South of Janakpur near the Indian border is the village of Phulgama. Out of its population of 4,500, nearly every household here has at least one son who is a migrant worker abroad.&nbsp; Some 40% of Nepali men between the ages of 20-35 are <a href="https://nepalitimes.com/news/die-first-get-paid-later">migrant workers abroad</a>, mainly in India, the Gulf states or Malaysia. In the last nine months alone, 741,297 people travelled overseas: mostly to the UAE, Saudi Arabia, Qatar, Malaysia and Kuwait. This does not include those who left on student visas, and there are no records of how many went to India. Most end up working in ‘3D jobs’ — &nbsp;dirty, dangerous and difficult. There is also a fourth D: dehydrating work.&nbsp; Risky outdoor as manual workers, <a href="https://nepalitimes.com/editorial/too-hot-to-work">excessive heat of the desert in the Gulf</a> or humidity of the tropical jungles of Malaysia, poor diet, dehydration and unhealthy lifestyles all contribute to a <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/A-mysterious-rash-of-kidney-failures,3639">higher risk of kidney failure among Nepali migrant workers</a>. Dhanusha district has one of the highest proportions of workers migrating for work to India and abroad. Nephrologists call kidney disease ‘the silent killer’ because patients do not show symptoms until it is too late, and migrant workers are especially susceptible to Chronic Kidney Disease (CKD) or End-Stage Renal Disease (ESRD).&nbsp; Increasing demand for cheap labour and minimum pre-departure health awareness training makes migration more risky than it should be. From a survey of hospitals and dialysis centres in Dhanusha and Kathmandu, the risk of kidney failure<a href="https://nepalitimes.com/opinion/comment/saving-kidneys-to-save-nepal"> appears higher among male migrant workers</a> than in Nepali men of the same age group.&nbsp; “This disease is idiopathic, meaning it is not caused by one specific factor,” explains Rishi Kafle of the National Kidney Center Nepal. “But after screening migrant workers going to the Gulf and developing End-Stage Renal Disease in 3-4 years, we can say that migration increases the likelihood of kidney failure.” Kafle adds: “Because of the need to maximise earnings, working in extreme heat for long hours dehydrates them. And many opt for Coca-Cola and meat instead of healthier water and vegetables.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250118070128_b86cd132e88fecad9cde6d6faa648f76b40979660e6d28e846b25469668df9d8.jpg" data-media-id="editor_4" data-image-id="20250118070128_b86cd132e88fecad9cde6d6faa648f76b40979660e6d28e846b25469668df9d8" data-rendition-name="original" width="4032" height="3024" loading="lazy" alt="Dirty, dangerous, difficult, and dehydrating NT"> <figcaption>All photos: PINKI SRIS RANA</figcaption> </figure>  While the risk of kidney failure is higher in returnee migrant workers in Nepal, the disease is on the rise globally due to <a href="https://nepalitimes.com/banner/sick-of-it">lifestyle changes,</a> diabetes or undiagnosed hypertension. Currently, there are 28,266 kidney patients enrolled in the <a href="https://dohs.gov.np/">Department of Health Services</a> for free treatment under the government’s <a href="https://mohp.gov.np/program/medical-treatment-of-deprived-citizens/np">Bipanna Nagarik Kosh</a>, of which 17,044 are male and 11,222 female. Just in the past year, 9,176 more patients were added to the fund. Most hospitalised kidney patients are from age 15-65. In a healthy person, toxins and waste in the blood are filtered by the kidneys. But patients with kidney failure need to circulate their blood regularly through a haemodialysis machine. The whole process takes about 3-4 hours and causes blood vessels in the arms to swell over time. Nearly 2 million Nepalis suffer from chronic kidney disease (CKD), which is about 8% of the population. The rise in diabetes and hypertension is contributing to an increase in the disease. Everyone from migrant workers to many of Nepal’s top politicians suffer from kidney failure. Prime Minister Oli himself has had two kidney transplants. Even with dialysis twice a week, some patients develop nausea, swelling and other problems when they eat or drink. The extra dialysis sessions cost money, and the livelihood allowance given to patients is never enough or timely. Not every migrant working in hot climates returns with kidney disease, but a recent yet-to-be-published study led by nephrologist Sailendra Sharma states that one-fourth of all kidney patients in Nepal are migrant returnees. It points to recurrent heat stress as a primary risk factor. The<a href="https://mihs.edu.np/"> Madhesh Institution of Health Sciences</a> in Janakpur has 103 regular patients who come for dialysis. Of them, 30 are returnee migrants not just from Dhanusha, but also Sarlahi, Siraha, Mahottari and Sindhuli. “Not by the nature of the disease, but the way kidney disease is growing, I would call it an epidemic,” adds Kafle. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250118070128_43731248e116cfdc42bfc08b8f7d71e5ff3d44b938065a5ad9e9a337e666b9c7.jpg" data-media-id="editor_9" data-image-id="20250118070128_43731248e116cfdc42bfc08b8f7d71e5ff3d44b938065a5ad9e9a337e666b9c7" data-rendition-name="original" width="1463" height="798" loading="lazy" alt="Dirty, dangerous, difficult, and dehydrating NT"> <figcaption>HARD LABOUR: Jagdish Sah shows a picture from his time in Malaysia.</figcaption> </figure>  Jagdish Sah left for Malaysia ten years ago. He had taken a loan for his sister’s marriage and he had to pay it back. As the eldest son, he was also expected to get married next, but he faced multiple rejections. “Women have expectations too. They want to get married to well-to-do families. They didn’t want to get married to a family that lived in a mud house like ours,” says Sah, now 35. Foreign employment was a one-stop solution to his problems. Or so he thought. Sah was 24 when he left for a tailoring job at a garment factory in Malaysia. He often worked overtime, sometimes up to 12 hours a day in the hopes of earning extra ringgits. Even so, his highest monthly income would only be Rs35,000.