This paper explores the options that can be used by aid organizations working in human settlement development to more effectively address disaster risk management. Qualitative research was carried out in El Salvador at both the household and institutional levels – to analyze the needs, capacities, and perspectives of slum dwellers and aid organizations. A clearer understanding of the gaps between what households need and undertake to deal with disasters and risk, and how organizations support them, yields important insights for the restructuring of development aid. At the household level, the research reveals a huge variety of crucial but somewhat weak coping strategies. At the institutional level, organizational structures and mechanisms for social housing provision and financing offer a potentially powerful platform for tackling disaster risk.