Madagascar Expat Health Insurance Guide
Madagascar is a country unlike any other. It benefits from both extreme isolation and a large geographical area, which has allowed animals and plants to evolve here that can be found nowhere else on the planet.
Whether we’re talking about the sadly now-extinct elephant bird that stood over three metres tall, or the hundred or so lemur species residing here, an astonishing 90% of the flora and fauna here is unique to Madagascar.
Couple this one-of-a-kind wildlife spectacle with the coral reefs, dense rainforests and the fascinating ethnic culture to be found here and it’s fair to say that a visit to Madagascar is one that will stay with you for years to come.
Madagascar offers a truly diverse climate. At over half a million square miles, and benefitting from a considerable mountain range, a huge range of climate variations are to be found here. Generally speaking the east of the island is the warmest – with temperatures regularly reaching 30’C or more. This area also experiences far more rain, brought in by the Indian Ocean trade winds.
The west of the island is generally drier and cooler, making for more comfortable living conditions. At altitude, frosts are not uncommon so it really is possible to travel from “chilly” to “tropical” in a single day. This great diversity of climate not only adds interest to Madagascar as a travel destination, but has also had a part to play in the vast wealth of plant and animal species to be found exploiting unique biological niches.
Like many more equatorial areas, Madagascar typically experiences an annual cycle of hot and dry weather (November to April), followed by a cooler wet season (May to October). It should be noted that there is a significant risk of cyclones in the dry season, so visitors during this period should pay close attention to local weather forecasts. Significant damage regularly occurs to buildings and public services under such circumstances which can make travel rather more challenging.
Historically Madagascar was clothed in virgin rainforest, though these days much of the forest has been cleared for “slash and burn” agriculture. Today, Madagascar’s largest export is rice, though beef production is also a common source of Malagasy income. These days the last remnants of the forest are to be found in the form of national parks. Here everything from the well-known predatory fossa to the world’s smallest chameleon eke out an existence.
Over successive generations Madagascar has been colonized by a wide variety of ethnic groups. The first colonizers are believed to have arrived from Borneo, and indeed ethnographers have pointed out the many similarities between the Malagasy language and those dialects spoken in Borneo.
Since those first fateful arrivals however Madagascar has also experienced arrivals from African and Asia. France also invaded the island in 1883 and left much of their language and culture behind after Madagascar’s independence in 1958.
Today all these differing ancestors provide a patchwork of different cultures and ethnic groups. Great diversity can consequently be experienced here, and one of the true pleasures of visiting Madagascar is taking the time to understand the many groups who call this island home.
The largest traditional ethnic group of all on Madagascar are the Merina, who typically resided on the high plateau to the west of the island. In terms of their cultural identity two aspects are notably prevalent. First comes “razana” – a name which describes the power of dead relatives. In Madagascar the dead are frequently venerated, with both good and bad fortune blamed on how well-treated these individuals have been recently.
Leading on from this respect of the dead come a number of taboos – known as “fadys”. These taboos vary by ethnic group and by region but may include limitations on certain foods or the wearing of certain costume.
The cultural diversity experienced in Madagascar has led to the development of some unusual pastimes. A unique form of martial arts known as “Moraingy” is popular here, as is “Tolon-omby” – the questionably safe art of cattle wrestling.
98% of the population of Madagascar now speak their own unique language – Malagasy. This is not an easy language to pick up for foreigners, though attempts are generally regarded with good humour and are greatly appreciated as a sign of respect.
Perhaps it is fortunate, therefore, that Madagascar’s second official language is French. In more popular urban areas English may sometimes be spoken. Fortunately it is relatively cheap to hire a guide for your travels, who can double-up as a translator when necessary.
While Madagascar is a huge land mass, transportation on the island can be challenging. Very few “proper” roads exist outside of major urban areas, and many are simply dirt tracks. In the wet season these can quickly become rain-sodden and almost impossible to drive on.
This means that should you consider driving in Madagascar, a four wheel drive vehicle will almost certainly be necessary. Travellers should note that it is very difficult to hire a vehicle in Madagascar to drive yourself around.
Almost all car hire firms instead provide a driver with any vehicle. This should not be a concern as the cost is almost identical, and your driver can then double up as tour guide and translator. Furthermore it should be noted that no breakdown services exist in Madagascar so a further benefit of recruiting a driver is having an experienced mechanic on hand should the worst happen.
There are, of course, other forms of transportation. Taxis, for example, are relatively cheap and safe and can be found in more urban areas. Note that it is very uncommon for taxis in Madagascar to possess a meter, so you should agree a price with your driver in advance.
An even cheaper alternative are the many minibuses which service the country. Known as “taxi-brousses” they are often slow, cramped and uncomfortable. That said, many visitors enjoy this “authentic” travel experience and it can be a great way to meet the locals and save some money.
Madagascar does benefit from a small number of train lines, and these can provide a wonderful view of the country. That said, they are often crowded, so it is advisable to book well in advance and, if possible, to book a first class seat to ensure a comfortable journey.
For long distance travel there are a wealth of internal flights. Alternatively it should come as no surprise that travelling by boat is both easy and enjoyable. For a true Malagasy experience consider a trip in one of the traditional dugout canoes known as a “pirogue”.
Madagascar is still a relatively poor country, and as a result healthcare facilities may fall short of Western expectations. In more urban areas a limited number of healthcare facilities may be found, though these are often grossly understaffed.
In more rural areas the problem can be even more extreme. In many cases more serious medical emergencies will need to be dealt with abroad; air-lifting to mainland Africa is a distinct possibility in such situations.
It is critical therefore to invest in a suitable health insurance policy before travelling abroad, in order to ensure you can afford the potential costs involved with such an operation.
