Water and sanitation are a big problem in Madagascar
Diarrheal disease is the second most lethal disease for children under 5
According to the Bureau Municipal d’Hygiène, only 24% of households in the urban commune of Antananarivo have a private water connection with the remainder dependent on standpipes and water kiosks, unimproved sources, and a very small minority (1%) from wells. Overall, only 20% of the population has direct access to toilets, 55% use sanitary pails and 15% defecate in the open.