Devkota Hridaya Raj, Bhandari Bishnu, Adhikary Pratik
Institute for Social and Environmental Research Nepal (ISER-N), Nepal.
Community Support Association of Nepal (COSAN), Kathmandu, Nepal.
J Migr Health. 2020 Dec 4;3:100013. doi: 10.1016/j.jmh.2020.100013. eCollection 2021.
Poor mental health and illness among the working population have serious socioeconomic and public health consequences for both the individual and society/country. With a dramatic increase in work migration over the past decades, there is recent concern about the health and wellbeing of migrant workers and their accessibility to healthcare services in destination countries. This study aimed to explore the mental health and wellbeing experiences of Nepali male returnee-migrants and non-migrant workers, and their perceptions about risk factors for poor health and health service accessibility.
This qualitative study was conducted among Nepali migrant and non-migrant workers in February 2020. Four focus group discussions comprising 25 men and a total of 15 in-depth interviews were conducted with male non-migrant and returnee migrant workers from Gulf countries and Malaysia. The discussions and interviews were audio-recorded, transcribed, translated into English and analysed thematically.
Migrant workers reported a higher risk of developing adverse mental health conditions than non-migrant workers. In addition, fever, upper respiratory infection, abdominal pain, ulcer, and occupational injuries were common health problems among both migrant and non-migrant workers. Other major illnesses reported by the migrant workers were heat burns and rashes, snake-bites, dengue, malaria, gallstone, kidney failure, and sexually transmitted diseases, while non-migrants reported hypertension, diabetes, and heart diseases. Adverse living and working conditions including exploitation and abuse by employers, lack of privacy and congested accommodation, language barriers, long hours' hard physical work without breaks, and unhealthy lifestyles were the contributing factors to migrant workers' poor mental and physical health. Both migrant and non-migrants reported poor compliance of job conditions and labor protection by their employers such as application of safety measures at work, provision of insurance and healthcare facilities that affected for their wellbeing negatively. Family problems compounded by constant financial burdens and unmet expectations were the most important factors linked with migrant workers' poor mental health.
Both migrant and non-migrant workers experienced poor mental and physical health, largely affected by their adverse living and working conditions, unmet familial and financial needs and unhealthy life styles. Greater compliance is needed by employers of work agreements and the promotion of labor rights for worker's health and safety. In addition, policy interventions to raise awareness about occupational health risks and effective safety training for all workers (migrant and non-migrant) are recommended.
劳动人口的心理健康不佳和患病对个人及社会/国家都有严重的社会经济和公共卫生影响。在过去几十年中，劳动力迁移急剧增加，最近人们开始关注移民工人的健康和福祉以及他们在目的地国获得医疗服务的情况。本研究旨在探讨尼泊尔男性归国移民和非移民工人的心理健康和福祉体验，以及他们对健康不佳风险因素和医疗服务可及性的看法。
2020年2月，对尼泊尔移民和非移民工人进行了这项定性研究。对来自海湾国家和马来西亚的男性非移民和归国移民工人进行了4次焦点小组讨论（共25名男性）和15次深度访谈。讨论和访谈进行了录音、转录、翻译成英文并进行了主题分析。
移民工人报告称，出现不良心理健康状况的风险高于非移民工人。此外，发热、上呼吸道感染、腹痛、溃疡和职业伤害是移民和非移民工人共有的常见健康问题。移民工人报告的其他主要疾病有热烧伤和皮疹、蛇咬伤、登革热、疟疾、胆结石、肾衰竭和性传播疾病，而非移民报告的有高血压、糖尿病和心脏病。包括雇主的剥削和虐待、缺乏隐私和拥挤的住宿、语言障碍、长时间无休息的艰苦体力劳动以及不健康的生活方式在内的不良生活和工作条件是导致移民工人身心健康不佳的因素。移民和非移民都报告称，雇主对工作条件和劳动保护的遵守情况不佳，如工作时应用安全措施、提供保险和医疗设施，这对他们的福祉产生了负面影响。因持续的经济负担和未满足的期望而加剧的家庭问题是与移民工人心理健康不佳相关的最重要因素。
移民和非移民工人都经历了身心健康不佳的情况，这在很大程度上受到他们不良的生活和工作条件、未满足的家庭和经济需求以及不健康生活方式的影响。雇主需要更好地遵守工作协议，并促进保障工人健康和安全的劳动权利。此外，建议采取政策干预措施，提高对职业健康风险的认识，并为所有工人（移民和非移民）提供有效的安全培训。
