By Vital Signs
Published in DAWN on March 27, 2022
A deel Riaz was only 22 years old when he died in November 2018 in Saudi Arabia. He had three older brothers and two sisters. His family are farmers in a rural region of Pakistan. And he was part of a team that painted mosques.
“There was no engineer at the site to better guide them, [as] per the normal routine,” Adeel’s mother says, remembering the day she lost her son. The workers would be dropped off at a location and would have to undertake all tasks without any supervision, she says.
The day that Adeel died, only junior staff was present on the site — Adeel and three other co-workers. The men placed a ladder on the wrong spot, which had exposed electrical wires. All the men, including Adeel, were electrocuted. Two people were severely injured while the other two died.
Adeel’s death certificate states that the cause of death was “electrical short circuit” and adds that the death was “natural”. But his family wasn’t informed about this “natural” death. They found out about the accident when somebody posted pictures on social media. And they did not get confirmation of his death until one week later.
Adeel’s mother says that he worked in “abysmal” conditions, and his workplace lacked training and safety equipment. But, she says, due to the debt their family had incurred to send Adeel to Saudi Arabia, they had no funds left to seek compensation from his employer in Saudi Arabia.
“I have nothing to say,” Adeel’s mother responds to a question. “I am only heartbroken. The helplessness is the worst part, there is no recourse. There is no system of fair, impartial hearings,” she adds.
An initiative called Vital Signs is researching the deaths of migrant workers from five Asian countries — Pakistan, Bangladesh, India, Nepal and the Philippines — working in the six Gulf states of Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE. Eos presents some excerpts from its initial report, which examines key trends related to the deaths of migrant workers in the Gulf, and makes targeted recommendations to governments and other stakeholders
Adeel’s mother says that there is no legal remedy that her family can avail. They do not know what to do. “I do not know what is a greater curse — our poverty or our illiteracy,” she says.
Adeel’s death has left the family in significant amounts of debt to banks and to the local recruitment agent who arranged for Adeel’s employment in Saudi Arabia. “From the very beginning, it was all very difficult,” Adeel’s mother says. “We have spent everything on Adeel only so he could earn a better living and make us financially stronger. We sold off most of our valuables.”
“We have sold off land,” she adds. “We gave a lot of money to the agents, and [we] got Adeel’s dead body in return.”
Low-paid migrant workers are generally over-represented in the most dangerous sectors of the global economy and this is very clearly the case in the Gulf, where they occupy virtually all of the positions in labour intensive sectors such as construction, which have historically been badly regulated.
A 2009 paper by medical researchers in the UAE states that “the rapid development of projects employing large numbers of expatriates has often outstripped the ability of education, health and labour ministries to train and deploy adequate numbers of industrial hygienists and safety inspectors to protect workers’ health and safety.”
The economies of the six oil-rich Gulf states of Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE are highly dependent on low-paid migrant workers from Asian countries such as Pakistan, India, Nepal, Bangladesh, Sri Lanka and the Philippines. These workers sustain a wide range of sectors, from domestic service, to hospitality, to construction.
Despite widespread criticism of their systematic abuse and exploitation in the international media — notably in relation to Qatar’s preparations to host the 2022 World Cup — the Gulf states have largely avoided structural labour reforms, and origin states have been unable to ensure proper protection for their nationals abroad.
The perceived benefits of outward migration for origin states, combined with vested interests in the South Asian and Southeast Asian recruitment industry, and the Gulf states’ effective use of their economic and political leverage, in large part explains why origin states have never collectively demanded better protection for their workers.
Whereas rights groups, trade unions, academics and the media have extensively documented the serious abuses to which these workers are routinely subjected, and identified the laws and policies and practices responsible, there is a critical gap in this body of research: nobody knows how many of these workers are dying, or the causes of their deaths.
Here we take a look at what is currently known about the issue. And the knowledge gaps that exist.
