Much of Madagascar had already been suffering from drought before the worst cyclone season in years hit the Indian Ocean Island, leaving aid agencies and the government struggling to help communities cope without food, schools and hospitals.

Madagascar has faced a string of calamities - cyclones, tropical storms, unprecedented flooding, and chronic drought in the south – which have been unusually severe, even for this natural disaster-prone island.

"Madagascar has been hit by seven cyclone systems and heavy rains, which caused flooding at nearly a national scale. This was peaked by Cyclone Indlala which hit us on March 15th with heavy winds and rains damaging roads, bridges and triggered landslides limiting access to many communities," said Krystyna Bednarska, the UN World Food Programme (WFP).

The combined effects of the disasters left nearly half a million people in need of humanitarian assistance by the end of March. Indlala, which struck the northeast and northwest, reaching wind speeds of up to 220 km per hour, created extensive damage and left 88 people reported dead.

"I lost everything and I don't know what to do. Our houses were destroyed and we lost all our possessions. We managed to save our cooking pots, everything else was taken by the river," Maronama, a 53 year old widow caring for five children and six grandchildren in Ambolodibe East village, in the northeast of the country, told IRIN.

Unusually early and heavy rains throughout most parts of the island at the beginning of 2007 flooded areas around the capital, Antananarivo, the northwest, the northeast, and the southeast, destroying an already poor road network and tens of thousands of hectares of rice, the staple food.

With access to affected areas severely limiting the delivery of humanitarian aid, WFP launched a four-week helicopter transport operation in the northwestern Antsohihy and Ambanja districts. The last delivery was made last week.

Relief items, including 100 metric tonnes of food, and various non-food items such as water filters, buckets, soap, tents and school kits – as well as food items such as high-energy biscuits – provided by the UN’s Children Fund (UNICEF), were airlifted to 20,000 isolated people.

“After the cyclone was gone I went round to all the villages and made a list of all the people affected. There are still communities out there that need help but they are very isolated,” said Paul-Bert Andralahy, deputy mayor of Ambolodibe East.

The remote community, with a population of around 1,150, received little warning Andralahy said: “Most people did not know a cyclone was coming. A nearby village has a radio and they heard about the cyclone, they came to warn us but nobody believed them.”

“Now life has become very difficult because we can't find enough food. The village lives mainly from cattle and the river flood took many of our animals... and the landslides and floods destroyed the rice fields."

Bruno Maes, UNICEF representative in Madagascar, said children were particularly at risk during emergencies. "As drinking water becomes scarce, the number of cases of diarrhoea increases and with the floods, the abundance of mosquitoes means increased risk of malaria." The trauma children have faced is also of concern, and it was important for them to be able to return to their “normal” lives as soon as possible, added Maes.

But for 14-year old Marie Floiere Julianna, school classes are still conducted in the rubble that used to be her classroom. “I can barely recognise my village. Everything is gone, the whole school is gone,” she said.

Almost 150,000 children have been unable to attend classes since the cyclone hit the region. According to Madagascar's Ministry of Education, 136 schools have been completely destroyed and 591 others have been partially destroyed since December 2006.

“Rebuilding schools will be a slow and difficult process, but communities have made great strides to bring education to the children, with churches and community halls being used as classrooms, local carpenters crafting school benches and tables, and masons transporting construction materials on their backs, often taking days to reach their destinations," a UNICEF statement said.

Madagascar is one of the world’s poorest countries, ranked 143 out of 177 on the United Nations Development Programme Human Development Index in 2006. Seasonal food insecurity is commonplace, with the lean season between December and April coinciding with the cyclone season.

Donors had covered 50 percent of a US$19.5 million UN Madagascar Cyclones and Floods Flash Appeal by 11 May. The appeal warned that “in-country resources have been exhausted,” due to the number and severity of crises the government and humanitarian actors have faced.