Yam Bahadur Rana died in Qatar on 22 February 2020. The 34-year-old was employed as a security guard at the Hamad International Airport in Doha. He died while on duty as a result of what the Qatari authorities described as “acute cardiorespiratory failure due to natural causes”.

According to Rana’s family, he was of healthy constitution and cautious of what he ate.

Rana’s death certificate has no mention of whether he had any underlying conditions, and his family suspects that his death was linked to his working conditions.

A claim filed by Rana’s family at the Qatari consulate for compensation was rejected. They were told there’s no compensation for death by heart attack.

The story has been lived by many families of migrant workers in Nepal, Bangladesh, India and other South Asian countries.

A recent study conducted by Amnesty International highlights how Qatar routinely issues death certificates for migrant workers without conducting adequate investigations and instead attributes the deaths to “natural causes” or vaguely defined cardiac failures.

“Certifying a death due to natural causes rules out the act of compensation for bereaved families who have lost their only breadwinner,” says the report published on Thursday.

The only compensation Rana’s family received was from his insurance company and from Nepal’s Foreign Employment Welfare Fund.

“Since becoming a widow, I get 2,000 rupees monthly from the government. Sometimes when I get a job, I go to work on roads, farm and drainage. It is the only

way to meet the family’s needs,” Rana’s widow Bhumisara told Amnesty.

With her meagre earnings, Bhumisara looks after her daughter, 11, and son, 13.

Amnesty International had consulted leading medical experts and reviewed government data relating to thousands of deaths, analysed 18 death certificates and interviewed the families of six men for the study.

Of the 18 death certificates of migrant workers issued by Qatar between 2017 and 2021, 15 provided no information about underlying causes and used terms such as “acute heart failure natural causes”, “heart failure unspecified” and “acute respiratory failure due to natural causes”.

Similar phrases were used in reports for more than half of the 35 deaths which have been recorded as “non-work related” on World Cup facilities since 2015, suggesting meaningful investigations were unlikely to have been carried out in these cases.

“These are the phrases that should not be included on a death certificate without a further qualification explaining the underlying cause,” Dr David Bailey, a leading pathologist and member of the WHO Working Group on death certification, told Amnesty. “Essentially, everyone dies of respiratory or cardiac failure in the end and the phrases are meaningless without an explanation of the reason why.”

In the report, epidemiological experts say that in a well-resourced health system, it should be possible to identify the exact cause of death in all but 1 percent of cases. However, Amnesty’s review of data from major labour-sending countries found that the rate of unexplained migrant worker deaths in Qatar may be close to 70 percent.

One of the most well-documented and foreseeable risks to workers’ life and health in Qatar is exposure to extreme heat and humidity, which has been the subject of numerous reports.

A 2019 study in the journal Cardiology found a correlation between heat and deaths of Nepali workers in Qatar, concluding that “as many as 200 of the 571 cardiovascular deaths [of Nepali migrant workers] during 2009-2017 could have been prevented” with effective heat protection measures.

Qatar recently introduced some new protections for workers, but major risks remain and authorities have done little to investigate the scale of heat-related deaths, the report says.

“When relatively young and healthy men die suddenly after working long hours in extreme heat, it raises serious questions about the safety of working conditions in Qatar. In failing to investigate the underlying causes of migrant workers’ deaths, the Qatari authorities are ignoring warning signs which could, if addressed, save lives. This is a violation of the right to life. They are also denying bereaved families their right to remedy, and leaving them with painful unanswered questions,” says Steve Cockburn, head of Amnesty International’s Economic and Social Justice.

An investigation by the Guardian found that 69 percent of deaths among Indian, Nepali and Bangladeshi workers, between 2010 and 2020, were attributed to natural causes.

None of the families Amnesty interviewed were offered any form of post-mortem examination to identify the underlying cause of death of their loved ones. This meant it could not be determined whether working conditions had contributed to the deaths, thereby precluding the possibility of compensation from either employers or Qatari authorities.

When Tul Bahadur Gharti died in Qatar on June 3, 2020, temperature in Doha reached 39 degrees Celsius and never fell below 20 degrees Celsius. He died at the prime of his life, aged just 34.

Gharti’s job involved cutting wire in the construction sector and he was outdoors for 10 hours a day.

His wife Bipana was told by a man from her village in Qatar that her husband’s body was not autopsied.

“I wanted to explore in more detail, but everyone told me not to go after it. We can’t do much in our own Nepal; what else can be done abroad?” Bipana told Amnesty. “I have cried many times in emotion... Being alone is very difficult. I feel like my life has been wasted. There is a big difference between doing this alone and doing it together.”

The struggles of the families of migrant workers who died unexplained deaths in Qatar illustrate the cycle of exploitation which continues to ensnare so many individuals in one of the richest countries in the world.

Amnesty International has called on Qatar to strengthen its laws to protect workers and to improve the investigation, certification and compensation of migrant workers' deaths.

“Qatar must establish a specialist team to properly investigate the death of every worker and ensure that compensation is paid in any case where working conditions such as exposure to extreme heat cannot be ruled out as a contributing factor,” says Steve Cockburn, the head of Amnesty International’s Economic and Social Justice.