Studies show that handwashing with soap can reduce the risk of contracting diarrhoea by up to 47%. In Fort Dauphin, a small town in the South East of Madagascar, poor hygiene practices and widespread open defecation has had serious consequences for a population struggling with diarrhoea and malnutrition. Poverty and poor infrastructure means that the overwhelming majority of residents do not have in-house water connections. Water must bought by the bucket, at public water points throughout the town. With water such a scarce resource, handwashing is not always seen as a primary concern.