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250118070128_7dd5030951c805302adec46afdef623bbdbb6fe1c0f12b7a77fd612531865af1.jpg" data-media-id="editor_10" data-image-id="20250118070128_7dd5030951c805302adec46afdef623bbdbb6fe1c0f12b7a77fd612531865af1" data-rendition-name="original" width="2048" height="1536" loading="lazy" alt="Dirty, dangerous, difficult, and dehydrating NT"> <figcaption>Sah at a garment factory in Malaysia where he worked, often dehydrated, and not taking toilet breaks to earn more.</figcaption> </figure>  Workers got a 30-minute break for lunch, and there were limited toilet breaks. So, Sah just worked straight out. Back in Nepal for a break in 2017, Sah had blurred vision and fainted. He thought it was high blood pressure, but a few months later at age 28, he was diagnosed with double kidney failure. “Whatever he saved in Malaysia went for his treatment in Kathmandu. We even sold a plot of our land,” recalled Sah’s mother, Mantoriya Devi.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250118070128_dc353dd6ce449c05bda6d562907dd961d8900c1b747dc4afec1680bb65b805b7.jpg" data-media-id="editor_11" data-image-id="20250118070128_dc353dd6ce449c05bda6d562907dd961d8900c1b747dc4afec1680bb65b805b7" data-rendition-name="original" width="3995" height="2871" loading="lazy" alt="Dirty, dangerous, difficult, and dehydrating NT"> <figcaption>Sah is now gaunt and frail in this picture taken duing his biweekly dialysis at Madhesh Institute of Health Sciences in Janakpur recently.</figcaption> </figure>  Sah drives his motorcycle twice a week from his village to the Madhesh Institute of Health Sciences in Janakpur for free dialysis. His family says it is as if the Jagdish who went to Malaysia and the one who came back are two different people. &nbsp; “This disease has already doomed my life. Why ruin someone else’s?” says Sah of his lack of marriage prospects. “It is because of dialysis that I have survived so far.” His parents are too old and occupied with their chores to accompany him. Since Jagdish cannot work, his father, Ram Dev sells popcorn by the sidewalk from a wheeled cart. Mithu Kumar went to Saudi Arabia to work as an electrical supervisor two years ago. He was 25. Recently when he started vomiting, he was taken to a local hospital. He was diagnosed with chronic kidney disease and was sent back to Nepal. As Kumar lays down for his dialysis treatment at Save Lives Hospital in Janakpur, he says, “My only wish is that I am healthy enough to work again.”&nbsp; Umesh Kumar Yadav also worked in Saudi Arabia as a guard. He returned with chronic kidney disease, but he says he is the only one to contract the ailment among all the returnees from his village. “Only the ill-fated people have this disease,” says Yadav. “Otherwise, it would have been the same for every other person from the village who is abroad working.” Ambar Bahadur Sarki, 46, travels from Sindhuli for three hours every Monday and Thursday to Janakpur for his free dialysis at the Madesh Institute of Health Sciences. Sarki worked in a palm oil plantation in Malaysia, where heat stress often exceeded the wet-bulb threshold for heat and humidity. “It was extremely hot at all times,” he remembers. He first got hypertension, which made both his kidneys fail. Ram Udgar Mandal from Dhanusha started working in Saudi Arabia in his late twenties. He spent the next 17 years in the desert working as a driver. Now in his late forties, he was diagnosed with End-Stage Renal Disease (ESRD) four years ago.&nbsp; But this is an intergenerational cycle. Mandal’s son has now also gone to Malaysia to supplement the family income. He fears his son will meet the same fate as him. “We do not have a choice, do we?” he says. Lalit Balampaki, 28, from Dhanusa was diagnosed with ESRD a year earlier in Dubai. He stays in Kathmandu along with his older brother’s family on a rented floor. Balampaki worked in extreme heat conditions in a smelting factory in Dubai. He had to work night shifts twice or thrice a week. Sleep deprivation and extended periods without food were part of his daily routine. The pay was good, but his savings have all gone now towards hospital fees. “More than the money, I earned the disease,” says Balampaki. &nbsp; Suraj Thapa Magar, 30, was the sole breadwinner of his family. He installed aluminum windows and doors in Kuwait “It was the hottest in summer and coldest in winter,” says Magar, who worked for 10 hours a day even in 50°C. He also often neglected hydration, and one night he vomited blood. At 26, he was diagnosed with ESRD and has been in Nepal ever since. Thapa has no other choice than to rely on the Rs5,000 allowance, but even that is not timely and not enough. He has to take loans to travel for his dialysis. The government hospitals are supposed to provide some medicines for free, but they are often out of stock. Thapa has looked for jobs, but kidney disease is a stigma and no one wants to hire him. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;*** In 2016, Nepal started providing free hemodialysis treatment for the poorest patients. Two years later, a monthly livelihood allowance of Rs5,000 was to be distributed to patients suffering from chronic diseases like dual-kidney failure and cancer. Free dialysis is provided in 107 hospitals across the country, but that is only in theory. Many facilities do not have nephrologists because the government does not provide salaries. The machines also often are not working because they need constant maintenance. Among the 11 hospitals that provide free dialysis in Madhes Province, three are in Janakpur. Nepali Times visited the enlisted hospitals but there were no nephrologists to supervise the treatment, and they were run by general physicians or senior nurses.&nbsp; “The government does not provide adequate salaries for the nephrologists,” says Kafle. “That is why nephrologists are mainly affiliated with the private hospitals.” Bagmati Province has 44 hospitals with free dialysis, which is why many dual-kidney failure patients have opted to live in Kathmandu. The hospitals service over 8,000 kidney patients.&nbsp; Since most of them are migrant workers, the end result is that Nepal’s poorly-resourced health system ends up bearing the cost of treating kidneys that failed while working as labourers in hot, rich countries. &nbsp;

