Last week, when the health condition of a Nepali migrant worker in Tokyo deteriorated due to Covid-19, he sought treatment at a nearby hospital.

The 41-year-old man from Tanahun district in Nepal had tested positive nine days before. Doctors at the hospital, however, suggested that he stay in home isolation, as the facility was packed with Covid-19 patients.

He, however, managed to get in touch with Danphe Care, an organisation that runs telemedicine service from Nepal, according to an associate with Danphe.

“When the man contacted us, his health condition appeared to be in a critical state. His oxygen level was low and he was suffering from pneumonia,” Kabin Maleku, programme head at Danphe, told the Post. “With the help of the health committee of the Non-resident Nepali Association in Japan, we managed to arrange for the man’s hospitalisation.”

The patient was immediately taken to the intensive care unit, according to the organisation.

The man in Tokyo was lucky to be able to come in touch with the Non-resident Nepali Association (NRNA) through the NGO that runs telemedicine service.

But not everyone is.

According to the health committee of the NRNA, around 400 Nepali migrant workers have died from Covid-19-related complications in various countries and over 70,000 are reported to have been infected so far since the start of the pandemic.

“Not everyone can manage to get timely hospitalisation as the man from Tanahun did,” said Dr Prabhat Adhikari, an infectious disease and critical care expert who provided telemedicine service to the patient. “All migrant workers cannot contact the right place for medical help, and getting help is not always easy.”

It is estimated that nearly 3 million Nepalis are working abroad, a majority of them based in the Persian Gulf countries, Malaysia and South Korea.

Last month, a Nepali migrant worker in Saudi Arabia, who is in his late 30s, became seriously ill after being infected with the coronavirus. His room-mates were transferred to quarantine facilities, and he was asked to stay in isolation in his room.

“Due to the language problem, the man was unable to seek medical care. His health condition was deteriorating fast,” said Maleku of Danphe Care. “When he came into our contact, we helped him get admitted to the hospital. He recovered well.”

The Covid-19 pandemic brought a series of ordeals for Nepali migrants working in various labour destinations. As Covid-19 cases started erupting in those countries, Nepali workers first feared for their safety before suffering job losses, pay cuts, arbitrary breach of contracts and even returning home empty-handed, often with massive loans.

Nepali migrant workers make a substantial contribution to the country’s economy, but the government appears to have been nonchalant towards their plight.

Migrant workers were hailed as heroes when they came forward to supply hundreds of oxygen cylinders and oxygen concentrators to their home country after it was devastated by the second wave. Hospitals at that time were forced to turn patients away for a lack of beds and oxygen.

According to Dr Sanjeeb Sapkota, coordinator of the health committee of the Non-resident Nepali Association, it is not easy for migrant workers to get medical care in foreign countries when they are infected with the coronavirus.

“There are multiple barriers to their access to health facilities, including language and non-cooperation from local authorities,” Sapkota, who is now in Kathmandu, told the Post. “Even if they self-isolate, in faraway countries, they don’t get the care they would have received at home. Multiple factors could lead to their reaching hospitals only at a critical stage.”

The health committee of the Non-resident Nepali Association, formed in 2017, has been active in over 6o countries and ever since the pandemic began, it has been extending its support to Nepali migrant workers in need of help.

Sapkota, a medical epidemiologist who has worked for the World Health Organisation and the US public health agency, chairs the Global Health Support of the Non-Resident Nepali Association.

Danphe Care, a Dillibazar-based social business organisation that provides online counselling through telecare platform, has been providing telemedicine services to migrant workers for about a year after signing a memorandum of understanding with the Non-resident Nepali Association.

The association pays doctor’s consultation fee and fee for other services to Danphe.

“But migrant workers can get the service for free, as the NRNA health committee pays the service charge,” said Maleku.

The organisation, in which over 70 doctors are engaged part-time, is also registered in the USA but provides services from Nepal only.

Meleku said that over 200 migrant workers, whose health condition was critical due to Covid-19, have taken telemedicine services from the organisation. The number of infected people in Nepal taking its services is over 3,000.

“If the patients who come into our contact need hospitalisation and doctors in the hospital where patients are admitted need help from experts, consultant doctors provide a second opinion,” said Adhikari, the infectious disease and critical care expert.

Doctors at the organisation regularly monitor the health condition of the infected people and give suggestions.

“Like in Nepal, a lot of migrant workers, who are our compatriots, are getting infected; a lot of them do not know how to get help,” said Sapkota. “We have been providing telemedicine services from Nepal and abroad.”