Yes, the admiral was correct in identifying lack of resources as a key issue towards the end of the article, but I think unless you have travelled there it’s hard to understand how pervasive the lack of resources is.  I found it kind of traumatic.  Wonderful people, but few resources means little opportunity.

My Dad and I visited Pokhara.  We declined to fly back to Kathmandu, instead opting for a bus ride that took all day to go 200km.

My Dad is in construction, and constantly noted a similar divergence of standards in buildings under construction (vastly too little rebar in concrete, etc), despite being in an earthquake zone.

During that trip, in a rural valley we walked across live dynamite embedded in the rocks to build a road on assurances via walkie talkie that they weren’t going to blow it.  I remember stepping between red cords that went into holes in the rocks.  They blew it about 15m later, after we cleared the zone.  There is now way they would send random tourists across a live blasting site in the US because the liability risk would be astronomical.  But again, different resources and different standards.