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Dirty, Dangerous, Difficult ... and Dehydrating

At the National Kidney Centre in Kathmandu, a substantial number of the staggering 800 patients who come for regular kidney dialysis are migrant returnees from the Gulf and Malaysia.&nbsp;
Last month alone, 90% of the 90,000 Nepalis who went abroad were migrant workers. Most of them went to West Asia. They are healthy when they leave, but are <a href="https://nepalitimes.com/editorial/too-hot-to-work">exposed to extreme temperatures</a>, and many return with ruined kidneys.
Nepal is suffering an epidemic of renal failure due to the workers’ continuous exposure to excessive heat, chronic dehydration, harsh work environment, and the tendency to go for energy drinks immediately after returning from work. The problem will get worse in coming decades with nonsurvivable wet-bulb summer temperatures in the countries where Nepali migrants work.&nbsp;
Truth be told, renal failure is not confined to migrant workers. Increasingly high numbers of young Nepalis are suffering from lifestyle-related ailments. Individuals as young as 25 are living with high blood pressure, fatty liver, and diabetes, among others.
In the past 40 years, Nepal has seen a dramatic transformation from a country with mortality mostly from infectious diseases to one where people are living longer but are dying due to lifestyle-related ailments. A <a href="https://nhrc.gov.np/wp-content/uploads/2022/02/BoD-Report-Book-includ-Cover-mail-6_compressed.pdf">2019 study by the Nepal Health Research Council</a> found that non-communicable diseases accounted for 71% of deaths in the country.&nbsp;
Diabetes, high blood pressure, and the irrational use of painkillers are some of the main reasons behind this figure. Kidney failure can be prevented if diabetes and hypertension are controlled in the initial stages.
Renal health is very much linked to the quality of life and economy. Patients do not suffer alone, often they are the sole breadwinners and their condition will greatly impact their families.
As per the World Health Organization, 10% percent of Nepal’s total population (300,000 people) suffer from kidney issues, 30,000 of them are in the final stage, and 3,000 need dialysis or transplant every year.
The increasing burden of non-communicable diseases is a global phenomenon but developing countries like Nepal face a double whammy as we continue to battle preventable infections too.
The chances of survival for people suffering from renal failure are slim, but the good news is that the government provides dialysis and transplantation services free of cost.&nbsp;
Currently, over 90 health facilities throughout the country provide free dialysis services to over 6,000 patients with renal failure. Over 3,000 patients have undergone kidney transplants since the service started about a decade ago, including a former prime minister and other senior government officials.&nbsp;
Every year Nepal spends Rs2.11 billion on the treatment of patients with renal failure. Local governments also provide monthly livelihood allowances to those with kidney failure or undergoing transplants. This is the highest amount the government has been spending for any single disease.&nbsp;
Even so, the focus is on the treatment of the 3,000 people living with kidney failure and scant attention has been paid to 270,000 others who suffer from some sort of kidney disease, and another 270,000 who are at risk of kidney disease.
Providing free dialysis service is not a sustainable solution. Authorities concerned should promote prevention, and encourage renal failure patients to opt for transplants. Despite the legal provision that allows any immediate family to donate a kidney, many with renal failure cannot find one.&nbsp;
Road traffic accidents are one of the biggest causes of deaths today and a kidney from brain-dead donors is a viable option. But this requires increased awareness about organ donation.
Preventing kidney disease is the best way, and the first step is to launch awareness campaigns, the cost of which is minimal compared to the treatment cost of renal patients.
The public should be told about the dangers of obesity, excessive consumption of alcohol, tobacco, salt, and junk food as well as insufficient intake of vegetables and fruits. Regular exercise, drinking plenty of water, and cutting on sugar should be promoted.
Screening is crucial to early diagnosis and a lot of lives can be saved if testing for non-communicable diseases is made free once a year for all age groups. Even then, most Nepalis do not undergo tests unless it is an emergency.&nbsp;
The government has established laboratories at the health post level to carry out the test, but very few make use of the service. People can monitor protein levels in urine and do a creatinine test, a measure that shows how well one’s kidneys are performing or filtering waste from blood. The tests cost just Rs100.
