The semantics of tissue vs. toilet paper
We were eating Mohinga at a friend's house in Battle Creek, Michigan. The point of the photo is not to show you Mohinga, but the "napkins" (a roll of toilet paper), which, the host explicitly said, she would not give to an American visitor.
For us Burmese, it's "tissue paper" and it's used everywhere outside of the bathroom. In Burma, it would be at a tea-shop, street vendors and even some restaurants. It may be used in a toilet. But we would address it as "tissue paper" :)
So it's weird for an American to be using a piece of "toilet paper" with a meal. The semantics of words really have a powerful effect in our brains. By using the word "tissue paper", we don't associate it with a toilet any more :)