I don't know if people up North might have lost any tolerance for Giardia, but in any case this discussion is veering away from relevance to NOT.

Enough that living conditions are difficult, and we in the Soft South don't know all people there live through as a daily reality.

They must do the best they can for themselves, and grasp at opportunities offered, including by governments and by the chance of valuable minerals in the ground. The communities are separated by long distances, so it is natural they each have different agendas and may benefit from different routes for roads and rail. They all share a long history of dealing with untrustworthy outsiders and broken (or misunderstood) promises.