By Olenka Frenkiel
BBC Radio 4's Crossing Continents
Concerns that a mining project in Madagascar will harm the environment have largely been calmed, but a new fear has emerged that its workers will bring HIV/Aids from South Africa.
Madagascar is known as a biodiversity hotspot, renowned for its unique plants and animals, but it is also one of the poorest countries in the world.
The mine will provide a new source of income for Madagascans
In order to survive, the population cuts down trees to burn wood for charcoal, and land is cleared for subsistence farms.
Only 10% of the original forest is left now, much to the dismay of conservationists, eco-tourists and scientists searching for the next wonder-drug.
However, one of the world's largest international mining companies, Rio Tinto, has promised a partial solution to both the deforestation and the poverty.
A biodiversity hotspot facing development
Its subsidiary QMM is building a mine in the south, the country's poorest region.
It will extract ilmenite from the sand beneath the forests, which is used to make titanium dioxide, a whitener for the manufacture of paint, paper, plastics, even toothpaste.
Demand is growing fast, particularly from China's booming economy. But there has been fierce opposition to the plans.
Friends of the Earth opposed the project for years arguing it would make many species extinct.
Others cited the chequered history of mining companies in the developing world.
Many people now believe the project will benefit the environment
Rio Tinto itself has been criticised in the past for exploiting workers and damaging the environment.
It has even been accused of generating a bloody civil war in Papua New Guinea, a charge the company denies and has been fighting in the courts.
Rio Tinto subsidiary QMM's Regional Director Ny Fanja Rakotomalala said: "Over the last 20 years, mining has a history which hasn't always been very good.
"We have learnt the lessons of the past."
QMM has consulted and even recruited many of those who had concerns about the damage the mining would bring.
For example, Manon Vincelette is a forest engineer formerly from Conservation International. She was hired by QMM to ensure natural species would be saved.
"My team and I managed to adapt their plans. We convinced them to preserve important sections of forest," Ms Vincelette said.
"We are now saving forest that otherwise would go through slash and burn."
Alison Jolly, a primatologist famous for her studies on Madagascar's unique family of primates, the lemurs, was also brought on board as part of an independent advisory panel.
She too was sceptical at the start, but after extensive research she concluded the mine was a gamble worth taking.
"This place is no tropical paradise for its people. They need development," she said.
QMM has also agreed to help fund schools and clinics, all of which Ms Jolly hopes will set a new standard for mining companies bidding for contracts.
However, some problems have yet to be resolved. The water supply for example, sanitation for the workers, and the influx of people the mine would attract.
But one problem towers over the others.
At a roadside stall I asked a woman about her children who are very small.
"I have 13 children," she told me, "nine have died." I asked her age and she said she was 36.
The rate of infection is small compared to neighbouring countries
She is small and emaciated. Her teeth are rotten, and many have fallen out.
My translator explained that many poor women have children by different fathers.
Sexually transmitted diseases are common but so far Madagascar has a low rate of HIV infection.
It is currently said to be under 2%, a small fraction of the rates of neighbouring countries in Africa.
But QMM has admitted that it will need to bring in specialised workers from abroad, quite possibly South Africa, at least at first.
This has led to concerns about what would happen if QMM/Rio Tinto brought workers from Rio Tinto's old ilmenite mine in Richard's Bay in South Africa, where the rate of HIV infection is much higher than the national average of 13%.
QMM and the Madagascan government have been wrestling with how to prevent the mine becoming a Trojan horse for this devastating disease.
They have made Fort Dauphin a priority zone of the national HIV/Aids plan.
The government is attempting to minimise the risk to the area
They have plans for public health campaigns to warn people of the dangers, and to educate them about the use of condoms.
QMM talks of strict rules for its staff, forbidding sexual contact between workers and local people.
But in a project set to last up to 60 years there are doubts this will work.
Jean Chrysostome Rakotoary, director-general of the National Office of the Environment said they are not going to screen the workers coming from South Africa.
The ilmenite mine will be a mixed blessing
He was the man who gave the government go-ahead for the mine.
Screening would be discriminatory, he argued, and against the principles of human rights to which the government is committed.
But behind the scenes, it is believed there is a plan being discussed by the Health Ministry and the mining company, that QMM would insist foreign workers come with a level of medical insurance not available to anyone who tests HIV positive.
The ilmenite mine will be a mixed blessing, not just for outsiders who want to preserve the natural flora but also for the locals.
They are desperate for the jobs and prosperity they hope the mine will bring, little knowing, or caring, about the problems that may come alongside.
BBC Radio 4's Crossing Continents was broadcast on Thursday, 3 November, 2005 at 1102 GMT.
The programme was repeated on Monday, 7 November, 2005 at 2030 GMT.