There is an airport departure tax. There are Honorary Consuls located in Philadelphia, Pa. and Palo Alto, Ca. Overseas, inquiries may be made at the nearest Malagasy embassy or consulate. Madagascar completed a transition to a multi-party democracy in 1993 and held an orderly presidential election in 1996. Travelers should nonetheless avoid political gatherings or demonstrations and not photograph airports or military installations.
Many medicines are unavailable.
Doctors and hospitals often request immediate cash payment for health care services. U.S. medical insurance is not always valid outside the United States. Supplemental medical insurance with specific overseas coverage, including air evacuations, is highly recommended. Street crime, including muggings and purse snatchings, poses a growing risk for visitors, especially in Antananarivo. The loss or theft abroad of a U.S. passport should be reported immediately to local police and to the nearest U.S. embassy or consulate.