Death in destination countries

A few days ago a news item carried by The Guardian, a UK daily, created a major stir in the national media of several Asian countries. The piece was an expose of an ongoing tragedy involving deaths of migrant workers in Qatar. It revealed that more than 6,500 migrant workers from South Asia have died since the country earned the right to host the 2022 FIFA World Cup. On average, every week, 12 migrant workers have died since December 2010 while working on various infrastructure projects including stadiums, an airport, roads, the public transport system, hotels and a new city.

The report stated that 69 percent of deaths among Indian, Nepali and Bangladeshi workers were officially categorised as "natural". Other significant causes were road accidents (12 percent) workplace accidents (seven percent) and suicide (seven percent). Interestingly, the classification of natural death was usually made without an autopsy and thus failed "to provide legitimate medical explanation for the underlying cause of these deaths".

The Qatar government did not dispute the number of deaths. The figure includes white collar workers who have died naturally, and the government insists that "the mortality rate among these communities is within the expected range for the size and demographics of the population".

The Guardian report was revealing in many ways. Not only has it highlighted "the lack of transparency, rigour and detail in recording deaths in Qatar", it maintained that embassies in Doha and labour sending countries were "reluctant to share the data, possibly for political reasons". The reluctance of the labour sending countries in engaging with the issue is palpably demonstrated in the inconsistencies between figures furnished by various government agencies, largely due to the absence of a "standard format for recording causes of death".

In view of the massive infrastructure development that is taking place in preparation for the World Cup, The Guardian report has zeroed in on Qatar. While such a spotlight helps generate awareness about the ongoing tragedy in the country concerned, we must bear in mind that avoidable premature deaths of relatively young migrant workers is a pervasive phenomenon in all the Gulf states. The deaths in Qatar have given rise to some important insights.

Firstly, the unwillingness of both countries of destination and origin to share information and data on deceased workers is a major challenge. Further, lack of clarity and transparency impedes framing of appropriate policies and actions to address problems. It also works as a major barrier for the families of the deceased migrants to access justice and claim compensation.

Secondly, the propensity of receiving states in asserting that most workers die of "natural causes" is unacceptable. There is an urgent need for amending laws for ensuring "autopsies to require forensic investigations into all sudden or unexplained deaths". It is worthwhile to mention that as early as 2014, in a report, the Qatar government's own lawyers recommended commissioning an independent study into the deaths of migrant workers from cardiac arrest, and amend the law to "allow for autopsies…in all cases of unexpected or sudden death". There is also the need for labour receiving countries to pay heed to the call of Human Rights Watch to "pass legislation to require that all death certificates include reference to a medically meaningful cause of death".

Thirdly, heat stroke has been identified as an important cause of death of many migrant workers. The ineffectiveness of the summer working hours ban as highlighted by a ILO commissioned study in October 2019 was acknowledged by the Ministry of Labour and the Supreme Committee for Delivery and Legacy of Qatar. The study found that workers working outdoors were "potentially performing their job under significant occupational heat stress conditions for at least four months of the year". The Ministry of Labour disseminated enhanced guidelines on heat stress aimed at workers and employers earlier, but unfortunately those were neither comprehensive nor obligatory for employers and did not come with any enforcement mechanisms. It is also pertinent that Cardiology Journal in July 2019, based on a study on 1,300 Nepali workers between 2009 and 2017, found "a strong correlation between heat stress and young workers dying of cardiovascular problems in the summer months". The study was conducted by a group of climatologists and cardiologists.

In official records, deaths deemed of "natural causes" include cardiac arrest, heart attack, respiratory failure and "sickness". Analysts have argued that such terms make it impossible to understand whether they may be related to working conditions such as heat stress. Once categorised as "natural causes", labour laws in most of these countries, including Qatar, deprive the families of any compensation. As an overwhelming majority of migrant workers are the principal breadwinners of their families, the slackness in identifying actual causes of death not only ruin those families, it fails to bring proper closure to the loved ones of the deceased migrants.

Cardiac arrest as a cause of death has been viewed as "highly problematic". The United States Center for Disease Control (CDC) offers guidance to doctors that "The mechanism of death (for example cardiac or respiratory arrest) should not be reported as the immediate cause of death as it is a statement not specifically related to the disease process, and it merely attest the fact of death" (emphasis added).

The Guardian report has drawn attention to the dark reality of labour migration in the Gulf states. In many instances, contract substitution after arrival, not being placed against jobs as per the contract, non-payment and irregular payment of wages, ill treatment and abuse by employers and supervisors, and lack of access to healthcare and redress mechanism—all inflict immeasurable mental harm on the workers. Also, poor living conditions including crammed settings, inadequate water supply, lack of sanitary toilet facilities and the like hinder migrants' enjoying quality rest during breaks. All these factors, among other conditions, are likely to contribute to hypertension, respiratory or cardiac arrests or exacerbate existing conditions.

More than 28,000 bodies of deceased Bangladeshi migrants were repatriated under the auspices of the Wage Earners' Welfare Board from 2011 to 2020. A majority of those were from the Gulf states. Stroke, heart attack or accidents were assigned as prime reasons for death of men, while women were alleged to have committed either suicide or died of torture. On average, more than seven families received the bodies of their migrant loved ones each day (54 returns per week).

Evidence from the field informs us that there have been cases in which bodies with obvious injury marks were certified to have died from proverbial "natural causes". So far, such malfeasance of the state authorities of destination countries with the acquiescence of the authorities of countries of origin has allowed the tragedies to persist. There is an urgent need to put a halt to this avoidable misfortune. The process should start with the recognition by state authorities of the reality that young migrants are indeed dying of causes that are preventable. This should be followed up by proper investigations in suspected cases after the bodies of deceased migrants arrive in countries of origin.

The origin countries should demand that destination countries ensure that all migrants, male and female, in public or domestic spheres, work and live in decent conditions and are able to secure redress of their grievances. They should also push destination countries to conduct mandatory autopsies in all cases of unexpected and sudden deaths and recompense the families if the latter qualify for it. The origin countries should also rally forces in the Colombo Process, Abu Dhabi Dialogue and the Global Forum on Migration and Development to demand an immediate end to this tragedy in the spirit of the much celebrated Global Compact of Migration.

C R Abrar is an academic with interest in migration and human rights issues. He is the Chair of the Bangladesh Civil Society for Migrants.