The Foreign Employment Board has decided to provide telemedicine services to Nepali migrant workers from Wednesday.

While some doctors said it is a welcome step, others doubt its effectiveness when the authorities have failed to implement the service within the country.

“The service will begin from 10 am on Wednesday,” a statement issued by the board, a government agency responsible for the welfare of migrant workers, said. “It will be provided during office time, except for public holidays.”

Nepali migrant workers seeking the service will have to call at 9851345701 or 9851345702 through Whatsapp, Viber or IMO.

Rajan Paudel, information officer at the Foreign Employment Board, said that currently three health professionals–a medical officer, a health assistant and a staff nurse–will handle the calls, provide initial counselling and prepare reports for recommending if a worker requires a specialist's attention.

“A specialist’s counselling will be provided on Fridays and Sundays, when workers get their weekly-off in most of the destination countries,” said Paudel.

The workers will get the counselling services for free. The board, which has signed an agreement with Bir Hospital in Kathmandu to provide the service, will bear all the cost, said Paudel. “But the workers will have to pay for the medicine.”

Dr Yagya Prasad Timalsina, chief operation officer at Danphe Care, said the availability of a genuine service is a welcome move.

Danphe Care in cooperation with Non-Resident Nepali Association provided teleconsultation services between the first and second waves of Covid-19.

Though Danphe Care examined around 200 cases during that period, Timalsina does not consider it to be a success.

“Though it was much publicised during the pandemic, it only lasted for around four months,” Timalsina said.

“We received calls from Nepali workers as well as residents in countries like Japan, Malaysia, United Arab Emirates, Qatar, United Kingdom and United States of America in the period,” said Timalsina. “There were scenarios when workers had health insurance, but were unable to get treatment facilities in destination countries.”

“The NRNA had formed various wings in destination countries to prescribe medications,” said Timalsina. “We consulted with such wings.”

But Timalsina argued the government needs to focus on implementing telemedicine services in the rural parts of the country as well.

“Though most of the agendas in our country are widely promoted in the beginning, they get neglected in the long run,” said Timalsina. “Their continuity and sustainability are important for their success.”

Dr Mingmar Gyalzen Sherpa, former director general of Department of Health Services, doubts if the telemedicine service will be effective for migrant workers.

Though they might receive advice from doctors in Nepal, they need to be treated under the observation of a health worker, Sherpa said.

“Telemedicine is not a service which a doctor is supposed to provide directly to a patient,” said Sherpa. “It is actually to connect doctors and health workers, especially in a rural setting, with a specialist for consultations to treat a patient.”

“The government could have collaborated with hospitals in destination countries to impart the service more practically,” Sherpa added.

In 2011, Sherpa was the focal person when the telemedicine service was inaugurated at Patan Hospital.

Around 25 hospitals of remote districts of Nepal used to consult the Lalitpur-based Patan Hospital for telemedicine services.

“But, the service has been defunct ever since my retirement in 2013,” said Sherpa.

The telemedicine services can benefit a large number of patients in Nepal, but the government has failed to understand its importance, according to Sherpa. “The federal government has totally neglected it.”

Health and safety issues of migrant workers have largely remained unaddressed.

“In the fiscal year 2021-22, as much as 1,395 Nepali migrant workers were reported to have died, with most deaths certified as having occurred due to ‘natural causes’,” says the Nepal Labour Migration Report 2022. “More than 150 cases of deaths of Nepali migrant workers have each been reported annually in Malaysia, Saudi Arabia, Qatar and the UAE from 2019-20 to 2021-22.”

Hundreds of young and healthy Nepalis have been losing their lives in foreign lands, but no one knows exactly why.

Migrant rights activists told the Post in 2020 that healthy men going to destination countries and suffering cardiac arrests did not constitute ‘natural deaths’.

The report also says that a significant number of Nepali migrant workers return home with mild to severe injuries and illnesses. “The health risks migrant workers face are linked to their exposure to occupational safety and health hazards, poor working and living conditions, lack of access to social protection, including medical/health services, language and cultural barriers, and forced overtime labour among others.”

Paudel from the Foreign Employment Board said that their priority right now is to provide timely advice and counselling to address the health issues of migrant workers.

“We plan to evaluate the effectiveness of the programme after some months and add more services, if necessary,” Paudel said.