Let's put aside problems of education, employment, economic development, governing, and social issues.

It seems hard to believe that such basic human needs like good access to clean drinking water remains a broad problem in native reserves in many areas of Canada.

Same goes for proper septic systems,and housing to survive the cold winter climates.

The mix surely includes history, culture, different views on governance, bureauracy and inefficiency, corruption, greed, remote locations, land claims, and considerable mistrust. But, it's hard to believe basic needs could not be worked out, as they seem like something almost anyone could devise a plan and agreement for progress. Yet, there seems so little progress over so many years.
Considering the monies spent, if only a fraction went to solve those issues, it seems hard to believe we would be where we are now.

While the situation is bad accross Canada, there are success stories where native community have has good success.