Madagascar Safety Guide
Health, security, and travel safety information
Emergency Numbers
Save these numbers before your trip.
Healthcare
What to know about medical care in Madagascar.
Healthcare System
Madagascar's healthcare system is severely under-resourced with significant disparities between urban and rural areas. Public hospitals lack basic equipment, medications, and supplies. Private clinics in Antananarivo and major cities offer better care but still fall short of international standards. Medical evacuation to Réunion or South Africa may be necessary for serious conditions.
Hospitals
Private clinics such as Clinique des Soeurs, Espace Médical, and HJRA in Antananarivo provide the best available care. In other cities like Toamasina, Mahajanga, and Toliara, options are very limited. Always seek private facilities over public hospitals when possible.
Pharmacies
Pharmacies (pharmacie) are found in cities but medication quality and availability are inconsistent. Counterfeit drugs are a significant problem. Bring a comprehensive medical kit including all prescription medications in original containers with prescriptions. Common over-the-counter medications may be unavailable or of questionable quality.
Insurance
Comprehensive travel insurance with medical evacuation coverage (minimum $100,000 USD) is absolutely essential. Verify your policy covers Madagascar and includes air ambulance/medical evacuation. Medical facilities require cash payment upfront regardless of insurance.
Healthcare Tips
- Bring a complete medical kit including prescription medications, antibiotics (if prescribed), antimalarials, oral rehydration salts, and first aid supplies
- Carry copies of prescriptions and medical records in English and French
- Identify the nearest acceptable medical facility at each destination before arrival
- Keep your travel insurance emergency contact numbers readily accessible
- Consider medical evacuation membership services for remote travel
- Avoid medical procedures requiring needles or blood transfusions unless absolutely necessary
- Dental care is poor quality; complete dental work before traveling
Common Risks
Be aware of these potential issues.
Pickpocketing, bag snatching, and theft from vehicles are common, especially in Antananarivo, Toamasina, and tourist areas. Thieves often work in groups using distraction techniques. Theft from parked or stopped vehicles is frequent.
Armed robberies occur, particularly at night and in isolated areas. Bandits (dahalo) operate in rural areas and on certain roads. Express kidnappings for ATM withdrawals have been reported in cities.
Road conditions are extremely poor with potholes, lack of signage, and unpredictable hazards. Accidents are common due to poorly maintained vehicles, reckless driving, pedestrians and zebu cattle on roads, and lack of lighting. Many roads become impassable during rainy season.
Malaria is endemic throughout Madagascar, including urban areas. Dengue fever and chikungunya also occur. Risk is present year-round but higher during rainy season.
Traveler's diarrhea, typhoid, hepatitis A, and cholera are risks. Tap water is unsafe throughout the country. Food hygiene standards are often poor.
Madagascar experiences seasonal plague outbreaks (both bubonic and pneumonic), primarily September to April in highland areas. While tourists are rarely affected, outbreaks can be serious.
While piracy in Somali waters is the primary concern in the region, vessels off Madagascar's coast have occasionally been targeted. Yachts and small vessels face some risk.
Scams to Avoid
Watch out for these common tourist scams.
Individuals approach tourists claiming to be official guides, offering tours at inflated prices or taking tourists to shops where they receive commissions. Some guides abandon tourists mid-tour or demand additional payment.
Sellers offer precious or semi-precious stones (sapphires, emeralds) at seemingly low prices, claiming they're genuine. Most are fake or low quality. Tourists are told they can resell for profit abroad.
Taxi drivers, vendors, and some businesses charge tourists significantly inflated prices. Taxis may take circuitous routes or claim meters are broken. Restaurants may have different prices for foreigners.
Individuals claim to represent orphanages, schools, or charities requesting donations. Some may show fake documentation. Money rarely reaches intended recipients.
One person creates a distraction (spilling something on you, asking for help, staging an argument) while accomplices steal belongings. Common in markets and crowded areas.
Individuals posing as police or officials demand to see documents, claim violations, and request fines or bribes. Some may demand to inspect wallets for counterfeit currency.
Hotels or guesthouses show photos of better rooms than what's provided, or claim booked rooms are unavailable and offer inferior alternatives at the same price.
Safety Tips
Practical advice to stay safe.
