 Ecotourism in Anosy grew rapidly in the early and mid-1990s, but temporarily collapsed during 2007–2009 due to the complete booking of Tôlanaro hotels for QMM employees and contractors.UK-based charity Azafady began poverty-relief efforts in southeast Madagascar in 1994.Tôlanaro suffered a cholera outbreak in 2000–2001 and syphilis outbreak in 2007, the later resulting in a state of emergency.