Study flags major healthcare gaps in Assam’s flood-prone riverine villages

Guwahati: Strengthening rural sub-centres (elevated above flood waters), ensuring round-the-clock boat clinics, restoring transport links, and embedding flood preparedness at the community level are critical solutions to Assam’s recurring flood–health crisis, a new peer-reviewed study has concluded after documenting how annual inundation in riverine villages systematically blocks healthcare access and drives preventable disease.

Published in 2023 in The Open Public Health Journal, the research offers one of the most detailed ground-level assessments of morbidity and healthcare access in flood-prone riverine villages of Assam, focusing on six chronically inundated settlements in Lakhimpur district along the Brahmaputra valley.

Drawing on a mixed-method study of 83 households covering 475 people, the research reveals that acute illnesses dominate both flood and non-flood periods but intensify sharply during floods.

Fever emerged as the most widespread ailment, rising from 28.4% in normal conditions to 42.7% during floods. Skin infections, diarrhoea, dysentery, cough, and pneumonia showed notable increases during inundation, directly linked to contaminated water sources, poor sanitation, and overcrowded living conditions.

The study identifies three recurring structural failures that cripple healthcare access during floods: absence of transport, non-functional health sub-centres, and financial hardship.

Riverine char and chapori villages, often physically cut off from the mainland, face the severest impact as roads submerge, boats become scarce or unaffordable, and sub-centres operate without staff, medicines, or electricity. Underlying socio-economic fragility compounds the crisis.

Nearly half of the surveyed households earn below Rs 1 lakh annually, over 91% live in kutcha houses, and 47% lack toilet facilities, forcing open defecation. These conditions sharply increase vulnerability to water-borne and vector-borne diseases during floods. Children under five, women, and the elderly were found to be disproportionately affected.

While state-supported boat clinics provide a vital lifeline to isolated villages, the study notes that their reach and frequency remain inadequate during peak flood periods. As a result, residents increasingly depend on para-professionals, pharmacies, and informal providers, exposing persistent gaps in Assam’s public health delivery during disasters.

The study concludes that flood-resilient health infrastructure, fully functional sub-centres with adequate manpower, assured emergency transport, and community-driven preparedness and awareness programmes are essential to break Assam’s long-standing cycle of floods, illness, and healthcare exclusion.