With the rise of expendable income in developing countries, malls fill a need to buy items to improve their standard of living. I'd argue developed countries have already improved their quality of life enough that malls aren't needed as much.
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The river? Contaminated since they don't have sewer system.
The best place to go according to locals? The mall.
Want to go anywhere else in Paraguay? It'll take you ages due to a lack of infrastructure.