Background Community perceptions and response to natural disasters can determine survival and the extent of long term economic, social and psychological impacts. In India, floods have the largest numbers of casualties every year. Assam, a state in north-east India is especially vulnerable to natural disasters due to its geographic location, which make it prone to earthquakes, and flooding as the second largest river in the world, the Brahmaputra, traverses through it. The state also has one of the highest drowning mortality rates in India. With climate change exacerbating the risk and consequences of natural disasters it is important to investigate how communities respond to and are affected to identify priority areas for future interventions and mitigation strategies.

Methods This was an exploratory qualitative research study guided by a grounded theory approach. Focus group discussions (n=5), in-depth interviews (n=9), and observations were done with community leaders from the Char population residing on sand-bars in lower Assam.

Results Drowning among young children inside their homes while waiting for flood water to recede was a major concern. Contextual factors related to poverty, loss of land and livelihoods, river erosion, and water pollution created major challenges to communities in responding to and recovering from natural disasters. Disaster management infrastructure or rehabilitation practices were lacking. Communities highlighted the need for interventions focused on environment modifications.

Conclusion Sustainable, local solutions to build resilience and manage flood risks and other hazards are much needed. Emergency preparedness practices and training, hazard mitigation strategies, and post-disaster relief needs to be strengthened to reduce long-term social and economic impacts. This can be achieved through local stakeholder support for building sustainable solutions, and greater political will at the national level to addressing disaster risk reduction and response. Implementation of existing disaster-related policies needs to be ensured to minimise loss of life and further environmental impacts.