Unveiling the Hidden Epidemic
Fatal epidemics of Chronic Kidney Disease of non-traditional origin (CKDnT), unrelated to diabetes, hypertension, or other known risk factors, are occurring globally. The precise etiology of this condition remains uncertain. Extensive documentation exists regarding the occurrence of this condition among agricultural workers in Central America, who endure arduous manual labor in extremely hot environments. The evidence supports interventions aimed at mitigating these risk factors and disrupting the causal chain. While research has predominantly focused on agricultural settings, CKDnT has also been observed in construction workers and miners who share similar exposures to manual labor and heat stress.
Unraveling the Threat to Migrant Workers
As global citizens, we cannot remain indifferent to the alarming mortality rates and disproportionately high prevalence of kidney failure among young Nepalese migrant workers in the Gulf States and Malaysia. Inadequately protected workers, who toil outdoors in extreme temperatures, face the grave risk of succumbing to repeated heat stress, including heat exhaustion and heat stroke. While climate change and global warming affect us universally, it is the low socio-economic countries that bear the brunt of these impacts.
Nepal Development Society (NeDS) and La Isla Network (LIN) officially forged a partnership in 2022, aiming to comprehensively ascertain the magnitude and impact of CKDnT and its intricate connection to climate change and global warming. NeDS, a non-profit, non-governmental organization headquartered in Nepal, stands as a pioneering force in the realm of public health. It oversees the largest non-communicable disease (NCD) cohort in the country. Collaborating with NeDS, La Isla Network (LIN) emerges as the foremost global organization and consultancy dedicated to occupational health research, with a specific focus on safeguarding workers in a progressively warming world. LIN’s decade-long track record encompasses conducting scientific research, advocating for policy reforms based on data-driven insights, and working steadfastly in Mexico and Central America to protect sugarcane farm workers and other at-risk laborers.
Urgent need for intervention
By joining forces, this endeavor will enable Nepal to benefit from LIN’s experience gained in Central America. Our collective efforts have already garnered the attention and involvement of esteemed journalists from prominent outlets such as TIME, The Washington Post, The Guardian, and Arte, who have extensively covered this issue. Recognizing the crucial importance of adequately documenting the problem, we have embarked on a clinic-based prevalence study of end-stage renal disease (ESRD) within the clinics of the National Kidney Center in Kathmandu. Our objective is to characterize the disproportionately affected population accurately. Building upon this foundation, we plan to expand the prevalence study to a larger clinical setting, ensuring that the generated data becomes more representative of the national population.
Furthermore, this fall, we intend to initiate a population-based prevalence study coupled with a socioeconomic assessment, employing comparable protocols to those employed in Mesoamerica (REAL and DEGREE).
Our collective efforts will enable the Nepalese health system to gain a deeper understanding of the actual burden of kidney disease, its associated risk factors, and the economic costs involved. This knowledge will pave the way for effective primary and secondary prevention strategies. The systematic and scientific study of this issue will generate invaluable data, empowering policymakers and government bodies to implement necessary changes to safeguard workers and prevent the disproportionate mortality rates and high prevalence of kidney disease, as well as the resulting cardiovascular burden.
As we delve into studying the risks, identifying risk factors, and advocating for policy changes, it is crucial that we take decisive action in the midst of uncertainty. The persistent occurrence of fatalities and fatal kidney disease necessitates an immediate response to protect workers. By actively engaging with the government of Nepal and destination countries, we will strive to enhance awareness, develop educational materials, and distribute them among migrants, their families, the local community, and various stakeholders at different levels. These materials will specifically focus on preventing heat-related health issues, including CKDnT.
In conclusion, we hope that this concise overview has provided you with a clear understanding of our organization, the work we do, and the vision of our project. We humbly request your support in furthering our efforts to address the critical issue of Chronic Kidney Disease of non-traditional origin (CKDnT) among returning migrant workers (RMWs) in Nepal. Your invaluable support will serve as a catalyst for progress, allowing us to expand our reach, amplify our impact, and work towards a future where workers are protected from the devastating consequences of fatal kidney disease.
Any donation will go to LIN, an initiative of La Isla Foundation, a registered charity with 501(c) and your donation will be tax deductible per IRS regulations. The donation will exclusively be used by NeDS to support this project and to advance public health awareness in Nepal.
