Horse cart drivers transport goods and passengers through deep flood waters Saturday in Sicap Mbao, a neighborhood on the outskirts of Dakar, Senegal. Torrential rains have lashed Africa’s western coast for the past three months, killing 159 people and flooding the homes and businesses of more than 600,000 others, according to the United Nations Office for the Coordination of Human Affairs.

Fass Mbao, Senegal ? The only piece of furniture that survived the most recent flood in Fatou Dione’s house is her bed. It’s propped up on cinderblocks and hovers just above the water lapping at the walls of her bedroom.

The water stands a foot deep throughout her house. She shakes off her wet feet each time she climbs into her bed. To keep it dry, she tries to place her feet on the same spot so that only one corner of her mattress becomes moist.

Torrential rains have lashed Africa’s western coast for the past three months, killing 159 people and flooding the homes and businesses of more than 600,000 others, according to the U.N. Office for the Coordination of Human Affairs.

They include the patients of one of Burkina Faso’s largest hospitals who had to be carried out on gurneys after water invaded the wards. They include those living on the banks of a river in northern Niger, whose homes were swept away when a dike burst under the weight of the rain. And they also include tens of thousands of people like Dione whose homes took on a foot or less of water and whose ordeals are not a priority for the country’s overwhelmed emergency response teams.

While the rains have been extreme, people are also to blame, said Col. Singhane Diagne, spokesman for the country’s firefighters. The home where Dione lives should never have been built, he said. During the droughts of the 1970s, people began illegally building houses in the low-lying marshes that surround Dakar, the Senegalese capital. When the drought ended and the rains returned, these bowl-shaped neighborhoods began to flood.

“Every year we pump the same houses. Not just once. Over and over. You pump the water out — and it comes right back. Like a boomerang,” says Diagne. “These people need to leave.”

Among the six countries where the flooding has been most severe — Senegal, Sierra Leone, Mauritania, Burkina Faso, Niger and Ghana — the neighborhoods most affected are the poor ones. Typically these communities are the result of urban sprawl, built without municipal approval, using unsafe materials. In Ouagadougou, the hard-hit capital of Burkina Faso, many of the flooded homes were made of nothing more than clay.

In Senegal, the government has built a satellite community of around 150 homes outside the flood plain, but the homes are already nearly full. The U.N. estimates that just in Senegal, 264,000 people have been affected by flooding. And although many families say their homes flood every year, they say that they do not have the money to move.

As the rain continues to come down, families are waging individual battles with water. About 20 miles away from Fass Mbao, in the flooded suburb of Tivaouane, 37-year-old Mansour Ndiaye tries to scoop water into a bucket using a large sponge. The courtyard to his family’s home is a pool. He had managed to dry out the hallway of his family’s home by the time the afternoon rain started. “I’m doing the best I can,” he said.

His elderly neighbor, Assane Sock, had spent the day before carrying buckets out of his house. The water seeped back in overnight. He spends the afternoon looking for pieces of wood and stones to try to elevate his furniture and his Singer sewing machine. He’s a tailor, he explained. And he can’t sew if his clients’ clothes are trailing in the water.

“I live like a fish,” he said. “I eat in the water. I sleep in the water. And now I work in the water.”

Limited aid is being distributed to the most affected regions. The World Food Program hopes to give out food rations to 125,000 people, including in Rosso, the small community on the banks of the Senegal River in southern Mauritania.

The water was so deep in some neighborhoods that people were forced to swim out.

“I lost my entire house. All of my furniture. All of my things. We swam for 45 minutes to get out of the flooded area,” said 54-year-old Marieme Fall in Rosso.

Even as the aid begins to arrive, the rain continues to fall. On a recent evening in Fass Mbao, 40-year-old Saliba Ndiaye was hurrying to get home. The dun-colored water on the main road came up to her hips. As she pushed her way through, it started to pour again. She was soaked by the time she pushed open the door to her house, where her six young children were waiting. Unlike her neighbors, her floors are dry, even though rain sprays in through a hole in the roof.

She grabbed her baby and pulled him close, his dry body smack against her soaked, brown shirt. He nursed, oblivious to his wet mother. “We’ve learned to live with the water,” she said.