For years, Madagascar has been one of the world's last remaining hotspots for the plague, a.k.a. the Black Death, a once-global epidemic that's now in the domain of world history teachers rather than doctors. Although 1,000 people still contract it every year, it's not exactly popping up in New York City. Even in Madagascar the illness has been mostly isolated rural villages and relatively self-contained.
But now, according to the World Health Organization, two people in the country's capital have been infected with the plague and one has died. It's a troubling situation, and one that was unfortunately predicted back in September when VICE Reports visited Madagascar to take a look at this very issue.
As part of a documentary released in September, correspondent Ben Shapiro helicoptered into a village about 1,000 kilometers north of the capital that was considered a hot zone.
Now that the disease has made it to a densely populated area, a major outbreak seems likely, inevitable. In Antananarivo, the capital, garbage is dumped in the streets and public restroom conditions are terrible. Black rats—the primary vector for the disease that killed about 100 million people in the 14th century—run freely between buildings.
The people there there told Shapiro that they were scared of an outbreak, and they should be: After a 2009 coup, international aid to the country has pretty much dried up.
"There is now a risk of a rapid spread of the disease due to the city's high population density and the weakness of the healthcare system," the WHO said in its report, while noting that a task force has been activated to manage the outbreak.
Without money from Western nations coming in, though, the country doesn't have much to work with, though the African Development Bank is allocating $200,000 to fight the plague. As Shapiro noted in his report, the conditions leading up to the outbreak mirror those that caused the Ebola virus to spread throughout West Africa.
"Belief in old practices, rampant misinformation, and apathetic, corrupt politicians have combined to make the current outbreak much more widespread than it should be," he said in the documentary. "For Madagascar, though, it's unclear how many more people will die of plague before things start to change."
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