Back-to-back cyclones have torn through Madagascar in just ten days, killing dozens of people and affecting more than 450,000, with entire neighbourhoods in Toamasina devastated and communities cut off from food, clean water and health care. Homes, schools, health facilities and livelihoods have been destroyed, and rising floodwaters are increasing the risk of disease outbreaks as thousands of families are left without shelter or basic services. The Malagasy Red Cross Society, with support from the IFRC, is delivering life-saving relief including emergency shelter, clean water, health services and early recovery assistance, but urgent funds are needed to reach 45,000 of the most vulnerable people and scale up before conditions worsen.