Above all, these awareness campaigns should be launched at the school and community levels so that we have an early chance to save every kidney from severe damage. Before things get worse, we Nepalis and Nepal can bring down the burden of non-communicable diseases, cut medical costs, and save lives.
Rishi Kumar Kafle is a senior Nephrologist and is the founding President of the National Kidney Center in Kathmandu.

Saving kidneys to save Nepal

Nepal’s cricket team first beat powerhouse West Indies in two out of three matches in September, the first time it won a match and then a series against a test-playing nation.&nbsp; Then the Rhinos played six qualifiers in Oman for the 2026 T20 World Cup which is being held in India and Sri Lanka from 7 February to 8 March next year. The national team qualified comfortably with two games to spare, and won all six matches anyway. In the three months before the World Cup, cricketers will play the second season of the Nepal Premier League from 17 November to 13 December.&nbsp; After a hugely successful first season, steady upgrades have been made. The flood-lit Tribhuvan University Cricket Ground has been fitted with 15,000 seats, even though this takes away from the festival-like atmosphere of fans on their feet on the grassy slope.&nbsp; Last season, matches began at noon and three in the afternoon. Late-evening matches in winter under flood lights will increase attendance and viewership.&nbsp; There is also now technology that will display how far a six was hit and how fast a ball was bowled. Foreign players who will play in the league include Chris Lynn, D’arcy Short, Ravi Bopara, and Sohail Tanvir, all good ex-international players that people have heard of.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_9db0830fb65d0743e3d36cc4b4473e61d750789028a130f5dff8a619307b0215.jpg" data-media-id="editor_0" data-image-id="20251101031128_9db0830fb65d0743e3d36cc4b4473e61d750789028a130f5dff8a619307b0215" data-rendition-name="original" width="1365" height="1803" loading="lazy" alt="Nepal cricket"> <figcaption>Aasif Sheikh drives through the covers on his way to 69 off 41 vs Samoa.</figcaption> </figure>  But the most important point of the Nepal Premier League will be to prepare and experiment for the World Cup, which starts less than two months after the NPL ends. Team Nepal will be extra eager to play well, given that the matches are happening in South Asia and Nepali fans can make the trip.&nbsp; Head coach Stuart Law will be watching each NPL match keenly, to gain more insight into how to best use his current starters.&nbsp; As each of the eight teams are only allowed a maximum of four foreign players in their starting eleven, Law and Nepali fans will also be scouting new talent who will be hungry to emerge and prove themselves to earn a place in the World Cup Squad.&nbsp; ALL-ROUNDERS One of the most unusual features of the current Nepali squad is how many all-rounders there are. Kushal Bhurtel, Rohit Paudel, Kushal Malla, Gulshan Jha, and Dipendra Singh Airee are all regular starters, and they all bat and bowl. Opener Aasif Sheikh is also the wicketkeeper.&nbsp; Airee, of course, is also an excellent fielder. In the first five games of the qualifiers, he got a record five runouts with direct hits, and was on a roll with a run in every single game. This depth means that almost always seven players bowl for Nepal, and the wealth of options keeps the opponent batting order guessing, but it may create hesitancy within the team in tough situations against stronger teams.&nbsp; Countries at the top level of the sport tend to have more specialists. Perhaps Stuart Law might want to tell Bhurtel to really focus on his batting, or Airee to hone his bowling, which seems to be their strengths. The team would be better off with them performing one aspect consistently well than being hit or miss with both. &nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_c30fdbab65736ea728f2f94fa121d2169e4d3627194ce1fe9de26eebdb3fc5b3.jpg" data-media-id="editor_1" data-image-id="20251101031128_c30fdbab65736ea728f2f94fa121d2169e4d3627194ce1fe9de26eebdb3fc5b3" data-rendition-name="original" width="957" height="1269" loading="lazy" alt="Nepal cricket"> <figcaption>Lalit Rajbhansi with tricky left arm spin, 3/13 vs Samoa.</figcaption> </figure>  POWERPLAYS The Nepali team likes batting first. It chased only against Japan, but they struggle to put up really competitive scores of say, above 170 unless two batsmen do really well.&nbsp; In the second match against the West Indies, Aasif Sheikh’s 68 and Sundeep Jora’s 63 set up Nepal at 173/6. Against Samoa, Aasif Sheikh had 69 and Airee had 53, before Lokesh Bam’s fierce 39 off 12 featuring 4 sixes set up 211/4.&nbsp; Besides these games, Nepal tends to score up to 150 batting first. To the experienced teams that Nepal will face at the world cup, this is not at all an intimidating score. One reason is that Nepal just cannot seem to get going in the first six powerplay overs, when there are limited fielders on the boundaries.&nbsp; A solution to this might be to promote Gulshan Jha up the order. Although Jha has also been an excellent batter in the end overs, using him at three or four might help set up a more productive powerplay and bigger scores. He should try it out with the Karnali Yaks.&nbsp; Despite all the controversy that comes with Sandip Lamichhane, and his strange decision to sit out the West Indies series minutes before the first match started, his output with the ball is undeniable.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251101031128_453d54ce627367c537d459c38d260d8aca1d56949c49c8023de582f3e72bb678.jpg" data-media-id="editor_2" data-image-id="20251101031128_453d54ce627367c537d459c38d260d8aca1d56949c49c8023de582f3e72bb678" data-rendition-name="original" width="1499" height="1000" loading="lazy" alt="Nepal cricket"> <figcaption>Nepalis turn out to support the team vs Samoa at Al Ameret Stadium in Oman.</figcaption> </figure>  He took wickets in each of the six qualifiers, most notably five vital ones in the match against Qatar that Nepal won by five runs. Lamichhane also gives away very few runs, which cuts some of the more part-time bowlers some slack.