India is one of the most flood prone countries in the world, flooding annually about 9 million hectares and accounting for one-fifth of global flood deaths. Approximately 56.5 % of flood-affected Indians live in Bihar. Out of 38 districts in Bihar, 22 are flood prone, including Begusarai. The life line to the community is the Primary Health Center (PHC) which is at stake during a disaster such as floods.

To study the status of primary health care in rural parts of Begusarai during recurring floods, a survey was undertaken to analyze the preparedness and response mechanism at various hospital levels. The status of rural hospitals during a flood was represented by a case study on the PHC of Bakhri block of Begusarai district. To determine the prevailing situation during floods, the chief medical officers of each level of health care centers were interviewed.

The PHC of Bakhri caters to a population of about 408,896, which is four times the normal load for a PHC. In 2007, it was affected severely by flooding from the Baghmati River. The PHCs that were studied perennially face a shortage of human resource and infrastructural support. This is compounded by unsafe locations and structural hazards associated with the hospital building, rendering the working conditions unsafe for the medical team during disasters.

This paper envisages the functionality and challenges of healthcare providers during floods despite their limited available resources. The prevailing case scenario demonstrates the challenges in rural India, and the best practices for safe rural hospitals in coping with disasters in a resource-poor setting will be discussed.