The trash is pretty common in all of Central America in my experience. Of course the Keys are cleaner. I agree, you must set your expectations if you have never experienced much of Central America other than the very touristy areas. Having said that, we greatly prefer West End over West Bay. The resort feel there is not something we are looking for, we love the more local experience. We stay in West End in condos for 6 weeks or so every year for the past several years. The diving is good, the food is good. To each his own, I guess.