Madagascar is an island country located off the southeast coast of Africa with a population of over 20 million people and a density of 33 people per square kilometer. The average life expectancy is dramatically lower than in the US, at around 18 years of age, due to diseases like malaria and respiratory infections. Diseases spread easily in Madagascar due to poor sanitation and malnutrition, with malaria, respiratory infections, typhoid, and bubonic plague posing major health risks. Food and water-borne illnesses are also common problems for the local population to acquire due to the lack of access to approved, safe foods and beverages.