&nbsp; Airee is also economical, and his 3/22 was vital in the one-run win against the UAE. Together with Lamichhane the duo constricted the opposition in the middle overs. Veteran Sompal Kami has not been as productive with the ball, and gave away a lot of runs in the series against the West Indies.&nbsp; This is a weakness, because Kami does not contribute with the bat much. While his experience is valuable to ground the young Nepali team, Stuart Law should look out for fast bowlers during the NPL to help balance out quality spinners.&nbsp; One of the most impressive and professional parts of Nepal’s winning streak has been the attention to detail. The players have been generally excellent in the field, giving away very few runs due to wides or no balls. They had three run outs against the UAE and two against Qatar and Japan and in the first game against the West Indies.&nbsp; The fielders seem much calmer and focused when executing difficult catches, a welcome change from past complacency. This attention to detail makes the difference in narrow games and keeps morale high.&nbsp; The Nepali team has performed well, but besides the narrowly-beaten UAE, all the matches were against teams ranked lower in the world T20 rankings. And the series against the West Indies was against a weakened team. In the world cup, Nepal will be facing much stronger teams and will lack the element of surprise it had in the 2024 World Cup.&nbsp; If Nepal wants to keep improving, it now has to be able to dominate teams like Kuwait and Oman. It also should set up more series with associate nations like Scotland, Ireland, Namibia and The Netherlands. This will help accurately gauge the team’s progress and expose its weaknesses.

Nepal’s prospects at World Cup 2026

Imagine a high-end fair trade tea brand from Nepal that has done everything right, with ethical sourcing practices and international certifications. It has built a loyal base of socially conscious, premium customers in an export market and focuses on quality over quantity. Then one day, a government in the export market introduces a new ‘listing criteria’ that requires exporting a certain amount of tea to at least three countries in the past five years. But this was never a numbers game, it was about a niche market of socially responsible tea lovers.&nbsp; Suddenly, fair trade tea companies are restricted from exporting tea to that country.&nbsp; Pretty unfair for the company, for consumers, for the tea sector. More importantly, for tea farmers and families benefiting from fair standards. The overseas labour industry is facing a similar risk as recruiters, including those that have adopted ethical standards, may soon be barred from finding workers for Malaysia.&nbsp; On 27 October, the Malaysian Ministry of Foreign Affairs sent letters to five countries including Nepal, Bangladesh, Burma, Pakistan and India to ‘rationalise the number of licensed private recruitment agencies permitted to facilitate recruitment and placement of workers to Malaysia’.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_050274dddc6cf10224b0ad9283eec7b3bc3c0acd650543a808a8ea473ecf40db.jpg" data-media-id="editor_0" data-image-id="20251030141040_050274dddc6cf10224b0ad9283eec7b3bc3c0acd650543a808a8ea473ecf40db" data-rendition-name="original" width="961" height="1135" loading="lazy" alt="Malaysia recruitment"> </figure>  The letter includes 10 criteria for private recruiting agencies including at least five years of operating experience, deployment of 3,000 workers in the past three years of operation, &nbsp;experience sending workers to at least three countries, a 10,000 sq m office maintained for three years, valid licenses and good conduct certificates, five employer testimonials, and operating their own training and accommodation centres. Two conditions stand out as potentially harmful to Nepal’s ethical recruitment movement. First, although the letter cites a minimum of 3,000 workers, it says three years in the heading and five in the body text. A big enough difference to affect a significant number of recruiters from making the cut, but problematic regardless.&nbsp; Second, the requirement to send workers to at least three countries disproportionately impacts responsible recruiters in Nepal and elsewhere. Turning the selection of workers into a numbers game is dehumanising. Responsible &nbsp;recruiters deprioritise volume, focus on quality of jobs even when business sustainability comes under threat as ethical opportunities that do not require workers to pay any feed and ensure greater transparency are difficult to come by. Sending workers is further impacted by a series of external shocks. For example, in the Malaysian context Nepal banned emigration to Malaysia for two years followed by the Covid pandemic, and then Malaysia’s decision to stop the intake of foreign workers for the last two years.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_b1b88b3ae2e94c6bc077529ac6f2a4e380a385ee9a22219edfed25067c9d25a1.jpg" data-media-id="editor_1" data-image-id="20251030141040_b1b88b3ae2e94c6bc077529ac6f2a4e380a385ee9a22219edfed25067c9d25a1" data-rendition-name="original" width="595" height="841" loading="lazy" alt="Malaysia recruitment"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_2cf252908d18aaf09c875002eef2d92ab45897a56b560addd2dc02311725c8a7.jpg" data-media-id="editor_2" data-image-id="20251030141040_2cf252908d18aaf09c875002eef2d92ab45897a56b560addd2dc02311725c8a7" data-rendition-name="original" width="590" height="238" loading="lazy" alt="Malaysia recruitment"> </figure>  Many ethical recruiters have focused on Malaysia because it is a more common labour market for responsible recruitment than other destinations like the Gulf. There is no credible justification to why responsible recruiters well regarded by scores of Malaysia-based multinational companies and with decades of experience should be ‘disqualified’ for not diversifying. Finding jobs for Nepalis in new markets is difficult given fierce competition, challenges &nbsp;identifying companies which follow the employer-pays principle, lack of networks and shortcomings in marketing strategies. These factors hit responsible recruiters harder because profit-motivated employers are often unwilling to cover the costs and fees associated with workers’ recruitment.