It is sadly known that over the past decades Isla Hispaniola (Haiti and the Dominican Republic) has been exposed to the devastating passage of several hurricanes and tropical storms. Territories that are economically weak and extremely poor in terms of natural resources have been shaken by severe flood events that caused the loss of thousands of human lives, displacement of people and damage to the environment. On May 24th 2004, the flooding of the trans-boundary river Soliette killed over 1000 Haitian and Dominican people, wiping out villages and leaving behind desolation and poverty. After this catastrophic flood event, the General Direction for Development and Cooperation of the Italian Department of Foreign Affairs funded through the Istituto Italo-Latino Americano (IILA, www.iila.org) an international cooperation initiative (ICI), coordinated and directed by the University of Bologna. The ICI involved Haitian and Dominican institutions and was twofold: (a) institutional capacity building on flood risk management and mitigation measures and policies; (b) hydrological and hydraulic analysis of the May 2004 flood event aimed at formulating a suitable and affordable flood risk mitigation plan, consisting of structural and non-structural measures.