HEALTH RISKS FOR LOW-PAID
There are approximately 30 million migrants in the Arab Gulf states, accounting for 52 percent of the region’s total population of 58 million, according to estimates provided in the United Nations Department of Economic and Social Affairs International Migrant Stock 2019. A significant proportion of these migrants — between 70 and 80 percent — work in low-paid sectors of the Gulf states’ economies.
Low-paid migrant workers in the Gulf are subject to a combination of risks to their physical and mental health. These risks originate from the workplace, their living conditions (encompassing their accommodation and their broader neighbourhoods), and the environment. They vary in seriousness and they are, to varying extents, under-researched and under-reported.
Some of the risks are more measurable than others, but they are cumulative, and the likelihood is that, when they combine (as they often do), they can do so to deadly effect.
The lack of investigations into migrant worker deaths means that there is rarely any e! ort to determine if a fatality was related to occupational accidents or diseases. As a result, the families of workers who have died cannot claim any compensation from employers or from the Gulf states.
Heat and humidity is one of the risks that can be most easily measured and where protection is most obviously lacking. Dust storms are also a frequent occurrence in all of the Gulf states throughout the year. A 2019 paper explored the association between exposure to poor air quality and acute mortality in Kuwait during a 17-year period from 2000 through 2016. The report concluded that the risk of dying among non-Kuwaiti males was 5 percent higher during dust storm days as compared to non-dust days.
These risks are compounded by abusive working conditions, which often include excessive working hours. Occupational health specialists have partly attributed the disproportionately high rate of male deaths from occupational diseases — 80 percent of the global total deaths involve men — to their involvement in occupations with a heavy physical workload.
The aforementioned risks disproportionately affect male workers, but the gendered aspects of migration mean that women are also acutely at risk from their working conditions. It has long been established that domestic work makes women vulnerable to physical, psychological and sexual abuse, and these abuses have been extensively documented in the Gulf.
A Human Rights Watch report that documented abuses of domestic workers in Oman and the UAE found that 21 out of 87 domestic workers they interviewed experienced “psychological or health problems upon their return because of their exploitative working conditions in the Gulf.”
In 2012 a therapist at Hamad Hospital’s Psychiatric Unit in Doha told a local newspaper that 12 to 15 domestic workers visited the unit daily for treatment to cope with anxiety, including suicide ideations and attempts.
The Covid-19 pandemic further exacerbated many of the health risks facing migrant workers. The pandemic also exposed systemic problems with migrant workers’ access to healthcare, which is often dependent on their employers providing them with health cards that they need to access affordable, subsidised care.
A MURKY PICTURE
The data that is available on the deaths of migrant workers in the Gulf is incomplete and contradictory in places. It precludes effective analysis of the extent and gravity of the problem. And these problems are compounded by a general lack of transparency.
In Pakistan, for example, the only data available on this issue relates to the raw numbers of claims made for compensation to the State Life Emigrants Insurance Fund, with no disaggregation at all.
In India, where a relative wealth of data is available, there is a serious discrepancy relating to the number of nationals who have died in Saudi Arabia, the Gulf country that employs more migrant workers than any other. Whereas India’s Minister of State in the Ministry of External Affairs said that 12,595 Indians had died in the Kingdom between 2015 and October 2019, the Indian Embassy in Saudi Arabia, responding to a right to information request from the Centre for International Migration Studies in Kerala, said that 7,444 Indians had died in almost exactly the same period — a difference of 5,151 people.
Despite the number of migrant workers it employs, Saudi Arabia publishes no meaningful mortality data, so India’s data cannot be cross-checked against anything published by Saudi Arabia.
A more systematic discrepancy is evident in the distribution of causes of death. According to the Indian authorities in Kuwait, 42 percent of deaths were classified as heart attacks. The Indian authorities in Bahrain, meanwhile, reported that only 4 percent of Indian deaths there were from heart attacks, while 47 percent were attributed to “cardiac arrest”.
These discrepancies are critically important and point to serious problems — either in the investigation, the certification, or the categorisation of these deaths, or a combination of all three problems. Whereas a heart attack is something that physicians can diagnose as an underlying cause of death and can appear on a properly formulated death certificate, ‘cardiac arrest’ provides no information on the underlying cause of death and should not appear on a death certificate.