&nbsp; “The volume of deployment does not determine a recruiter’s capability or the quality of services provided,” says Sujit Shrestha of the Nepal Association of Foreign Employment Agencies (NAFEA). Nepal recently scrapped the licensing renewal requirement that mandated sending at least 100 workers a year as it was impractical. The new Malaysian criteria is similar in nature, he added. The ball is now in Nepal’s court at a time when the interim government does not even have designated heads in the Foreign Ministry and the Ministry of Labour, Employment Employment and Social Security. When rumours about the Malaysian action started circulating, NAFEA had raised the issue, but was assured that this was not an attempt to set up a syndicate.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141044_83c8a174ef116603f747d1cd254c4d353e8b855a41fb99feec54e701f5fc4c3f.jpg" data-media-id="editor_3" data-image-id="20251030141044_83c8a174ef116603f747d1cd254c4d353e8b855a41fb99feec54e701f5fc4c3f" data-rendition-name="original" width="3456" height="5184" loading="lazy" alt="Malaysia recruitment"> </figure>  How will governments and recruiters in other origin countries now respond? There is precedence from Bangladesh. Dhaka-based journalist at the Daily Star, Porimol Palma who says, “Earlier, the Malaysian authorities had selected 101 Bangladeshi recruiters unilaterally, despite Bangladesh’s call for a syndicate-free recruitment mechanism.” Between 2022-2024, 450,000 Bangladeshis were recruited under this system with workers paying between $4,500 and $6,000, even though the legal limit was $750. Palma attributes part of the high fees workers had to pay were for commissions or bribes to recruitment syndicates. Adrian Pereira heads the North South Initiative in Malaysia says: “The criteria seems a bit fishy, as they do not appear to address the actual problems in the the recruitment of foreign workers. Some of the criteria seem to encourage a system of monopoly or syndicate rather than a rights-based approach. Every government has the right to set criteria for recruiters, but conventions and ILO (International Labour Organization) standards on recruitment exist. It looks like we’re back to square one.”&nbsp; Whether migrant origin countries including Bangladesh and Nepal accept the terms sent without reservations or push back in good faith remains to be seen. In an ideal world, a collective stance should put workers’ needs and welfare at the centre. How rational is the proposed ‘rationalising strategy’? What aspects of it are promising to curb recruitment abuse and what merits serious reconsideration?&nbsp; Even if the move from the Malaysian side is well-intentioned to address rampant malpractices migrant workers face, Nepal should deliberate on the conditions set, the collateral damage especially on the responsible actors and small but capable recruiters. Alternate options that might serve everyone better before rushing to respond with a chosen list by 15 November. If the proposal is accepted, how would it be done in a transparent and accountable way? It is noteworthy that Indonesia was not listed even though it has the most workers in Malaysia among the 16 countries that send migrants to Malaysia.&nbsp; The Responsible Business Alliance (RBA), the ILO, the International Organization for Migration (IOM), and certification programs like On the Level (OTL) also need to use their leverage to ensure that recruiters, including those they have trained or certified on ethical recruitment principles, are not penalised.&nbsp; This is more than just about protecting the ethical recruitment movement, but raising even more basic questions: Who can legally be a recruiter in Nepal? There are already obligations like hefty security deposit and minimum office requirements. But requirements to have building facilities with ‘accommodations’ or ‘testing centres’ are not among them. There are 1,150 plus players in Nepal’s recruitment sector, with a few hundred engaged in the Malaysian market. A unilateral selection criteria could risk foul play, or lead to unintended, unfavourable consequences. To be sure, overseas recruitment in Nepal is known for ‘settings’, corruption, dog-eat-dog competition, and collusion. The profiteering is out of control, often at the expense of workers. But the solution does not lie in stifling the industry with criteria like deployment volume, building worker accommodations or expanding office floors.&nbsp; The focus should instead be on enforcing rules and laws in both countries that govern the industry, and the Malaysian labour agreement that has not been renewed since October 2023.&nbsp; Meddling in the industry in ways that harms fair competition and ethical actors means workers suffer. The only issue that should be taking precedence is: how will Malaysia’s 10-point criteria and planned arrangement affect migrant workers? We have seen how for identical Malaysia-based jobs, one worker might pay zero while another pays up to Rs400,000, depending on the employer and recruiter. It is unclear if the 10-point selection criteria rewards the responsible employers and recruiters.&nbsp; As a longstanding host country for Nepali migrants, Malaysia deserves credit for nurturing the small but growing ethical recruitment industry here. Export-oriented companies in Malaysia need responsible recruitment partners and have mentored recruiters to strengthen their practices and move away from worker-paid models.&nbsp; The business case for ethical recruitment standards has led many recruiters in Nepal to pivot with many now in various stages of transition from traditional to hybrid or purely ethical practices. This progress needs to be acknowledged and built upon.&nbsp; Large, well-networked recruiters with large physical assets and high volume of workers seem to be the winners of Malaysia’s 10-point criteria after two years of waiting for the Malaysian market to reopen. Responsible recruiters endure long periods of minimal or no deployments that threatens their survival. The letter now sitting on the desk of the interim government in Nepal deepens the concern: rather than just failing to recognise or reward responsible recruiters, does the international recruitment market actually punish them? Upasana Khadka heads Migration Lab, a social enterprise aimed at making migration outcomes better for workers and their families. Labour Mobility is a regular column in Nepali Times.

