 Eighty percent of its inhabitants don't have access to clean water, one in six suffer from serious respiratory illness, literacy is less than 20%, and 65% of the watershed slopes are highly degraded.The majority of those living in Anosy practice traditional folk religions.The two largest Christian denominations in the Anosy region are the Roman Catholic and the Malagasy Lutheran Church, both established in Fort Dauphin (now Tôlanaro) in the 1890s.