If a great job came up in a region with the highest HIV/TB coinfection rate in the country, and the country had one of the highest TB rates in the world, would you take it? What if it meant sharing a room with 11 strangers and a bed with at least one of them?

What if you were located on the nearest border of a neighboring region, though?

Hello from Kilombero District! Kilombero has no roads to its remote border villages of Uchindile and Kitete, so I spent three hours driving through Mufindi District to get here. The new mothers I have met here delivered their babies in Mufindi District. The engineers who arrived to drill boreholes arrived through Mufindi District. In fact, the only way Kilombero government can access this population, without going through Mufindi, is by a twice-weekly train that runs through the two towns. The train didn’t run until 2012.

This might not be a big deal except for a couple statistics. The HIV prevalence rate in Kilombero is 4%. In Mufindi, it’s 14%. The TB prevalence rates haven’t been published yet, but in Mufindi, over 50% of TB patients are co-infected with HIV, meaning the devastating effects of TB bring patients to swifter, more agonizing ends.

Any project operating in these towns is most likely to consult Kilombero District data for indicators of health (until last year there had never been a doctor in either village). But since these villagers interact predominantly with Mufindi District, Mufindi data is more suitable to local conditions, and Mufindi’s health risks are multiple times greater.

Companies often profess to have little influence over politics and little interest in being involved. There are cases where that’s clearly not the case – such as when tax law is onerous or export duties are unpayable.

Often, however, governments will modify district borders in response to the planned development of a corporate project. Autocratic leaders redistrict projects into their home regions. Where borders are unclear, governments may set arbitrary borders just to create better clarity for a company. These acts have human rights impacts.

Over here, the impacts are mixed. The presence of this forestry project, and the recent boom in forestry throughout the area, has brought attention to these neglected communities for the first time in their existence. It’s not clear that the government would have sent teams to dig boreholes for clean water if industry hadn’t arrived in the area. Likewise, the trains that usually bring partial fulfillments of medical orders brought doctors to both towns last year. But the company’s laborers may be working under false notions of health and safety. The company can (and should) attentively assess and manage health risks, but a corollary action may be to support existing initiatives to redistrict Kitete into Mufindi.