Who gets to recruit for Malaysia?

With the holidays over and elections only four months away, Nepal’s interim government led by Prime Minister Sushila Karki is trying to get down to brass tacks. But it is not easy.
On Wednesday, Karki held the first three-way meeting between GenZ representatives, political parties and the government. Despite some acrimony, there was near unanimity about creating the environment for elections on 5 March. 
Only the UML is holding out, still not taking responsibility for the 8 September massacre, and calling for the reinstatement of Parliament. GenZ delegates poured their wrath on the unrepentant UML, but were themselves talking at cross purposes on the demand for a directly-elected executive. 
Karki was on the defensive, her exasperation spilling over: “How do we undo the damage done by corruption, exploitation, and discrimination over the last 35 years in a single month?” 
She is reported to have added, “There is a tendency to not allow this government to work, and then turn around to criticise it for not achieving anything. We are trying our best, and will fulfil our goal of elections no matter what.” 
The Wednesday meeting does seem to have turned the attention of old parties towards elections, and spurred the GenZ and others with political ambition to form parties.
With the deadline for party registration looming, several like-minded individuals and collectives are coalescing, or trying to. The Election Commission is already reviewing applications from more than a dozen new political parties. 
Kathmandu Mayor Balen Shah has held talks with RSP members, but his popularity on social media is not matched by public visibility and accessibility. Intriguingly, Shah and his supporters on social media have been publicly asking for the resignation of Home Minister Om Aryal for not arresting members of the UML-NC government for the 8 September killings. Aryal used to be Mayor Shah’s legal adviser.
Sudan Gurung of GenZ, ex-RSP Sumana Shrestha, and Energy Minister Kulman Ghising are all shopping for existing or new political parties to join. 
The RSP with its alternative anti-corruption agenda would be the logical choice, but there is a question mark over the role of its head Rabi Lamichhane, who is back in jail on charges of embezzlement.
LARGER CABINET
This week, Karki expanded her Cabinet for the third time by inducting Sudha Sharma Gautam as Minister for Health and activist Bablu Gupta as the Minister for Youth and Sports. 
Recommended by GenZ members, Gupta, 28, is the youngest Minister in Karki’s team. But, as has become the norm with this electoral government, two other controversial nominations fell through. Khagendra Sunar was dropped as Minister for Labour because of several ongoing criminal charges, including for assault and inflammatory speech. And Ganapati Lal Shrestha for Minister of Land Management declined at the last moment after he was not given the Tourism and Culture portfolio as preferred. 
Critics say there is a lack of due diligence on the part of Karki’s advisers in selecting candidates. Last month, Sangeeta Mishra who was nominated for Health Minister was dropped after it turned out that she was under investigation at the CIAA. However, Kulman Ghising also had complaints filed at the anti-corruption body, but was still given three portfolios. 
Then the nomination of Tashi Lhazom was withdrawn after an online controversy over her citizenship. There was also outrage on social media about Mishra and Lhazom being singled out for their ethnicity and gender.
Internal leaks making her choices prematurely public has made Karki’s team overcautious about Cabinet expansion. It is also distracting her from her main goal — to hold credible elections by striking a balance between the political parties and GenZ groups.
After a preliminary hearing on 16 writ petitions against the House dissolution and appointment of new government, the Supreme Court on Wednesday refused to issue an interim order.
“The formation of the government is unconstitutional, and a government formed unconstitutionally is not allowed to make any decisions, until the final hearing,” stated advocate Surendra Bhandari. 
The UML, still smarting from the September protests, is trying to put a spanner in the works of the election government. The GenZ, meanwhile, still do not have a consensus over fundamental demands prior to elections. Combined, these two factors portend a precarious future.

Future imperfect

A little more than one month into its six-month term, Nepal's interim government recalled ambassadors from 11 countries: China, Japan, Malaysia, Qatar, Saudi Arabia, Israel, Russia, Spain, Germany, the UK, the US, and Japan.&nbsp;
Mostly appointed by previous governments, they have to return to Kathmandu by 6 November. The envoys who were retained, even if they were political appointees, tended to be women or from various ethnic minorities.
The recall has met with criticism back home. Prime Minister Sushila Karki is blamed for borrowing a page out of its predecessors’ playbook. Although it was a symbolically inclusive move in a diplomatic corps dominated by established groups, the government may have got its timing wrong.
