"Why Working Abroad Has Sparked a Kidney-Failure Crisis in Nepal,"

...

Every day, about 1,500 young Nepalis leave their country for work. Their earnings power a significant portion of Nepal’s economy, with remittances comprising more than 25% of the country’s gross domestic product in 2024. But this prosperity comes at a cost: young, healthy adults return home with failed kidneys.

“The country has benefited from remittances, but families have had to pay a higher price,” says Dipesh Ghimire, an assistant professor of sociology at Tribhuvan University, Kathmandu. The burden is particularly significant because the affected individuals are in their prime productive years, he says. The average age of a Nepali migrant worker is 29.

As temperatures rise in Gulf countries, there’s growing global alarm about rising kidney diseases among workers doing intense physical labor in extreme summer heat with limited water breaks and restricted bathroom access.

Dr. Rishi Kumar Kafle, a nephrologist who pioneered dialysis in Nepal, says that migrants to Gulf countries and Malaysia often develop kidney disease within three to four years of relocation. Since kidneys regulate fluid balance, the organs are especially vulnerable to temperature extremes. While the disease is not caused by one specific factor, Kafle says screenings of returnees over years suggest a strong link between geographic migration and a decline in kidney function...

Over the course of a decade, a kidney patient’s care costs the government 3 million rupees (21,669 dollars) in dialysis alone, while a patient pays an additional 2 million (14,447 dollars) from their own pocket, Kafle says.

Since 2016, Nepal has offered free kidney dialysis and transplants, plus a 5,000-rupee (36-dollar) allowance for patients with kidney failure.

While Nepal battles multiple serious diseases, Dr. Bikash Devkota, additional health secretary at the Ministry of Health and Population, says dialysis consumes the largest share of health care spending — 2.1% of the government’s health budget...

When Global Press Journal visited the National Kidney Center in January, one-third of the patients undergoing transplant and dialysis were migrant worker returnees. Doctors at the center say this has been the case for many years now...