The official currency in Madagascar is the “Ariary” which replaced the old Malagasy Franc in 2005. It is important to know this because many older persons still quote prices in “old money” so it is important to check on the exact currency being discussion.
To complicate matters still further, Madagascar’s long connection to France means that prices may also be quoted in Euros, and that this currency may also be accepted in some situations.
Visitors to Madagascar have reported problems with cashing traveller’s cheques, as many banks refuse them. You should either aim to bring cash with you, or to use a credit or debit card where possible.
Changing currency is relatively easy, courtesy of exchanges in most airports and numerous banks in more urban areas. Dollars and Euros are typically the easiest to exchange. Reports have emerged of foreigners being “short changed” however, so be certain to check your money before leaving the bureau de change.
In terms of ATMs visitors should be aware that Visa cards (debit or credit) are most widely accepted. Mastercard holders may find accessing their money slightly more problematic, while holders of other cards (Cirrus, Diner’s Club etc.) may find they are out of luck entirely. To be clear; if at all possible aim to bring a Visa card with you for ease of access to your funds.
Schooling in Madagascar is compulsory between the ages of 6 and 14. For expats, the Malagasy language can be problematic so many parents opt for one of the international schools. Unsurprisingly these are concentrated in the capital, Antananarivo. Here the American School of Antananarivo (ASA) is possibly the best-known and respected.
Irrespective of the school chosen expats should note that the prices can be considerable. Should you be moving here for work then it is wise to try and factor these costs into your expat package. Note also that reports abound of international schools here showing preferences for certain nationalities, so enlisting your child into a suitable school can take patience and hard work.
Food & Drink
The typical Malagasy cuisine is quite basic – some might argue plain. Rice is typically eaten with every meal, often accompanied by either meat or vegetables. As a result, vegans and vegetarians can be easily accommodated.
Generally speaking the food in Madagascar is not overly spicy, though visitors should be aware of “sakay”. This is a hot chilli relish which can be found across the island. The strength varies considerably by establishment so visitors are advised to sample their sakay before ladling it generously over their meal.
The meat-aspect of Malagasy cuisine is most commonly beef (“zebu”) though in more coastal areas seafood can make a welcome alternative. A popular national dish is beef stew – known locally as “romazava”.
Note that in more urban areas a range of international restaurants exist, serving everything from Italian to Chinese food. It is also worth noting that in Madagascar the word “hotely” generally refers to an eating establishment as opposed to lodgings.
The tap water in Madagascar is not considered safe to drink, so aim to consume only boiled or bottled water, and to avoid ice cubes in drinks.
The Foreign Office reports that most visits to Madagascar are without incident, but the country does arguably offer more risks than many other destinations. Arming yourself with the right knowledge will help you avoid many such instances.
For one, civil unrest is not uncommon since the recent political coup. Riots are not unheard of and visitors should aim to steer well clear of such demonstrations. These are most prevalent in Antananarivo.
Crime is sadly commonplace in Madagascar, and while this is generally focused on urban areas, even more provincial areas still see their fair share of action. Armed attacks and robberies, for example, are not uncommon, and have even taken place within the confines of national parks. Pick-pocketing and even car jackings are experienced here.
Visitors are consequently advised to take precautions. Never leave bags unattended and aim to keep valuables out of sight. Maintaining a low profile and being escorted by a professional guide can go a long way to avoiding trouble. If you are the unfortunate victim of a crime dial “17” for the emergency services.
Note that a number of unpleasant parasites and viruses may be found in this warm and damp part of the world. In recent years Madagascar has experienced rabies, Rift Valley fever, Chikungunya fever and schistosomiasis. Outbreaks of the plague are also not unheard of.
Visitors are advised to take suitable precautions to avoid such dangers. These should include the use of insect repellent, suitable immunization before your date of travel and an avoidance of bathing in stagnant water.
Places to Visit
Madagascar is a traveller’s paradise, literally dripping with stunning views, fascinating historical sites and wildlife treasure troves. Here are just a few of our favourite “must see” destinations:
Tsingy de Bemaraha
At 152,000 hectares Tsingy de Bemaraha is Madagascar’s largest nature reserve. But it’s not just the reserve’s size that is impressive; the area also benefits from enough geological interest as to be named a World Heritage Site. Here, unique limestone “needles” jut out above the forest canopy making for a truly memorable vista.
Ile Sainte Marie
Fans of Captain Jack Sparrow rejoice! Ile Sainte Marie offers a unique glimpse into the world of pirates, having allegedly been home to over a thousand of them in the 17th and 18th centuries.
Today it is unique in offering the only pirate cemetery in the world. And if that weren’t enough, the short channel separating it from mainland Madagascar is one of the very best places for whale watching, where humpbacks in particular are regularly seen breaching.
Nosy Be is arguably Madagascar’s premier beach destination. For those wanting to relax in the sunshine Nosy Be offers seemingly endless miles of pristine palm tree-lined golden sand. For the more adventurous Nosy Be is also a water sports capital of Madagascar, offering everything from jet skiing to world-class diving spots.
Avenue of the Baobabs
Emblematic of Madagascar are the giant “upside down” trees known as baobabs. The trees possess vast trunks to store water, while the “branches” have progressively shrunk in order to conserve water and now look more like spindly roots. The well-known Avenue of Baobabs represents Madagascar’s first national monument and offers one of the highest concentrations of these odd plants anywhere on the island.
Royal Hill of Ambohimanga
Ambohimanga is considered the most holy place in Madagascar by the local Merina people. This wonderfully-preserved palace and burial ground was once home to the Madagascan royal family, and today the area offers a unique glimpse into the cultures and ideals of ancient Madagascar.