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A medium-sized town, Nagua's economy relies primarily on the production of agricultural products, principally rice, coconuts and cacao. Located on the Northeast coast north of the Samaná Peninsula, Nagua lies on the highway leading from Puerto Plata to the town of Samaná. Nagua is located below sea level, a fact which some believe indicates the town faces an imminent flood that could destroy a substantial part of town. In fact, during the reign of Rafael Leónidas Trujillo (1930-1961), the neighboring town of Matanza (also below sea level) was destroyed by flooding caused by a magnitude 8.0 earthquake in 1946 (see 1946 Dominican Republic earthquake. Many residents of Matanza chose to resettle in the area that is now Nagua. Matanza (now known as "Matancita") is now a small town just south of the city limits of Nagua.
Foreign tourists generally bypass Nagua, as its tourist infrastructure is only minimally developed and the area does not boast any white sand beaches.
Habitat for Humanity works in Nagua, drawing in volunteers from around the world to work and, for a period of time, live in this community.