Killed in the line of duty

Ramita Shahi, looks on forlornly as her husband’s body is taken out of the casket at Pashupati on Tuesday for cremation. Hemanta Shahi, 34, died in Saudi Arabia in October but his body only just arrived home on a flight that afternoon. Ramita has been grieving for three months; she has no more tears left.

Hemanta’s body, wrapped in holy yellow cloth, is placed on the pyre. His six-year-old son lights it. Ramita sits nearby for the two hours it takes for her husband’s body to be reduced to ashes which are swept into the Bagmati.

Nearly 87,000 Nepali migrant workers flew to Saudi Arabia in 2015 for work last year. Hemanta was among the 273 who died there. He travelled from his village in Salyan district to Dammam in Saudi Arabia in February. He wanted to earn enough to feed his family and educate his two children, who are enrolled in primary school back home.

There are nearly 2 million Nepali migrant workers in the Gulf and Malaysia, and another 2 million seasonal migrants in India. Between July 2014–July 2015, 1002 of them died – most of them in Malaysia. More than half the deaths are due to what is called sudden unexpected death syndrome (SUDS). The workers go to sleep and never wake up. Health experts say the cause is overwork, stress, dehydration and poor diet.

Click on the ‘Visible layers section to select data from July 2013- July 2014 and July 2014- July 2015

A breakdown of the deaths last year shows that most migrant workers in Malaysia and Qatar die of SUDS, while in Saudi Arabia it is mostly due to hit-and-run accidents on highways. Hemanta Shahi’s supervisor told his family he died in his sleep, but a death certificate stuffed in the casket says he died in a road accident. Hemanta’s family is lucky to have received his body, at least 70 bodies are waiting to be flown back to Nepal from Saudi Arabia alone.

Hemanta’s wife reached Salyan after the funeral on Thursday after 15 hours on a bus. Her husband died before paying the loan he took to go abroad, and the debt is now on her shoulders. She is Nepal’s latest migration widow, her children the latest orphans.

Every day at Nepal’s only international airport in Kathmandu, migrant workers queuing up to board planes for jobs overseas have to watch as coffins are unloaded from the cargo holds of aircraft.

On average, 1,500 Nepali workers fly out to the Gulf and Malaysia every day from Kathmandu Airport. And every day three bodies of dead migrant workers are air freighted back to Nepal.

Migrant workers are leaving to feed their families, educate their children, pay for the medical fees of aging parents. Most are cheated and abused, never earn what they are promised, are forced to return without savings and unable to pay back the loans they took to pay middlemen. Some don’t even come back alive.

Between July 2014 to July 2015, more than 500,000 Nepalis migrated to work in construction sites in the Gulf states and in palm oil plantations and factories in Malaysia. During the same period, more than 1,000 migrant workers arrived shrink-wrapped and stuffed into plywood boxes.

“The rate at which Nepali workers are dying abroad is alarming because they are too young to die,” says Ganesh Gurung, Nepal’s foremost expert on labour migration. “If young and healthy people die at this rate, we must find out why it is happening.”

Migrant workers who die abroad are not just young but also certified as healthy. Overseas contract workers must be between 18-45 and must also pass a medical test to be considered fit to work abroad. This is why public health experts find the high mortality rate surprising, especially considering that most are dying not from work-related accidents but of sudden heart attacks at night.

Of the 1,002 Nepali migrant workers who died last year, 245 were said to have died in their sleep of Sudden Unexpected Death Syndrome (SUDS). They were fine, fit and slept like they always did, but never woke up. Much less numerous were deaths in traffic and work-related accidents and suicides.

Autopsies are rarely performed, and most SUDS deaths are classified as ‘heart attacks’ or ‘natural’ since airlines do not carry bodies unless the cause of death is stated in the death certificate. Insurance companies also do not compensate families of dead workers without death certificates clearly stating the cause.

“Without postmortem reports, it is difficult to believe what is written in the death certificates,” says Gurung, “the employers could be hiding the actual cause of death to evade legal action and having to pay compensation.”

