About 50 cases of avian influenza (bird flu) have been identified in Egypt since 2003; 22 people have died.
The aim of the research was to design recommendations for pandemic preparedness based on a bottom-top approach that engages migrant communities.
"Most health programmes in Cairo target UNHCR [UN Refugee Agency] recognised refugees. Rejected asylum-seekers, non-registered refugees and economic migrants are a particularly vulnerable group," said Roberto Pitea, research and project assistant with IOM. They tend to live in crowded urban areas where poultry are reared on rooftops, which puts them at risk.
Sudanese migrant and refugee communities were the focus of the study. "The Sudanese community tends to access health services provided by non-governmental actors, whereas pandemic response will be led by government," he said.
The Integrated National Plan for Avian and Human Influenza and the National Pandemic Preparedness Plan are Egypt's answer to a possible pandemic. "Neither of these plans have a migrants' component," said Rebecca Dibb, one of the main researchers on the report produced by the Centre for Migration and Refugees Studies (CMRS) at the American University in Cairo.
In Cairo, the research team gathered data from Sudanese migrants about access to health care, water and sanitation, and also tested awareness about avian influenza.
"The findings reveal that Sudanese migrants would be vulnerable in a pandemic, not only because they do not feature in the national pandemic preparedness programme of Egypt, but also because they do not have a sufficient level of awareness of the pandemic, and they are rarely mainstreamed into the work of civil society and international organisations involved in pandemic preparedness work," said the report, launched on 22 October.
Coordinated efforts are seen as vital to bridging this awareness gap: "National actions must be combined with simultaneous actions in the community, by the media and other relevant sectors. Combined efforts can ensure the Sudanese community is equipped with the awareness required to see behavioral change," said Yasmine Moataz, another researcher who worked on the report.
One challenge is the degree of mistrust between refugee communities and the authorities.
"There is mistrust of information especially from the authorities in Egypt and in the public services. Migrants see that the services provided are discriminatory and that it's a lower service quality than that provided by NGOs," said Dibb.
A young Sudanese migrant attending the presentation of the report said: "When refugees here get serious diseases like HIV/AIDS, they get deported. How can I trust the government?"
"Trust should be established between the different parties. If there is networking between the two stakeholders [the government and NGOs], it is going to be better for the migrant and refugee communities," said Moataz.
The report recommends NGOs advocate migrant-sensitive health policies to increase the level of trust between the Sudanese and health service officials.
According to Africa and Middle East Refugee Assistance (AMERA), an NGO promoting the legal protection of asylum-seekers and refugees, Egypt hosts the fifth largest urban refugee population in the world, mainly concentrated in Cairo and Alexandria.
Official sources say there are 50,000 refugees in Egypt, but NGOs and researchers estimate there are about 500,000, mainly from Sudan, Somalia, Ethiopia and Eritrea.
According to Barbara Harell-Bond, an expert on refugees in Egypt, "estimates for the number of refugees in Egypt vary from 500,000 to 3,000,000; however. it is impossible to give an accurate figure."
Some say the Sudanese are the biggest foreign population in Egypt. The World Refugee Survey has estimated them at 23,700 in 2008. Many experts say there are far more.