Flooding in West Africa has left more than 159 people dead and 600,000 displaced according to UN estimates. MSF has reinforced its teams in Burkina Faso and Niger to provide assistance, along with the Ministry of Health, to the displaced people. September 1 was no ordinary day. In Ouagadougou, the capital of Burkina Faso, 26.3cm of rain (a quarter of the annual rainfall) fell within 12 hours. More than 24,000 houses were destroyed and 150,000 people, one inhabitant in ten, were displaced. On the same day, in Niger, in the city of Agadez, 3,500 houses were destroyed and 28,000 people were affected by flooding. MSF teams in Burkina Faso and in Niger immediately took action to estimate the needs and to ensure, along with the Ministry of Health, that the victims had access to medical care, and that hospitals were operational. "The population of Ouagadougou acted both swiftly and massively," said Mohamed Morchid, head of the MSF mission in Burkina Faso. "These have been particularly massive floods. Nobody can recall such large floods in recent decades, but there is no chaos. Many displaced are being sheltered by relatives, tens of thousands are in schools or sometimes in health centres. "They are being given food and basic supplies. The Ministry of Health is providing free consultations at clinics set up at some of the gathering sites. But not all sites are covered and there is a lack of medicine. The added-value MSF has in this context is mainly its capacity to respond quickly to selective medical needs while large-scale measures are being set up." Five mobile medical teams are treating the displaced people in two districts in Ougadougou, Bogodogo and Boulmiougou. "We're seeing patients with infected wounds, injuries they received when they tried to save their belongings as the water rose," said Morchid. "Many people are also suffering from diarrhoea, certainly linked to the worsening hygiene conditions since the floods. Then there are also the usual diseases - malaria and respiratory and skin infections. We treat them on site because they can't go to their usual health centres." MSF teams are also distributing soap to the flood victims and evaluate access to drinkable water and hygiene conditions. They are constructing latrines and temporary showers at some of the gathering sites. The capital's main hospital, Yalgado, was damaged and some departments, the dialysis and the casualty departments for example, are no longer functioning. MSF has set up two 12-bed tents to increase patient capacity in the emergency paediatrics department in Bogodogo's district hospital. Medicines are being donated to MoH clinics at sites where flood victims have gathered In Agadez, in Niger, MSF activities include a mobile clinic, distribution of basic hygiene supplies to 2,000 families, and the construction of latrines in schools that are providing temporary shelter for the flood victims. During the rainy season, from June to September, flooding occurs in several western African countries. Two years ago, the toll was heavy: 300 deaths and 800 000 people affected across the region. This year, the number of deaths is particularly high in Sierra Leone (103 of the 159 dead).