The National Kidney Center in Kathmandu is a bustling facility where the beeping of old dialysis machines never stops. Nurses in dark blue scrubs rush around, tending to the 55 patients having their blood cleaned at any given time. Among them is 30-year-old Surendra Tamang, a former migrant worker who left his family to work in the Persian Gulf. Tamang spent six years doing construction work in Qatar, toiling in temperatures as high as 122 degrees Fahrenheit. Today, he spends 12 hours a week in the clinic for his dialysis treatment, unable to work due to his end-stage kidney failure.
Tamang’s story is not unique. He is among the 7.5 percent of Nepalis who have left the country in search of work, with many heading to the Middle East. The harsh working conditions faced by migrant workers in the Gulf often lead to health issues like kidney failure. Of the patients admitted to the dialysis clinic in Kathmandu, more than 20 percent had worked in the Gulf, highlighting the health risks faced by these vulnerable workers.
A recent study found that high temperatures combined with physically demanding work are driving a surge in chronic kidney disease globally. This silent epidemic affects workers in various industries, from sugarcane cutters in Central America to agricultural workers in South Asia. Despite being one of the fastest-growing killers, chronic kidney disease has remained largely invisible to the public and policymakers until recently.
In May of this year, the World Health Organization passed a landmark resolution recognizing the need to prioritize kidney care, highlighting the importance of simple measures like frequent breaks and access to drinking water in preventing thousands of deaths. The intersection of climate change, labor conditions, and inequality is putting vulnerable workers like Tamang at risk as the world warms.
As Tamang sat on a bench outside the clinic, recovering from his dialysis treatment, his story serves as a stark reminder of the challenges faced by migrant workers in the face of climate change and health risks. Despite his struggles, Tamang remains hopeful for a better future, highlighting the urgent need for action to protect the health and well-being of all workers.
Navesh Chitrakar / Reuters
The toll of CKD on these young men is immeasurable. Many come from rural areas, where family members rely on their remittances. Unable to work, they often lose their sense of purpose and struggle to maintain a sense of self-worth. “I have seen young men who have lost their confidence, their hope,” Adhikari said. “They feel like they have nothing to live for.”
In the meantime, the climate crisis is only making matters worse. As temperatures continue to rise, the risk of heat-related kidney damage will increase, putting more workers at risk of CKD. The time to act is now, before more lives are lost to this preventable disease. Governments, employers, and individuals must take steps to protect workers from extreme heat, provide adequate breaks and hydration, and ensure access to healthcare for those who are suffering from CKD. The future of these young men, like Tamang, depends on it.
It’s a typical day in the dialysis ward, where nurses like Adhikari work tirelessly to tend to patients with chronic illnesses. Among them are Buddhi Bahadur Kami and Kul Bahadur Dulal, two men whose lives were forever changed by their work in Saudi Arabia’s scorching heat. Kami, 41, spent over a decade painting diesel storage tanks, hoping to provide for his family back home. Dulal, 46, drove trucks across the desert, enduring long hours and harsh conditions. Both returned to Nepal with failed kidneys, their dreams of financial stability shattered by mounting healthcare costs.
For migrant workers like Kami and Dulal, the pressure to perform and send money home is exacerbated by a power dynamic with employers and the constant threat of deportation. Dr. Barrak Alahmad of Harvard University’s Occupational Health and Climate Change Program highlights the precarious living conditions, fatigue, and poor diets that further stress the kidneys of migrant workers in the Middle East. Many migrants live in cramped quarters, have limited access to healthy food, and struggle to find time for self-care amidst demanding work schedules.
The harsh reality of climate change is not lost on these migrant workers, who are often the first to feel its effects. From natural disasters in their home countries to the extreme heat of the Persian Gulf, they face a “double whammy” of climate-related challenges. Alahmad emphasizes that chronic kidney failure resulting from heat exposure is a stark reminder of the impact of climate change on vulnerable populations.
