http://travel-to-madagascar.blogspot.com/2011/10/health-and-medical-information-for.html
Health and Medical Information for Madagascar
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Health insurance is strongly recommended; it should include cover for emergency repatriation. Private and public healthcare is available, but public facilities can be very limited. Visitors should pack plenty of medication for stomach upsets as effective remedies on-the-ground are limited.
Food and drink:
Water quality country-wide is likely to be contaminated so water used for drinking, brushing teeth or making ice should be sterilised or boiled first. Milk is unpasteurised and so the widely-available powdered or tinned milk is advised. Dairy products are also best avoided. Vegetables should be cooked and fruit peeled. Check all food is well-cooked, especially meat and fish.
Other risks:
Bilharzia is common but travellers can avoid it by not swimming and paddling in fresh water; only clean, well-chlorinated swimming pools. Vaccinations against tuberculosis and hepatitis B are sometimes advised. There have been outbreaks of human plaguen Northwest Madagascar as well as in other regions; travellers should avoid handling sick or dead animals and take insect protection measures such as repellent.