Money and Valuables
- Use ATMs inside banks during business hours; cover the keypad when entering PIN
- Carry only small amounts of cash; keep emergency money separate from daily funds
- Use hotel safes for passports, extra cash, and valuables
- Make photocopies of important documents and store separately
- Divide money between multiple secure locations on your person
- Be discreet when accessing money; don't count cash in public
- Credit cards are rarely accepted outside major hotels; bring sufficient cash
- Exchange money only at banks or official exchange bureaus, never on the street
- Keep small bills (1,000-5,000 Ariary) for daily purchases to avoid change-making issues
Transportation Safety
- Avoid taxi-brousses (bush taxis) if possible; they're often overloaded and poorly maintained
- For taxis, use hotel-arranged transportation or known taxi companies
- Never travel by road after dark; plan journeys to arrive before sunset
- Wear seatbelts when available; sit in the back seat of taxis
- Consider domestic flights for long distances despite higher cost
- If driving yourself, rent from reputable companies and get comprehensive insurance
- Always hire a local driver familiar with road conditions and hazards
- Check vehicle condition before long journeys; ensure spare tire and tools are present
- Inform someone of your travel plans and expected arrival times
Accommodation Safety
- Choose accommodations with security features (guards, locked gates, safes)
- Keep doors and windows locked at all times, even when inside
- Don't open doors to unexpected visitors; verify identity through hotel staff
- Store valuables in room safes or hotel safety deposit boxes
- Keep ground floor windows closed and locked at night
- Note emergency exits and evacuation procedures
- Keep room key secure and don't leave it at reception if security is questionable
- Use door wedges or portable locks for additional security in budget accommodations
Health and Hygiene
- Take antimalarial medication as prescribed; don't skip doses
- Apply insect repellent regularly, especially at dawn and dusk
- Wash hands frequently with soap or use hand sanitizer (60%+ alcohol)
- Drink only bottled water; check seals are intact before purchasing
- Avoid ice unless you're certain it's made from purified water
- Carry oral rehydration salts for treating diarrhea
- Bring a comprehensive first aid kit and any prescription medications
- Get all recommended vaccinations before travel (Hepatitis A & B, Typhoid, Yellow Fever, routine vaccines)
- Consider rabies vaccination if planning animal contact or remote travel
- Seek immediate medical attention for fever, severe diarrhea, or unusual symptoms
Personal Safety
- Stay aware of your surroundings; avoid appearing distracted by phones or cameras
- Walk confidently and purposefully; avoid looking lost or vulnerable
- Travel in groups when possible, especially after dark
- Trust your instincts; remove yourself from situations that feel unsafe
- Don't resist if confronted by robbers; possessions can be replaced
- Vary your routines and routes to avoid predictability
- Learn basic French or Malagasy phrases; communication helps in emergencies
- Keep your embassy's contact information readily accessible
- Register with your embassy or consulate upon arrival
- Avoid political demonstrations and large gatherings
Photography and Electronics
- Be discreet with cameras and phones; don't display expensive equipment
- Ask permission before photographing people; offer small payment if appropriate
- Don't photograph government buildings, military installations, or airports
- Keep electronics secured and out of sight when not in use
- Bring portable chargers as power outages are common
- Back up photos regularly; store devices separately
- Consider travel insurance that covers electronic equipment
- Use camera straps that are difficult to cut; keep equipment close to your body
Communication
- Purchase a local SIM card for reliable communication (Orange, Telma, or Airtel)
- Keep phone charged and carry portable battery backup
- Share your itinerary with family or friends back home
- Keep important phone numbers written down in case phone is lost or dead
- Learn basic French phrases; English is not widely spoken
- Download offline maps before traveling to remote areas
- Know the address of your accommodation in local language
- Keep your hotel's business card with you for showing taxi drivers
Cultural Sensitivity
- Respect fady (taboos), which vary by region and community; ask guides about local customs
- Dress modestly, especially in rural areas and when visiting villages
- Remove shoes before entering homes and some sacred sites
- Don't point at people or tombs; use an open hand gesture instead
- Ask permission before entering villages or sacred areas
- Be respectful at burial sites; never touch or climb on tombs
- Avoid public displays of affection
- Give and receive items with both hands as a sign of respect
- Learn about local customs before visiting different regions; they vary significantly
Information for Specific Travelers
Safety considerations for different traveler groups.
Women Travelers
Women travelers can visit Madagascar safely but should take additional precautions. Solo female travelers may face unwanted attention, catcalling, and occasional harassment, particularly in urban areas and tourist zones. Sexual assault, while not common, has been reported. The risk increases significantly after dark. Women are generally respected in Malagasy culture, but foreign women may be perceived differently. Traveling with companions or in organized tours can reduce risks.
- Avoid walking alone after dark; use trusted transportation or travel with companions
- Dress modestly, covering shoulders and knees, especially outside resort areas
- Wear a wedding ring (real or fake) and mention a husband to deflect unwanted attention
- Book accommodation with good security; choose rooms on upper floors away from easy access
- Be firm and assertive when declining unwanted attention; don't worry about being polite
- Avoid isolated beaches, parks, and quiet streets, even during daytime
- Don't accept drinks from strangers or leave drinks unattended
- Trust your instincts; remove yourself from uncomfortable situations immediately
- Keep phone charged and accessible for emergencies
- Consider joining group tours for activities and sightseeing
- Research and book reputable guides and tour operators in advance
- Be cautious when using dating apps or meeting people online
- Inform hotel staff of your plans and expected return times
- Avoid sharing detailed personal information with strangers
- Carry a whistle or personal alarm for emergencies
- Learn basic French phrases for declining attention and seeking help
LGBTQ+ Travelers
Homosexuality is legal in Madagascar with no specific laws criminalizing same-sex relationships. However, there are no legal protections against discrimination based on sexual orientation or gender identity. Same-sex marriage and civil unions are not recognized.
- Exercise discretion regarding sexual orientation and gender identity, especially in public
- Avoid public displays of affection with same-sex partners
- Be cautious when discussing LGBTQ+ topics with locals; gauge attitudes carefully
- Book LGBTQ+-friendly accommodations when possible; research in advance
- Consider booking rooms with two beds to avoid questions or issues
- Be aware that some hotels may refuse accommodation to same-sex couples
- Exercise additional caution in rural and conservative areas
- Connect with international LGBTQ+ travel networks for current information and support
- Be prepared for lack of LGBTQ+-specific venues or community spaces
- Don't assume that tourist areas are necessarily more accepting
- Have a cover story prepared if needed (friends, colleagues, siblings)
- Be cautious about using LGBTQ+ dating apps; meetings could pose safety risks
- Keep embassy contact information readily available
- Consider traveling with LGBTQ+-friendly tour operators who understand local context
Travel Insurance
Comprehensive travel insurance is absolutely essential for Madagascar due to poor healthcare infrastructure, high risk of medical evacuation needs, common illness and injury risks, and potential for theft and trip disruptions. Medical facilities are inadequate for serious conditions, and evacuation to Réunion, Mauritius, or South Africa can cost $50,000-$100,000 USD or more. Without insurance, travelers face potentially catastrophic financial and medical consequences. Standard policies may not provide adequate coverage for Madagascar's unique risks.
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