In the mid-1980s,tens of thousands of people died in Western Sudan even though three million sacks of grain to prevent famine were given to the country.The people died because:

A) Western aid workers failed to listen to the Sudanese people about their basic medical and sanitary needs
B) people lacked clean water
C) people lacked decent sanitation
D) the Sudanese people did not receive vaccinations against various diseases
E) all of these choices

All of these choices are contributing factors to the deaths in Western Sudan. The provision of grain was not enough to prevent famine without addressing the basic medical and sanitary needs of the population. Lack of clean water and decent sanitation can lead to the spread of diseases, and without vaccinations, people are more vulnerable to illness. Western aid workers needed to listen to and address the needs of the Sudanese people holistically to prevent the tragedy.