Black Death lives on in Madagascar


Fever, chills, fatigue, a bloody cough and swollen, painful lymph nodes are all symptoms of the plague ravishing the southeast African island of Madagascar, according to the Centers for Disease Control. The plague that looms over the people of Madagascar is the same one responsible for one of the deadliest epidemics in history. What many people don’t realize is that the bubonic, or black plague didn’t die in the Middle Ages and is still deadly today. In Madagascar, there’s an outbreak every year.

Outbreaks usually occur from November to March. This is the rainy season in Madagascar, which forces infected rodents to roam the streets inciting the outbreak, according to a CNN report. This year, the first death due to the plague was reported in August. Experts still do not understand why this occurred so early but The Ministry of Public Health started investigating the case as soon as possible to contain the situation. The outbreak instead spread to the two largest cities in Madagascar, Antananarivo and Toamasina, which hold a combined population of about 1.5 million people. This rare occurrence has left behind a devastating tale of tragedy, killing approximately 84 people and infecting around 800 other civilians. These are the cases that have been reported so far, but that number could rise in the remaining rainy weeks.

The plague still exists because fleas and rats — the disease’s primary hosts — are difficult to exterminate and control. However, scientific advancements have been made to combat the plague and they’ve been mostly successful in that we’ve managed to avoid massive international outbreaks. Nevertheless, we haven’t been able to keep the people of Madagascar from falling victim to these infections. It’s a shame that in 2017 there are still people dying from a curable disease. Therefore, to successfully protect the 25 million people that inhabit the island, we must put the living conditions of Madagascar under a microscope and examine the faults that allow the plague to persist.

Since outbreaks are more common in areas intensely affected by poverty, the plague is describes as a “disease of poverty” by the World Health Organization. These regions are more prone to outbreaks because of unsanitary living conditions, the lack of availability to antibiotics, and a general absence of health and wellness education. The situation is often so dire that people need to walk miles to receive medical attention, which in most cases would be the care of a clinic and not a hospital.

Nothing guarantees that these clinics, or even that hospitals are properly stocked with the antibiotics that are needed to combat the bubonic plague. In these poverty-stricken areas, living conditions are unsanitary, which aides the dissemination of infections and diseases by attracting rodents and fleas. Following lack of proper medical care and proper living conditions, there is also a lack of education on what and how the plague affects its victims. If people were to understand the symptoms and recognize them sooner, cases would be diagnosed and managed sooner, potentially reducing the magnitude of the outbreak.

With all the advancements in technology and medicine, the plague should not break out with such ferocity in the modern world. Education and proper care is crucial in these developing countries because instead of letting the outbreaks happen we should work to prevent them. This is achievable because there are effective cures readily available in other parts of the world. In order to save lives, we must begin by teaching proper and effective ways of disinfection and hygiene as well as making them accessible to these communities. This implies having clean water and disinfecting agents available to these people. WHO, CDC and the Madagascar Ministry of Health need to keep closely monitoring the overall living conditions and making sure that the adequate medical supplies are available to these people but beyond that work to educate the citizens and provide more accessible adequately staffed clinics. Proper healthcare is a basic human right and the people of Madagascar should not have to fear the rainy season.

Claudia Rivera can be reached at

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