Kathmandu, Nepal – For four years, Jit Bahadur Gurung spent 12 -hour teams toasting meat on charcoal in a restaurant. Water breaks and bathroom visits were luxury. Rest has rarely come – a day off every two weeks.
When Gurung undertook a trip to the Himalayas of Gorkha’s Himalayas to Nepal to the stifling sand of Saudi Arabia at the age of 22, he thought he was so strong and in good health that he could manage n ‘I matter what. The agency that helped him cross the process told him that the work of a server would be easy.
He was no stranger to hard work.
Gurung had spent a good part of his adolescence to maintain the small farm of his family, casually the subsistence of the stubborn soil. Despite long hours in the fields, the harvest rarely stretched to feed your family throughout the year. The opportunity to work abroad seemed to be a rescue buoy – a chance to give his daughter the education he never had and to comfort his aging parents.
Four years after the server’s start, a few days before a vacation planned to see his family, he realized that his legs were swollen and each breath became a battle. When he went to the hospital, he discovered that his two kidneys had failed.
It was time to go home.
Now 32 years old, Gurung is at the National Kidney Center in Kathmandu to obtain dialysis three times a week. Its formerly strong framework is fragile and any physical work, including the lifting of heavy objects, could be fatal.
Each day, around 1,500 young Nepalese leave their country to work. Their benefit fuels a significant part of the economy of Nepal, the shipments representing more than 25% of the gross domestic product of the country in 2024. But this prosperity has a cost: young adults in good health come home with kidneys failed.
“The country benefited from funding, but families had to pay a higher price,” said Dipeh Ghimire, deputy professor of sociology at the University of Tribhuvan, Kathmandu. The burden is particularly important because affected people are in their first years of productivity, he said. The average age of a Nepalese migrant worker is 29 years.
While temperatures are increasing in the Gulf countries, there is a growing global alarm on the increase in kidney diseases in workers doing intense physical work in extreme summer heat with limited water breaks and restricted access in the bathrooms.
Dr. Rishi Kumar Kafle, a nephrologist who was the pioneer of dialysis in Nepal, says that migrants in the Gulf countries and Malaysia often develop a kidney disease in the three to four years of resettlement. Since the kidneys regulate the fluid balance, the organs are particularly vulnerable to extreme temperature. Although the disease is not caused by a specific factor, Kafle says that the screening for returnees over the years suggest a strong link between geographic migration and a drop in kidney function.
Behind the National Kidney Center is a house where 12 dialysis patients and their families have found a temporary shelter. Nearby, Gurung rent a room for 6,000 Nepalese rupees (43 US dollars) per month, sharing the tight space with his wife and daughters – a kitchen in a corner, a bed in another, and his luggage of Arabia Saudi stacked against the wall.
Three times a week, Gurung is heading for dialysis. Unable to work, he finds the community among other patients, their days marked by card games and shared stories. His wife has become family support for the family, breaking 8,000 rupees ($ 57) each month thanks to all the work she can find. But there are many financial difficulties. There were times when Gurung had to go on the streets.
During a decade, the care of a renal patient cost the government 3 million rupees (21,669 dollars) of dialysis alone, while a patient pays an additional 2 million (14447 dollars) on their own pocket, says Kafle .
Since 2016, Nepal has offered free renal dialysis and transplants, plus an allowance of 5,000 rupees (36 dollars) for patients with kidney failure.
While Nepal faces several serious illnesses, Dr. Bikash Devkota, additional health secretary of the Ministry of Health and Population, said that dialysis consumes most of health care spending – 2.1% the government’s health budget.
However, Gurung spends around 10,000 rupees ($ 1,382) per month on medical and medication tests.
When Global Press Journal visited the National Kidney Center in January, a third of patients with transplantation and dialysis were migrant workers. The doctors of the center say that this has been the case for many years now.
Like Gurung, workers who go to the Gulf countries and Malaysia, 59% are not qualified. Kafle says that being unskilled makes it more likely to obtain jobs that require sustainable lasting working conditions, endless operation and hours of physical work – often in extreme heat.
The Gulf Cooperation Council, including Bahrain, Qatar, Saudi Arabia, Kuwait, Oman and United Arab Emirates, recorded several of the hottest days ever since 1940 in the third week of July 2024. In Riyadh, the capital of Saudi Arabia, this month reached 116 degrees Fahrenheit (46 degrees Celsius).
Despite the increase in temperatures, many Gulf states do not have strict work prohibited at noon. Those in place “only prohibit outdoor work during predefined hours during summer months instead of using the temperature index of the humid bulb globe, a widely used index that measures thermal stress Professional based on air temperature and relative humidity ”, according to human rights shows.
However, the Gulf continues to be the most popular destination for Nepalese migrants.
After the boom in the construction of the 1970s in the Gulf, Nepalese workers saw important workforce opportunities in these countries and began to settle there in the mid-1980s. In 1990, shipments of funds of these workers contributed approximately 2% to the GDP of Nepal. Today, nearly 3.5 million Nepalese work abroad, most of them in the Gulf countries and in Malaysia.
Sagar Tamang has moved to Malaysia from the district distant from Nepal Sankhuwasabha with a dream of winning enough to build a concrete house in his village, one with robust walls and a roof that does not flee.
In Malaysia, he spent two years in agriculture, working from 12 hours to plant vegetables and pick fruit. But that didn’t pay her enough to realize her dreams. He therefore chose a “best work”, working as a security guard. He worked there for six years, undergoing quarters of 36 hours, he said. Each month, he carefully had 40,000 rupees ($ 289) to return home. With this money, his mother built a house – just as Tamang had dreamed.
The results of the years of work became clear when a concussion in the workplace has sparked serious health complications. During a five -day stay in a Malaysian hospital, he learned that his kidneys failed.
Emerging research shows that even for otherwise healthy workers, working in hot conditions without rupture leads to slow and subtle aggressions against the organ which often go unnoticed until it is too late. In a study in 2021 of the University of Bournemouth, 92.1% of Nepalese nephrologists indicated that most of the returnees suffering from diseases linked to the kidney did not have previous comorbidities.
Most migrant workers are deprived of basic health education and critical information, leaving them unprepared and unprotected, explains Rajendra Bhandari, president of the Nepalese association of foreign job agencies. This is aggravated by a migration system plagued by inadequate policies, poor access to health care and illegal travel and work problems, which hinder all screening and health protections for appropriate workers, explains Bhandari.
The government says it provides free dialysis to affected citizens. But Dandu Raj Ghimire, spokesperson for the Ministry of Labor, Employment and Social Security, says that “if workers do not pay attention to what they eat or do not eat and do not fall badly, c ‘is the responsibility of the individual, not that of the government. ”
Despite the search for a kidney donor, Gurung maintains an unshakable mind. Looking at his young person – energetic, full of life, entering the unknown – he finds no room for regret. “This suffering was part of my fate,” he says.