On Sunday, however, the Supreme Court issued an interim order against government decision to recall the 11 ambassadors. The court questioned the neccesssity and justification of such a move, concerned that it could affect Nepal's relations with the host countries.&nbsp;
Karki has said <a href="https://nepalitimes.com/news/future-imperfect">her priority is to hold elections in March</a>, and by recalling Nepal’s emissaries from important capitals like Washington, London, Bonn, Tokyo, Abu Dhabi and Kuala Lumpur her government has cut channels of communication and support from development partners and with the international community.&nbsp;
Nepal’s anti-corruption GenZ protest and the devolution of the youth movement into <a href="https://nepalitimes.com/here-now/relocate-reallocate-recover">arson, looting, and violence</a> after the targeted killing of protestors in September put the nation in the international spotlight. And the interest was especially keen in neighbouring New Delhi and Beijing.&nbsp;
The Nepal unrest has sparked similar protests across the world from <a href="https://nepalitimes.com/here-now/nepal-genzs-inspired-filipinos">the Philippines</a> to East Timor, Madagascar and Peru. But there is also worry in India where exposure of #nepokids on social media as well as corruption in high places could instigate copycat youth unrest.
And in China, there is still a lingering memory of the deadly protests in 1989 Tiananmen Square. But the Chinese also suspect that some in the GenZ movement have links to free-Tibet. &nbsp;
Foreign policy experts in Nepal reject conspiracy theories about foreign backing for the GenZ, characterising it as mostly triggered by home-grown outrage over chronic corruption of the governing elite.&nbsp;
Throughout its history Nepal has always had to balance the geo-strategic interests of its neighbours: the British in India and the Chinese Empire, and more recently independent India and Communist China.
When former PM K P Oli resigned, he had <a href="https://nepalitimes.com/opinion/comment/when-xi-meets-modi-and-oli">just returned from a visit to Beijing</a> and was a week away from making an official visit to India. A new Nepali prime minister typically makes the first visit to India, but Oli broke that tradition last year by going to China to sign the Belt and Road Initiative (BRI) framework agreement.
"Oli was China's trusted partner supporting <a href="https://nepalitimes.com/news/china-syndrome">Nepal’s participation in BRI</a> and SCO (Shanghai Cooperation Organization)," says geopolitical analyst Sanjay Upadhya. "Now, some in Beijing are apprehensive that there is external support for the youth protests that contributed to Oli’s sudden departure. It is perceived as a strategic setback for China."
Despite an ongoing dispute with India over a 364 sq km border territory, Nepal is heavily dependent economically on India with which it has an open border.&nbsp;
Rulers in Kathmandu have usually leaned over backwards to be closer to China to counterbalance India’s gravitational pull following a strategy of ‘equidistance’ between the two giant neighbours.&nbsp;
Growing American and Western disinterest in the region is making India and China more assertive towards smaller nations. Educator Dovan Rai says, “China is also becoming more aggressive and trying to show its presence in and around South Asia.”
She adds, “Nepal is an important neighbour for China, especially considering issues it regards as sensitive, like the Dalai Lama and Tibet.”
Indeed, the Chinese are said to be suspicious about the links that the <a href="https://nepalitimes.com/here-now/nepal-s-historic-youth-dissensus">GenZ movement</a> was infiltrated by elements linked with Free Tibet or with US-based interests.&nbsp;
What must have especially raised eyebrows at the Chinese Embassy in Kathmandu was that the Dalai Lama’s office in exile in India congratulated Sushila Karki — the first time in history it has sent such a greeting to a new prime minister of Nepal.&nbsp;
Although Nepal’s two neighbours do not see eye-to-eye, both agree and are worried about instability in Nepal, and if it might trigger a refugee crisis, empower extremist factions, or attract Western interference.&nbsp;
Nepal’s September protests were preceded and succeeded by similar movements in the region and around the world. In light of this global eruption of youth frustration, and desire to lead from the front, the hardline governments of Nepal’s two neighbours are undoubtedly wary of the possibility of similar unrest within their own borders.&nbsp;
‘India advocates democratic legitimacy, while China prioritises control and predictability. Recent upheavals demonstrate that neither democracy nor stability alone suffices for sustainable nationhood,’ Upadhya wrote in a recent blog.
With early elections scheduled for 5 March, <a href="https://nepalitimes.com/news/one-month-later">the main challenge for Karki’s transition government</a> is to maintain dialogue and establish consensus between youth groups, political parties, and other agitating forces to participate in polls — all while ensuring there is no covert external influence.&nbsp;
Indeed, with <a href="https://nepalitimes.com/here-now/nepals-democracy-keeps-doubting-itself">Nepal’s democracy</a> at stake as well as new political forces with competing interests set to battle it out in a new political landscape, experts warn that there could be powers that will want to fish in troubled waters.&nbsp;
Explains Dovan Rai: “Along with soft power, foreign countries including our neighbours could intervene in the online information space to promote their interests in Nepal. Fake narratives and disinformation could be spread &nbsp;through digital platforms. We must be careful and vigilant about our digital space.”

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Who gets to recruit for Malaysia?

Future imperfect

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