Sudanese refugees in Egypt expect the worst to come, with the United Nations refugee agency (UNHCR) suspending most of its medical treatment programmes because of a marked drop in funding to it.
The programmes suspended by the agency are essential, opening the door for serious effects on thousands of refugees in this economically-struggling country, who expect to be left without access to medical treatment, child protection services and other forms of aid.
"The suspension of these services is very bad news for refugees with health problems," Fatma Aly Mohamed, a Sudanese refugee in her late forties, told The New Arab.
"It just means that the refugees will be left to face the prospect of death in the absence of the required health services," she added.
Mohamed's 13-year-old son, Saleh Osman, suffers from recurrent epileptic fits and convulsions. The boy has to get treatment and undergo vagus nerve stimulation therapy, things the UNHCR used to make available in the past.
Now, however, the agency has stopped offering the same service because of the lack of the required funds, according to Mohamed.
"The suspension of these services poses grave dangers to my son's life," she said.
As they do this little boy, funding shortages and the subsequent suspension of basic health programmes by the UNHCR are expected to negatively affect all the refugees registered with the agency in this country.
Around 902,700 refugees from 58 countries were registered with the agency in January of this year. Those registered included 630,958 Sudanese nationals.
Those registered with the agency are only a fraction of the Sudanese who fled fighting in Sudan and ended up here.
Millions of Sudanese nationals were displaced, both internally and externally, soon after the civil war broke out in their country in mid-April 2023.
Those seeking refuge from bloodshed inside Sudan ended up in neighbouring states, especially Egypt, Chad and Ethiopia.
However, Egypt is by far the largest neighbouring recipient of Sudanese refugees. The North African country has so far received 1.5 million refugees since the beginning of fighting in Sudan, according to the UNHCR.
When they arrived here, the Sudanese refugees joined millions of other refugees and asylum-seekers from other countries.
In all, Egypt hosts around 9 million refugees, the International Organisation for Migration says.
These refugees put a strain on Egypt's economy, which already reels under the effects of the Russian-Ukrainian war and the regional turmoil induced by the current Israeli war on Gaza.
Fettered access
Like it does with all the refugees it hosts, Egypt allows access to its own healthcare system to the Sudanese refugees.
Nevertheless, the same healthcare system is usually overwhelmed and suffers a marked shortage of financing, which makes demand at the nation's hospitals significantly dwarf the services these hospitals are capable of offering.
Local right to health groups have been lobbying for an increase in the national health budget for several years now, but with Egypt's tough economic conditions, the government seems to have limited abilities to raise this budget.
The 2025/2026 state budget, which will start coming into effect as of June, includes a notable increase in allocations to the health sector, but it remains to be seen whether this addition of funds to the health budget will be enough to meet growing demand for health services.
These difficult financial conditions leave their toll on Egyptians who have to pay for their medical treatment most of the time, even as the Egyptian government spends billions of dollars to make free medical treatment available for the largest number of financially-incapable citizens.
Despite the creaky nature of the free medical treatment system, the same system is not available to the refugees living in Egypt, who have to depend on support by the UNHCR, pay for their own medical treatment or seek help from a local charity.
The suspension of the agency's essential medical programmes because of the funding shortage just means that the most of the refugees have only one option available to them: fending for themselves.
The programmes suspended include cancer surgery, chemotherapy, heart surgery, and medication for chronic diseases, such as diabetes and hypertension.
When the agency suspended its services to Mohamed's son, she had to seek the same services at a private medical centre in Faisal, a sprawling neighbourhood of Giza province where tens of thousands of Sudanese and other refugees live because of cheap housing.
Nonetheless, with the cost of treatment at the centre reaching 5,000 Egyptian pounds a month (roughly $500), Mohamed had to stop going there.
Her son now has to suffer the complications of his seizure alone at home, which puts immense psychological pressure on the family.
"Most of the people with health problems I know had to stop receiving treatment, which makes them prone to slow death," Mohamed said.
Sorry realities
Risks to the close to 13 million refugees registered with the UNHCR around the world were highlighted by the agency's officials in Geneva recently.
The funding shortages can cause approximately 12.8 million refugees, including 6.3 million children, to be deprived of critical healthcare services in 2025, according to UNHCR Head of Public Health, Allen Maina.
"The current humanitarian funding crisis, exacerbated by declining healthcare spending in host countries, is undermining the scope and quality of public health and nutrition programmes for refugees and host communities," Maina said.
"It is disrupting access to essential services and increasing the risk of epidemics, malnutrition, untreated chronic conditions, and mental health issues," he added at a press briefing on 28 March.
In Egypt, the suspension of UNHCR health programmes is expected to affect around 20,000 patients, especially those escaping the violence in Sudan.
UNHCR Public Health Officer in Cairo, Jakob Arhem, said many of the Sudanese families who fled the war arrived here with members who suffer health problems they could no longer find treatment to in Sudan.
"The consequences for people who will no longer get our support are hard to measure, [but] many of them will not be able to find the means to pay for healthcare themselves, and they will get sicker, weaker and many will die," the UNHCR site quoted Arhem as saying.
In 2024, the agency received less than 50 percent of the $135 million it needed to help more than 939,000 registered refugees and asylum-seekers from Sudan and 60 other countries now living in Egypt.
The drastic reduction in humanitarian funding since the start of this year, it said, has led to critical shortages, forcing it to make impossible choices over which life-saving programmes to suspend or maintain.
Spectre of death
Some of the Sudanese refugees who have arrived here launched their own businesses, especially in the food and clothing sectors, while others joined in the local labour market, particularly doing menial jobs at bakeries, supermarkets and restaurants.
Nonetheless, the vast majority of the refugees remain without work, which means that they find it hard to cater to their own basic needs, let alone the cost of their medical treatment, according to Sudanese community leaders.
"Unemployment is so high among the refugees and those who have work receive very meagre salaries," Motassem Mohamed, a Sudanese community leader, told TNA.
"These tough conditions make the suspension of UNHCR health programmes fatal for some of these refugees who cannot pay for their treatment," he added.
Mohamed says her son may need epilepsy surgery, if the medicines, which he stopped getting because of the lack of money, do not prove effective in managing seizures.
"I don't know how much the surgery can cost, and I don't want to ask, simply because I have no money at all," Mohamed said.
"All I have to do now is to stop buying medicines, stop going to the vagus nerve stimulation therapy and wait for intervention from God," she added.
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