The bizarre case in 2002 of a Sri Lankan domestic worker whose body was transported to Colombo from Kuwait without some organs like kidney was a shocking reminder of the vulnerability of migrant workers from South Asia. “If postmortem can be avoided, possibility of rich and powerful employers killing poor and vulnerable migrant workers to extract body parts cannot be ruled out,” says Gurung.

Laws in many labour destination countries require postmortems, but employers often persuade doctors to fill out death certificates in a way that allows them to evade liability.

Bimal Dhakal of the Nepal Association of Foreign Employment Agencies says most bodies of migrant workers are flown back to Nepal without autopsies. “Our government has failed to push for mandatory postmortems,” he adds.

Malaysia, Qatar and Saudi Arabia are top three labour destinations for Nepali migrant workers, and also where most workers die. Shamser Nepali is President of an association of 83 certified medical clinics that provide health checkups for migrant workers before they leave, and has made a breakdown of main causes of deaths.

“In Malaysia, migrant labourers work up to 18 hours a day and drink cheap spurious liquour before they sleep,” he says. “In Qatar it is the heat that kills. Nepali workers work outside in high temperature without precautions, sleep in air conditioned rooms and their bodies can’t handle it. Consumption of toxic alcohol is also a major factor.”

In Saudi Arabia it is actually highway accidents that is the main killer of Nepali workers. “Road accidents occur elsewhere, too,” he says, “but in Saudi Arabia Nepali workers are killed by hit-and-run drivers.” Shamsher Nepali says there are problems in health procedures in Nepal itself, where some clinics do not carry out proper checkups of workers. “The government must monitor clinics and scrap licenses of those who issue health certificate without conducting check-up,” he says.

Health experts have pointed out that migrant workers are not aware of the extreme conditions in which they have to work, the need to drink enough water, and about traffic rules. Janak Raj Regmi, Director at the Department of Foreign Employment says the government has made it mandatory for migrant workers to take an orientation course before departure. “For example, they are told how to cross multi-lane highways to avoid accidents, and what to do to avoid heat stroke,” he says.

However, many workers said the orientation was just a formality and they could easily get a certificate of participation without attending them. Labour recruiters, medical clinics and orientation companies use loopholes to bypass safeguards for workers.

Sumitra Rai was 18 when she got married to Bikram Yonghang of Ilam district. At 19 she gave birth to their first child. Shortly after, Yonghang left to work in Malaysia to earn for his family’s upkeep. A year later his body was sent home in a coffin, he had been killed in a road accident.

Since her husband’s death, Rai, now 22 (pictured, right, above with her mother-in-law) has spent much of her time commuting back and forth between Ilam and Kathmandu to claim his insurance money. This week the Foreign Employment Promotion Board, the government agency that needs to approve her insurance claim, rejected her application for the fifth time because of inadequate paperwork.

“Every time the officials tell me some paper is missing, and I need to go back to Ilam to get it,” she told us.

Rai’s village in Ilam is inaccessible by road and she has to walk for a day from the district headquarter. The Madhes unrest has also made it more difficult for the single mother to travel along the East-West highway.

“Once on our way home, we got stuck on the road for three nights,” said Rai, “I didn’t have enough money to buy food.”

Rai wants to start a shop with the insurance money, and hopes she can make enough to raise her son. “I do feel like giving up sometimes thinking about all the obstacles from officials, but I can’t. My son needs me,” she said.

The number of migrant workers dying abroad now averages three per day, breeding a new group of young widows in a country where the war had already left thousands without husbands.

Labour migration expert Ganesh Gurung says: “The rate at which young migrant workers are dying is resulting in an exponential growth in the number of young widows. The number of migration widows will soon surpass the number of war widows.”

Malaysia has the highest number of Nepali migrant workers overseas with 700,000 people employed in its plantations and factories. But the country also registers a disproportionate number of deaths of Nepalis.

