Sanitation is an issue often neglected in development decision making. This situation becomes more evident under the extreme conditions of a disaster aftermath, where lack of sanitation can expand from a mere inconvenience to a full-scale secondary disaster causing epidemic outbreaks, permanent degradation of water resources and social unrest. Furthermore neglecting the importance of sanitation during disaster rehabilitation may jeoardize the sustainability of entire rebuilding projects. This paper is an attempt to delineate and suggest solutions to the critical problems encountered in providing proper and adequate sanitation during refugee situations and post-disaster rehabilitation projects in underdeveloped tropical countries. The author records the experiences gained in several projects carried out as a partnership of Government and NGO sector organizations during the aftermath of the 2004 Tsunami incident in Sri Lanka. The paper also discuss how "proper and adequate sanitation" can be ensured through a proper disaster management framework. The paper would critically review the institutional drawbacks and failures which lead to the above mentioned unfortunate situations.