts help shed light on how people of each culture have a huge shock when first experiencing a bathroom from the other. Given how western cultural mores tend to be defaults in online spaces, the culture shock of an American encountering an Indian bathroom is easier to sympathize with. Likewise, many Indians struggle to feel comfortable with the quality of sanitation allowed by an American bathroom, and it takes a lot of conditioning to get used to :-)

The Rise of the Japanese Toilet