Where We Are


AREA: 301,338 km²
POPULATION: 60,599,936
HEADQUARTERS: Corso Massimo d’Azeglio 30, 10125 – Turin

H4O is an italian-based NGO headquartered in Turin, Italy.
We rely on transnational partnerships, drawing on expertise from diverse backgrounds and origins in order to carry out projects in Madagascar.


CAPITAL: Antananarivo
AREA: 587,041 km2
POPULATION: 24,430,325
RELIGIONSIndigenous Beliefs 52%, Christian 41%, Muslim 7%

92% survive on less than 2 USD/day
12% have access to improved sanitation services
Nearly 4,000 children die every year due to unsafe water and lack of access to sanitation and hygiene


AREA: 110 Km2
POPULATION: about 5500 people
MAIN VILLAGE: Ampangorina

Nosy Komba is where it all began. It is a small island off the north-west coast of Madagascar, between the larger island of Nosy Be and the main island. There are 5 villages on Nosy Komba, all of which are far removed from any kind of facilities or services- especially clean water, sanitation facilities, healthcare, roads, and electricity.


AREA: 2 Km2
POPULATION: about 400 people
MAIN VILLAGE: Nosy Iranja Be

Nosy Iranja is a small island located to the west of Nosy Be, in the
Mozambique Channel. It has around 400 inhabitants, 150 of which are children under 14. It is 50 km (90 minutes by speedboat) from the nearest basic services. Nosy Iranja’s self sufficiency is laudable but its isolated location and lack of health services or sanitation facilities put its inhabitants in a vulnerable position.


AREA: 320.02 Km2
POPULATION: about 75 000 people
MAIN TOWN: Hell Ville

Nosy Be is the main island of the archipelago. It is home to around 75,000 inhabitants. The largest city is Hell Ville and the main sectors of income are tourism, vanilla and ylangylang cultivation. Foreign private companies own and manage most of Nosy Be’s capital and are the primary beneficiaries of revenue. The lack of public services and infrastructure, in particular related to Healthcare, Water and Sanitation, contribute to the critical situation of the Malagasy population.