Mindful of migrants' mental health

On January 20, Prabhu Nath Teli in Kapilvastu received a call from Krishna Chaudhary in Malaysia, a co-worker of his 24-year-old son Suresh. The two had worked together at D&Y Textile for the past three years, and Suresh had been seriously injured after jumping off the first floor of his hostel.

Only three days before, Prabhu had spoken with his son who had sounded distraught after not being able to come home despite months of trying.  Suresh now has a serious spinal injury following the jump, which along with his erratic behaviour was a result of the severe mental pressure he was under.

“My son wanted to come home but his employer was not willing to let him return,” says Prabhu, adding that his son’s supervisor had called the police on him when they got into a disagreement over his absence. “This scared Suresh, and in an attempt to escape he jumped off the first floor of his hostel and got severely injured.”

 On the one hand, his employer was unwilling to let him go. On the other, personal family issues were piling up over the three years he had been away. To make matters worse, Suresh had a history of mental health problems. 

“He was suffering from depression before going to Malaysia, but he responded well to treatment. He got better over the years and was doing well in Malaysia,” recalls Prabhu. “But not being able to return home was a trigger, and his mental health problems re-emerged.”

 Jay Kumar Teli, Suresh’s uncle, who was in Kathmandu to help with his nephew’s repatriation and recovery, questions how the Malaysian employer could keep hard-working migrants against their will. 

 “They need to understand that their workers are human beings with personal problems and obligations. Not disposable commodities without emotions,” he says. 

But Suresh is not an isolated case.  “The ban on the recruitment of new foreign workers in Malaysia due to Covid-19 means employers are unwilling to let their workers leave” explains Deepak Dhakal, Labour Counsellor at the Nepal Embassy. 

“During the pandemic, there have been delays in the issuance of check-out memos which are like exit permits required for a worker to leave the country and many employers use this as an excuse to keep workers back. It doesn’t matter if workers want to return due to personal emergencies or because their contracts finished.” Dhakal adds. 

 This, in addition to increased workload due to labour shortages, pressure from families back home for financial support and strains in transnational relationships can take a psychological toll on them. 

“Mental health issues among migrants who face pressure from both the employers and families back home are rampant and need to be systematically addressed,” says Prakash Panthi, Labour Attache at the Nepal Embassy in Malaysia. 

While responsible employers in Malaysia and elsewhere take care of their workers, this is often not the case. Even in situations when workers need hospital-based medical care, they are kept in hostels with only very basic medication.

 But the most vulnerable are undocumented migrants, some of whom are brought to the embassy in Kuala Lumpur by Nepali volunteers when their situation has deteriorated without timely attention.

 Regularisation schemes like the Malaysian government’s Recalibration Program that allows undocumented workers to change their legal status could benefit undocumented migration, Dhakal notes.

Coordinated rescue effort 

 Following his fall, Suresh received care in the orthopaedic ward of a Malaysian hospital for his spinal injury and was kept under psychiatric observation before being transferred to a nursing home. 

 Suresh was scheduled to fly to Kathmandu on 5 February after pressure from hundreds of Nepali employees at the company. But the airline refused to fly him because of his health condition. 

Says Labour Attache Panthi, “The employer reached out to us to make agitated Nepali employees understand that the delay in Suresh’s repatriation was due to his health condition and not the employer’s apathy.”

There was also pressure on the employer to bear all medical costs till Suresh recovered.  His condition subsequently improved and he was deemed fit to fly but either a doctor or a nurse had to accompany him, which was too costly.

Eventually, he was approved to fly with a non-medical personnel, a co-worker who was returning to Nepal.

In Nepal, Suresh’s father Prabhu had to make five trips to Kathmandu over the last few months. “The agent in Kapilvastu said he could help if I paid him Rs100,000. The recruiter Al Rahim says he is taking the case up with the authorities. That is a lie, he has no clue that my son is already coming home,” Prabhu says.

In a desperate plea, Prabhu and his wife appealed to MP Arjun KC to help bring their son home. Says KC, “It was just one case, but the amount of coordination needed was tremendous. We had to directly or indirectly engage with the Foreign Employment Board, the Nepal Embassy, Nepal Airlines and the hospital here for his repatriation and further recovery. One weak link and it would not have happened.”

Private airlines were hesitant to accommodate a stretcher but Nepal Airlines agreed. The Nepali mission put pressure on the employer to bear the medical and travel costs. 

Without financial support from the employer or from the Foreign Employment Board, the only option would have been to rely on personal donations that would have further delayed the repatriation. 

Among many stories of an uncaring state, there are stories like that of Suresh Teli where different agencies of the state came together, surpassing the expectation of the people who are conditioned to not expect too much from the government.

The long road to recovery

In many ways Suresh was lucky. He survived the fall when he could have been one of the many coffins that arrive at Kathmandu airport every week. His medical costs in Malaysia and air tickets were borne by the employer. 

His family recognises these positive aspects and is happy their son is finally coming, but is also cautious of what lies ahead: the long road to recovery, from physical and mental wounds, from unpaid loans and foregone earnings, and from personal relationships strained by distance. 

The Teli family has only a tiny piece of land, and it has to pay Suresh’s medical bills by borrowing from local lenders. Formal support is unlikely to come through. 

The recently signed Social Security Agreement (SOCSO) between Malaysia and Nepal only applies to work-related injuries, illness, or death. Suresh’s family is hopeful that the Foreign Employment Board will provide injury compensation via the Welfare Fund, but even this is unlikely given uncertainties around his labour permit status as he has been away for three years. 

Arrival 

The evening of 23 April, Suresh was being pushed in a wheel-chair out of the arrival area at Kathmandu airport and put into an ambulance with the support of the medics and his father. 

As they waited for the rest of the family to join them before heading to the Trauma Centre, the medic in the ambulance held his hands and asked him questions about his health and the travel. He responded willingly, a marked progress from the initial phase of the injury.

 When his mother, Urmila Teli finally climbed into the ambulance, Suresh glowed and broke into a wide smile. Despite the discomfort due to his injuries and the support from the Jewett brace, he leaned aside from the stretcher to touch her feet. He was finally home. 

Read Also: Crossborder virus and Nepali migrant workers, Upasana Khadka