For people in Antambahoaka on the southeast coast, in Mananjary and surrounding area, raising twins is seen as a "fady" (taboo). The origin of the fady kambana or "taboo of twins" remains unknown. According to legend, the original Antambahoaka man married a woman who died after giving birth to twins. His two other wives suffered the same fate. This led him to decide that his descendants would never raise twins again. In the Manajary region, twins, regardless of their gender, are considered evil or even devilish.

The fady kambana continues to be an ancestral practice in Antambahoaka and consists of rejecting twins at birth or even abandoning them.  In the past, they were killed or one of them was excluded from the village. Anyway, for the sake of their children, some mothers have decided to break the ancestors’ oath and to keep their children even if it means being ostracized from the community. These mothers run the risk of being rejected by their spouses, their family, and the community, and excluded from the family tomb, which makes them even more precarious and fuels the belief in the taboo.

In 2008, the Analysis and Prospects Center on the Development of Madagascar (Capdam) conducted a survey on fady kambana at the request of the United Nations Committee on Human Rights. A book has been published: The Mananjary twins between abandonment and protection, explaining that abandoned babies have a low life expectancy because they are left at the bottom of a tree or on the roadside. In the old days, they were deposited along the Pangalanes Canal, promised to a certain death; today they are placed in reception centers where their destiny is not certain. Some families now prefer to place their twins in shelters, such as the “Centre d'Accueil et de Transit des Jumeaux Abandonnés” (CATJA)— the Reception and Transit Center for Abandoned Twins— or to have them adopted by close relatives.

"Many dies before the end of the first semester, mainly from dysentery and malnutrition, without mentioning the shock of abandonment. The luckiest ones may be taken care of by adoptive families in France," explains a volunteer from CATJA in Mananjary.

Finding one and a half tons of rice every month to feed the hundred or so children taken in, without state subsidies, is the ever-recurring challenge of the CATJA center. In 2013, the “Tsy Manary Zaza” association – “We do not abandon our children” association —was set up with the support of the United Nations Development Program (UNDP) to defend the rights of children and help parents raise their twins.

Sources: The New Humanitarian, United Nations Development Program, United Nations Children's Fund