Between July 2014-July 2015, 425 Nepali workers died in Malaysia, according to figures from the Foreign Employment Promotion Board in Kathmandu. Qatar, which has 550,000 workers from Nepal, had relatively fewer deaths: 178. Nine Nepali migrant workers died every week in Malaysia between July-November last year, according to the Nepali Embassy here, most of them from what health experts call sudden unexpected death syndrome (SUDS).

“Just a few months back another fellow Nepali worker simply dropped dead while walking to work,” said Dilip Malla, 43, a security guard in the Damansara neighbourhood of the Malaysian capital. “We later learned it was a heart attack.”

Malaysian doctors and labour activists are puzzled at the abnormally high mortality rate from SUDS among Nepali overseas contract workers in Malaysia, disproportionately more deaths than Qatar, UAE and other Gulf countries.

Although research is sparse and autopsies are rarely performed on dead workers, factors could be hard work in hot and humid conditions, excessively air-conditioned living quarters, worry about low pay and family back home, as well as consumption of illicit alcohol. An additional anxiety here is reduced earnings due to the falling Ringgit.

The money Nepali migrant workers send home forms 40 per cent of Nepal’s total overseas remittances, and Nepali workers are paying with their lives.

Aegile Fernandez of the Malaysian labour rights group, Tenaganita, says deaths of foreign workers are often overlooked despite the shocking figures. “We see high suicide rate and several cases of sudden death,” she said, “the government should be more transparent and in-depth research should be carried out. Unless that is done we won’t know why they are dying.”

A Malaysian government hospital doctor who treats migrant workers, and asked not to be named, said most sudden deaths are a result of cardiac arrest. “However I can’t say for certain what is causing them, we never carry out any detailed investigation,” she said.

Last year the Malaysian government decided to withdraw health subsidies and increased medical fees for non-nationals by 30 per cent. Public health experts here say this actually adds health risks to Malaysians, since many migrant workers also have TB or malaria.

Workers are also not aware of the precautions they need to take about the extreme climate in Malaysia compared to Nepal. “The Nepalis might not be used to such long hours of work, under scorching heat but they aren’t given proper health and other training beforehand,” adds Fernandez.

Last January, a riot broke out at a plywood factory in Kedah when Nepali workers protested the death of a colleague who had difficulty breathing and died because he wasn’t taken to hospital in time. Protesting workers were arrested, and five deported. A month earlier two Nepalis in the same factory had also died of SUDS.

In another case, more than 1,000 Nepali workers protested at the factory in Johor when a fellow worker died due to lack of health care last August. Some 50 workers were arrested and most of them were sent back to Nepal.

“To find out why this is happening, we must include a clause for mandatory post-mortems for dead workers in labour agreements,” said Ganesh Gurung, an expert on labour migration in Kathmandu. At present autopsies are not required.

After international outcry over the death of Nepali workers in Qatar, the authorities there argued that the fatalities corresponded to the national average for heart attack deaths in Nepal. However, statistics show that the death rate among migrant workers is ten times higher than in Nepal for sudden heart attacks among healthy young males.

Says Florida Sandanasamy of the Malaysian Trade Union Council: “Nepal is sending a huge labour force. Both the countries should be proactive and involved, because unless there is a political will to take action, migrant workers will continue to suffer and be abused.”

Another problem is that families of migrant workers in Nepal can collect insurance only if their relative dies on the job. Bimal Dhakal of the Nepal Association of Foreign Employment Agencies said: “We are lobbying to change this. Workers’ families must be eligible for insurance claims even if they die of sudden heart attacks.”

The list of woes migrant workers in Malaysia face is endless: breach of contract, being forced to work overtime, being paid below minimum wage, no sick leave, no insurance and medical benefits.

Security guard Malla tells a fellow-Nepali he can’t wait to go back home: “I won’t stay here long, and I want to tell Nepalis not to rush to come to Malaysia. There is nothing but pain here.”

Read also:

Zero cost migration really?, Om Astha Rai

Qatar is reforming labour laws, but is Nepal?, Om Astha Rai

Sudden death, Pete Pattisson

Workers in exile, Clare Hennig