Toamasina, Madagascar

Capital City

The coastal city of Toamasina, home to 225,116 people, bills itself as Madagascar's chief seaport, but the reality is a persistent bureaucratic headache and a climate prone to outbreaks of malaria and other diseases. Despite its importance as a commercial hub, the city has long battled epidemics, with plague outbreaks in 1898 and 1900. And while the draining of nearby marshes has improved conditions somewhat, the tropical rainforest climate still brings frequent rainfall and a breeding ground for mosquito-borne illnesses. Those drawn to Toamasina's role as a transportation and shipping nexus may find the health and administrative challenges too steep a price to pay.