Further evidence of systemic problems in the reporting of the causes of deaths is available in the data published by the Qatari authorities. From 2010 to 2015, a significant number of non-Qatari deaths were coded in categories indicating that the cause of death was unknown. However, from 2016 onwards, these numbers dropped dramatically, while at the same time the numbers of deaths classified as “circulatory diseases” increased correspondingly.
Information about the deaths of migrants in the six countries of the Gulf Cooperation Council (GCC) is fragmented and incomplete. This makes analysis of the causes and circumstances of migrant workers’ death more challenging. Not knowing how migrant workers have died means there is no pressure on governments to implement public health policies to better protect migrant workers and minimise preventable deaths. This also prevents families from seeking compensation that may be available to them.
In the case of Pakistan, for example, there is a lack of transparency in the reporting of deaths of overseas Pakistani workers in the Gulf. The only data available relates to death claims made to the State Life Emigrants Insurance Fund. Insurance is compulsory for migrant Pakistanis and 96 percent of Pakistani migrant workers are employed in the Gulf region, and thus this figure gives us a very approximate overview of the number of deaths in the Gulf each year.
However, not every death is likely to be reflected in a claim made by the deceased’s family, and it should also be noted that death claims of pilgrims and tourists are also included in the data.
The most serious problem with the data produced by the Gulf states is that the data is unreliable in relation to its specification of the causes of migrant worker deaths. Indeed, in criticising origin state failures in relation to data on deaths, it should be stressed that it is the responsibility of the authorities in the Gulf to provide origin states with specific and detailed information on how their nationals are dying.
Based on the material inconsistencies between the data on causes of migrant worker deaths made available by origin states and that made available by the Gulf states, and the apparently very high rate of deaths for which no underlying cause is provided, it is clear that this is not happening.
LACK OF INVESTIGATIONS
Carlos de Guzman Ely Jr from the Philippines died in Saudi Arabia on February 13, 2021, at the age of 45. His roommate tried to wake him up to go to work but found him lifeless.
Because of a lack of employment opportunities in the Philippines, Carlos had gone to Saudi Arabia to work as a pushback (the procedure during which an aircraft is pushed backwards away from its parking position) operator at Jeddah Airport.
His son says that Carlos was diagnosed with a heart condition and high cholesterol before he left the Philippines in 2018. Nonetheless, he worked 10 to 12 hour shifts, taking overtime whenever he could.
His son noticed that his father was frequently stressed, partly due to a lack of sleep because of changing shift patterns. The job required Carlos to work long hours outside, in intense heat. His son says that Carlos often had to go inside the airport staff lobby to cool down and drink water.
Despite his medical history and the fact he was taking medication for his heart condition, his death notification, issued by Saudi Arabia’s Ministry of Health, recorded the cause of death as “unknown”. His family say that, to their knowledge, there was no investigation into Carlos’s death. A friend of the family, who had worked as a nurse in Saudi Arabia, told them it was common practice for examining doctors to only check bodies for signs of injury.
According to Carlos’s son, the family were shocked by this at first, but decided not to press for an autopsy upon researching the issue and concluding that the remains of non-Saudi Arabians were not a priority.
Lack of transparency surrounding the deaths of workers such as Carlos is very common. As noted above, origin states do not, in general, report on this issue with sufficient detail or transparency. However, it should be noted that they are not responsible for investigating and certifying the deaths of their nationals abroad. That responsibility primarily lies with the Arab Gulf states and an examination of the manner in which they investigate the deaths of low-paid migrant workers reveals serious shortcomings.
There are currently no internationally recognised guidelines detailing how states should investigate the cause of someone’s death, but there are internationally accepted standards on death certification and these are inextricably linked to investigations.
