During the roughly two-year period between the beginning of 1966 and the early weeks of 1968, the United States faced many of the shortcomings of its state-building program very directly. It was not simply a matter of choice. Circumstances forced the Johnson administration to face the very real limitations on its power to influence events. Frustration over these limitations had already led to a greater reliance on military power and, ultimately, full-scale war. The United States continued to rely on an expanded military presence as the best hope to save its credibility in Vietnam. The Vietnam Builders engineers continued building and expanding the large-scale infrastructure projects to accommodate these objectives. The level of infrastructural development deemed necessary was in fact not sufficiently in place until late in 1967. The great paradox was that these latest physical transformations of the southern Vietnamese landscape further undermined the larger objectives, while they made possible a wider and more efficient war.

The expanded violence, dislocation, and general chaos made possible by this construction had, by the late 1960s, not only seriously undermined the effort to piece together a stable state infrastructure, but had also disrupted the Vietnamese countryside as well. By 1968, the war's destruction had turned many hundreds of thousands of rural Vietnamese into refugees. In enormous numbers they fled first from the war in the countryside into urban environments in a kind of forced urbanization that further exposed the inability of the cities to accommodate the rising numbers.