As Peruvian who has lived and explored a lot more of Peru than this person, I can guarantee that most people flush their toilet paper down the toilet. Obviously in poor places with bad tubing they have other requirements. Guess what, you see that in the US as well. I have seen places like that here in Virginia. Where I found it disgusting that they would throw the toilet paper in the trash can. The claim that this is Peruvian etiquette is this so called author crapping outside the toilet.