[jstanley]

Waste disposal. You can always put sewage in the bin, but you can't empty your bins into the sewage.

[zarzavat]

Yes after having living in cities with neither, a waste disposal system is absolutely more important.

No sewage system, you will be fine. People will use septic tanks instead.

No waste disposal system = trash everywhere.

Even if your waterways get polluted by raw sewage, that’s a lot easier to clean up than a waterway polluted by trash.

[muzani]

My wife's village has neither. We burn the trash, and have septic tanks. Diapers don't burn though.

There's a truck that comes in every now and then to clean it out, but that probably counts as waste disposal.