The countries that recruit these workers, such as the oil-rich nations of the Middle East, are complicit in the conditions that lead to their health struggles. Massive infrastructure projects, fueled by cheap labor, are a cornerstone of these nations’ development plans. Despite growing concerns about worker safety and well-being, protections for migrant workers remain inadequate. Human Rights Watch’s Michael Page stresses the need for stronger regulations and oversight to hold companies accountable for the well-being of their employees.
While some Gulf countries have implemented midday work bans during the hottest months, experts like Alahmad argue that these measures are insufficient. Heat-related illnesses can occur at any time of day, and true protection requires more comprehensive strategies. As temperatures soar to record highs in the UAE, the urgency of addressing the risks faced by migrant workers becomes increasingly apparent.
In the face of these challenges, nurses like Adhikari continue to provide compassionate care to patients like Kami and Dulal. Despite the physical and emotional toll of their work, these dedicated healthcare professionals find solace in knowing that they are making a difference in the lives of those who need it most. Nepal, by contrast, spent just $1 billion on health care — and that includes all its citizens, not just the migrant workers who return home sick.
But the burden isn’t only financial. The emotional toll of chronic kidney disease is immense, and it falls heavily on the families left behind. In the rural villages of Nepal, where the men leave, it’s often the women who bear the brunt. They must care for their sick husbands, often while also tending to the fields or working other jobs to keep their families afloat.
One solution, Page suggests, is to create a fund that the Gulf countries pay into to cover health care costs for migrant workers who fall ill. This would not only ease the burden on the workers’ home countries but also ensure that these men receive the care they need to live out their lives in dignity.
Ultimately, the issue of protecting migrant workers from heat-related illnesses is a complex one that requires a multi-faceted approach. From implementing mandatory summer working bans to providing better access to shade, water, and rest, there are many steps that can be taken to ensure the safety and well-being of these workers. By learning from the experiences of organizations like La Isla Network and enacting policies that prioritize worker health and safety, Gulf countries can take meaningful steps towards protecting the lives of their migrant labor force. In Nepal, the government has allocated a significant amount of $605 million for public health in the current fiscal year. However, despite this allocation, there are challenges faced by healthcare facilities, such as the National Kidney Center. Dr. Rishi Kumar Kafle, the founder of the center, highlighted the issue of low reimbursement rates from the Ministry of Health, with only $18 being paid for each dialysis session. This has resulted in financial strain on the center, leading to delays in payments to suppliers and staff.
Dr. Kafle emphasized the need to address this imbalance in funding and suggested that Gulf countries, which rely heavily on Nepali migrant workers, should contribute to funding transplants and educational campaigns in Nepal. He stressed the importance of raising awareness about health risks, particularly among migrant workers who may not be fully informed about conditions like dehydration and heat-related illnesses.
One of the key strategies proposed by the Ministry of Health and Population is to focus on prevention and early screening for chronic kidney disease (CKD). By implementing more rigorous testing for migrant workers before they leave for work and upon their return, the aim is to detect kidney damage at an early stage. Dr. Kafle underscored the importance of prevention over treatment, stating that early detection can significantly reduce the number of cases of kidney failure.
For individuals like Surendra Tamang, who require a kidney transplant to improve their quality of life, the wait for a suitable organ can be long. The demand for transplants exceeds the available supply, and patients often have to wait for at least six months unless they can find a suitable donor. In the meantime, patients like Tamang rely on regular dialysis sessions at the National Kidney Center to stay alive.
In conclusion, while the government’s investment in public health is commendable, there are still challenges that need to be addressed in order to ensure effective healthcare delivery in Nepal. By focusing on prevention, early screening, and increasing awareness about health risks, the country can take significant steps towards improving the overall well-being of its population. Is there a more iconic duo than peanut butter and jelly? This classic combination has been a staple in lunchboxes and kitchens for decades, and for good reason. The creamy, nutty flavor of peanut butter pairs perfectly with the sweet, fruity taste of jelly or jam, creating a delicious and satisfying snack or meal.
