There were many older civilizations who had a good understanding of sanitation and controlled sewage. In ancient Rome, eleven aqueducts provided water throughout the city to residents. Lower quality water would be used for other purposes still, such as bathing and latrines. Rome also had sewer systems that were covered by rock, which flushed water out to nearby rivers. As time passed, laws would be made against throwing waste into the streets, and violaters would be charged for damages.
The Aztecs also had a sanitation system used in Tenochtitlan, including acqueducts, and canoes that carried waste to be reused, or disposed of.