A recent study from the ENSURE-Nepal program, led by La Isla Network, unveils troubling statistics: migrant workers returning from hot climate regions face kidney disease, requiring dialysis at significantly younger ages compared to non-migrants. The report identified a disturbing pattern: migrant workers returning to Nepal from the Gulf states and other hot climate countries are developing severe kidney disease at a dramatically young age. A detailed survey of dialysis patients revealed that 1 in 3 men on dialysis had migration histories.
This phenomenon points to a critical occupational health crisis of kidney injury, which is largely preventable. The findings in this report support earlier data collected by La Isla Network and the Nepal Development Society showing that 31% of patients in two large dialysis centers based in Kathmandu are returnee migrants, and that 50% of returnee migrants were less than 40 years old.
The technical report was authored by Kristina Jakobsson and colleagues at La Isla Network, the Nepal Development Society, the National Kidney Center Nepal, the University of Gothenburn and Johns Hopkins University. Yoko Inagaki, researcher for ENSURE-Nepal affiliated with Johns Hopkins, said, “There is still much to learn about the relationship between working conditions and their impact on health. This report is a crucial step towards filling that knowledge gap.”
Three main patient groups were identified. The first is labor migrants, diagnosed abroad with kidney disease, starting dialysis already in their early thirties. A second group consisted of former labor migrants diagnosed in Nepal starting dialysis in their forties. The final was people who did not have a migration history, starting dialysis in their fifties.
Most importantly, this study points to an urgent need for interventions at workplaces abroad, including enhanced workplace heat stress management. Other preventative measures — pre-migration health screenings, health checks during migration and post-migration health follow-ups, and — are essential to address this growing crisis.
Sweta Koirala, Executive Director of the Nepal Development Society, said, “Is it not heartbreaking to know that the person’s median age at the start of kidney dialysis is 33 years? I cannot comprehend if it is a matter of pride that remittance supports maintaining the GDP in my country or we should level up our policies keeping in mind the occupational health hazard and increased number of disability-adjusted life years (DALYs).”
The alarming findings from this study call for immediate action by policymakers, employers, and health authorities globally. By understanding and addressing the root causes of this occupational health disaster, thousands of lives can be protected.
La Isla Network is an occupational health research and advisory nonprofit dedicated to ending heat-related illnesses among workers and their communities worldwide. We develop and implement data-driven worker protection and management assessment protocols to improve the resiliency of workforces and businesses to heat stress. Our work is backed by best-in-class researchers, industry leaders and government and multilateral institutions like the ILO. For more information please use our contact form.
ENSURE-Nepal is funded by a grant from the United States Department of State. The opinions, findings and conclusions stated herein are those of the author(s) and do not necessarily reflect those of the United States Department of State.
