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The main economic activities in Madi Okollo county are fishing in the Nile and peasant farming of sesame and cotton. Animal husbandry is also practised, with goats and cattle being the main animals kept. Goats do so well that Madi Okollos' are sometimes termed Madi Goats in the region. However, because of drought and degradation of soil, the number of goats in the county (especially Okollo sub-county) has dropped.
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