The black plague has broke out in Madagascar. In late 2013, a deadly outbreak of the plague hit small villages around the country killing dozens of people. Rumored to have taken root in overcrowded prisons, the disease has flourished amid Madagascar’s increasing poverty and poor waste management. Antibiotics to treat the disease have been developed and are available in most countries, but Madagascar’s rudimentary healthcare system has left a number of people stranded without care.

*This video originally aired on VICE in 2014