A consequence of this is that children remain illiterate for the rest of their lives. Although there are schools in the larger cities, families that cannot afford the fees often don't send their children to school. This is why one commonly sees children as young as eight years old on the streets,engaged in work like herding cattle or selling fruit, vegetables or charcoal to passers by. There is no government assistance, such as unemployment benefits or children endowment. No less can be said for the health system in Madagascar.
Sanitation is poor and hygiene levels are extremely low.
As a result such diseases as cholera, malaria, hepatitis, meningitis and yellow fever are extremely common throughout the country. Currently, there is a serious cholera epidemic and many people are dying ever day. Without any fixed housing thrust scheme, we see thousands of homeless people making their homes out of discarded cardboard boxes on the streets. People in the villages live in grass huts and only a few houses are built from brick or mud. Overall, the poverty is profound and the living conditions are no doubt, by anyone's standards, devastatingly low.