The Kere is a recurrent famine occurring in the south of Madagascar that emerged substantively in the 1930s. Each major event claims thousands of lives and keeps many in a cycle of impoverishment, despite the existence of various aid-based responses. This assessment presents qualitative research exploring two Kere-affected communities’ experiences of the phenomenon. Through focus group discussions, we learn that the Kere is a complex social-ecological disaster, compounded by an intricate chain of causation and impacts. Seeking a deep understanding of affected peoples’ perceptions and experience of the phenomenon, this paper challenges the idea that the Kere is a famine caused by recurring drought that can only be solved with provision of water and aid-based solutions. Based on community views and research literature, and the application of Ostrom’s social-ecological systems framework, we demonstrate that the Kere is a phenomenon compounded by multiple interacting, debilitating factors including deforestation, drought, pests and diseases, food insecurity, extreme poverty, lawlessness, and political malaise; thus, solutions require a comprehensive, sustained, holistic response.