hold it while out of the house

The people of Belama hold the belief that part of toilet-training is being able to go several hours without urinating, though normally this would cause issues anywhere else. They've been studied for this ability, and the studies show their bladder capacity is much larger without signs of damage. Some hypothesize a genetic mutation allowed for a much larger bladder capacity, some say it's something in their diet combined with being trained from a young age to hold it for longer periods of time, but no one truly knows.

It does take a little longer for a kid to be fully trained by this standard, but beyond daycares and elementary schools, only homes and hotel rooms reliably have toilets in them. Their most populated locations do have a select few "emergency toilets" mostly for sickness and what few tourists the island gets, but otherwise people just have to hold it, or ask someone to let you in their house.