Peanut butter is a versatile and nutritious spread that is made from ground, roasted peanuts. It is rich in protein, healthy fats, and essential nutrients like vitamin E, magnesium, and potassium. Peanut butter is a great source of energy and can help keep you feeling full and satisfied for longer periods of time. It can be enjoyed on its own, spread on toast or crackers, or used as a dip for fruits and vegetables.
Jelly or jam is a sweet and fruity spread made from fruit juice, sugar, and pectin. It comes in a variety of flavors, including strawberry, grape, raspberry, and more. Jelly is a great way to add a burst of flavor to sandwiches, toast, and baked goods. It is also a good source of vitamin C and antioxidants, which can help boost your immune system and protect your cells from damage.
When peanut butter and jelly are combined, they create a harmonious balance of flavors and textures. The creamy peanut butter provides a rich and nutty base, while the sweet and fruity jelly adds a burst of sweetness and tanginess. Together, they create a delicious and satisfying snack or meal that is perfect for any time of day.
One of the best things about peanut butter and jelly is that it is quick and easy to make. Simply spread a layer of peanut butter on one slice of bread, top it with a generous spoonful of jelly or jam, and then place another slice of bread on top to create a sandwich. You can also get creative and experiment with different types of bread, spreads, and toppings to create your own unique twist on this classic combination.
Whether you enjoy it as a simple sandwich, a tasty dip, or a flavorful dessert, peanut butter and jelly is a delicious and timeless duo that is sure to satisfy your cravings. So the next time you’re looking for a quick and easy snack or meal, reach for the peanut butter and jelly and treat yourself to a classic favorite. The COVID-19 pandemic has brought unprecedented challenges to the world, affecting millions of people and disrupting daily life in ways we could never have imagined. As we continue to navigate through this global crisis, it has become increasingly clear that we must adapt to the new normal and find ways to cope with the ongoing uncertainties.
One of the biggest challenges that the pandemic has brought is the need for social distancing, which has forced many of us to isolate ourselves from our friends, families, and loved ones. While technology has allowed us to stay connected virtually, the lack of in-person interactions has taken a toll on our mental health. Feelings of loneliness, anxiety, and depression have become more prevalent, as many people struggle to cope with the stress and uncertainty of the situation.
In addition to the emotional toll, the pandemic has also had a significant impact on our physical health. With restrictions in place and many businesses closed, it has become more challenging to maintain a healthy lifestyle. Gyms, parks, and other recreational facilities have been closed, making it harder for people to exercise and stay active. This lack of physical activity, combined with the stress and anxiety of the pandemic, has led to an increase in unhealthy behaviors such as overeating, smoking, and excessive drinking.
As we continue to navigate through this challenging time, it is important for us to prioritize our mental and physical well-being. Here are some tips to help cope with the ongoing uncertainties of the pandemic:
1. Stay connected: While we may not be able to see our loved ones in person, it is important to stay connected virtually. Set up regular video calls with friends and family members to maintain social connections and combat feelings of loneliness.
2. Practice self-care: Take time to focus on self-care activities that bring you joy and relaxation. Whether it’s reading a book, taking a bath, or practicing yoga, find ways to prioritize your mental health and well-being.
3. Stay active: Even if gyms and parks are closed, there are still plenty of ways to stay active at home. Try online workout classes, go for a walk in your neighborhood, or do yoga in your living room. Regular exercise can help improve your mood and reduce feelings of stress and anxiety.
4. Limit news consumption: While it is important to stay informed about the latest developments of the pandemic, too much exposure to news can be overwhelming and increase feelings of anxiety. Limit your news consumption to reputable sources and set boundaries for when and how often you check the news.
5. Seek support: If you are struggling to cope with the challenges of the pandemic, don’t be afraid to seek professional help. Many therapists and counselors are now offering virtual sessions, making it easier to access mental health support from the comfort of your own home.
The COVID-19 pandemic has brought unprecedented challenges to the world, but by prioritizing our mental and physical well-being, we can find ways to cope with the ongoing uncertainties and emerge stronger on the other side.