The lack of investigations into migrant worker deaths means that there is also rarely any effort to determine if a fatality was related to occupational accidents or diseases. As a result of this, the families of workers who have died cannot claim any compensation from employers or from the Gulf states. Instead, the burden to compensate workers’ families is shifted to the origin states or on to workers’ themselves via insurance schemes.
The families of Bangladeshi nationals who die overseas, for example, are eligible for compensation from its Wage Earners Welfare Board, which is a single trust fund pooled from the mandatory membership contributions of migrant workers. The board pays 3,500 Bangladeshi taka in fees to become a member, and other sources such as investment and interest income on these funds.
Families receive 35,000 Bangladeshi taka in burial costs when they collect their family member’s body at the airport and they then receive a 300,000 Bangladeshi taka payment in compensation. But these payments are only for the families of workers who were documented abroad at the time of their death.
UNSAFE WORKING CONDITIONS
Julhas Uddin was a 37-year-old farmer from the district of Tangail in Bangladesh, who moved to the Gulf for work in 2017. He moved owing to his inability to financially support his wife, two children and elderly parents through agriculture. He paid a local recruitment agent 450,000 Bangladeshi Taka (approximately 948,372 Pakistani rupees) to secure him a job as a sewage line cleaner in Saudi Arabia. He began the job in June 2017.
His family says that Julhas completed a mandatory medical check-up and was declared fit and healthy prior to departure. On October 23, 2017, Julhas was instructed by the company supervisor to enter a sewerage line without an oxygen cylinder.
He experienced breathing problems and made it back to the entrance to the sewage line, but he lost consciousness, fell and drowned in the sewage. Despite the fact that Julhas was not provided with essential safety equipment, his family says that there was no investigation into the circumstances of his death. His death certificate states that the cause of his death was that his “heart and breathing stopped.” Julhas’s family was informed of his death by his colleagues by telephone.
Julhas’s brother says that, based on information from Julhas’s colleagues, his employers had not provided him or the other employees with the Iqama card that serves as a work and residence permit and without which foreign workers can be detained and deported.
He says that the company only provided details of Julhas’s registration on the Iqama system after his death. Julhas’s colleagues told his family that they were all under pressure to perform unsafe tasks at work on account of their precarious status within the country.
They say that their employer often made men go into sewerage lines without oxygen cylinders in an effort to cut costs. Julhas had reportedly refused a previous order to go into the sewage line without an oxygen cylinder, but he complied with the order on the day he died because he felt under pressure.
Julhas’s family received compensation from the Bangladesh’s Wage Earners and Welfare Board (this is statutory compensation for all Bangladeshi workers who die abroad), but an official document provided to the family by the Bangladeshi authorities states that since the cause of death had been documented as “accidental”, the family would not receive any compensation from Saudi Arabia.
Julhas’s elder brother, Habibur, says that Julhas’s death has resulted in incalculable loss for this family, in particular for his two daughters, aged 13 and 7. The family, he says, is now completely reliant on the charity of others to survive.
The most fundamental duty of all states is to protect the lives of its nationals and all others under its jurisdiction. Where migrants are concerned, however, it appears that states around the world do not approach this basic obligation with the requisite rigour and seriousness. Tragedy and hardship for millions of the poorest people on the planet is the inevitable consequence of their inaction.
Life for a migrant worker in the Gulf appears to have a particularly high harmful potential for the millions of low-paid migrant workers employed there, whether in construction or domestic work or other sectors of their economies.
Despite the Gulf states’ practical dependence on their migrant workforces and the bolstering impact migrant worker remittances have on the economies of their homelands, both origin and Gulf states have for too long paid inadequate attention to ensuring they return home in good health. As a result, far too many workers do not return home at all, or do so in coffins or body bags.
There are many stories such as Julhas’s, Carlo’s and Adeel’s. And many will continue to add to the death toll, unless swift action is taken to address the issues.
Based on Vital Signs: The Deaths of Migrants in the Gulf, Report 1. The complete report can be accessed online on vitalsignsproject.org
Excerpted with permission from Justice Project Pakistan, one of the partners behind the report