Lack of resources, logistics, lack of peace, corrupt or poor leadership. These factors are only four horsemen of bad news as well as limitations of physical reality. They in one way or another are involved. Beyond that the first two are issues that money, supplies and labor could solve. The latter two require solution first or foreign aid can't even help and if/when it does it only leads to limited temporary relief then reverts back again to dysfunction and deteriorates to old state of affairs.
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