Is extreme heat to blame for chronic kidney disease in Nepali workers?

Why are otherwise healthy, young men requiring dialysis and transplants when they return from working abroad, asks Gerry Shih

Sak Bahadur Chhantyal was working on a construction site in Oman for six years before he was diagnosed with chronic kidney disease (Sagar Chhetri for The Washington Post)

Head nurse Rani Jha circles around her busy kidney ward, reeling off the list of patients who were too young, too sick, too many to count.

There, lying against the far wall, is Tilak Kumar Shah, who had worked in construction for seven years in the Persian Gulf before collapsing. The next bed had belonged to Mohan Yadav, who had laboured in Qatar – until he died two weeks earlier. Next to Jha’s cubicle, huddling quietly under a blanket, is another typical case: Suraj Thapa Magar, a shy 28-year-old who had left his mud hut in Nepal to install windows on skyscrapers in Kuwait, often dangling by a rope in the scorching, 48C purgatory between the sun and the desert.

Jha runs her finger through a large notebook filled with names written neatly in ink. About 20 per cent of the dialysis patients at the Second Provincial Hospital in southern Nepal were healthy young men before they went abroad to work, she estimates. Why did they keep getting sick and ending up back here?