About three months ago, Harish Chaudhari, uneducated but skilled youth from Nepal´s Tarai, went to Malaysia with a dream of earning better salary. Nepali agents had promised Harish a driving job in Malaysia.

Harish, however, ended up working as an orderly for a businessman in Malaysia. An orderly´s salary was obviously not at par with that of a skilled employee. To make matters worse, he did not even get his salary for two consecutive months. He was sent back to Nepal by some Nepalis working in Malaysia. "He was completely motionless," Dr Rabi Shakya, a psychiatrist at Mental Hospital in Lagankhel, recollects a recent meeting with Harish.

"He did not utter a single word. I spoke to his relatives at length to know what actually led to the situation." According to Dr Shakya, Harish has suffered from Catatonic Depression which generally makes a person unable to perform daily chores.

Back with mental problems
Many Nepalis, who go to gulf countries for overseas jobs, return home with nothing but different types of mental illnesses. Dr Shakya deals almost every day with mentally-ill people who developed the disease while in gulf countries. "Migrant workers suffer from a range of mental illnesses," he says. "Depression and schizophrenia are common among them."

An extensive study is yet to be conducted to gauge the degree of mental illnesses among migrant workers. Based on the outcomes of two recently conducted sample surveys, the problem is more serious than one can think of. Mental illness has resulted in suicide of many migrant workers in the past and forced many of them out of jobs even as the loans they had taken remain unpaid.

A 2009 study by Dr Nirmal Lamichhane, who works in the department of Neuropsychiatry at Charak Hospital and Research Center in Pokhara, reveals that over 70 per cent of migrant workers who return home with mental illness show multiple psychiatric symptoms. "Though the relationship between migration and mental problems may be spurious, foreign job may cause or precipitate metal illness," Dr Lamichhane concludes in his report recently published in a medical journal.

Maiti Nepal, a non-government organization fighting trafficking of Nepali women, surveyed women migrant workers who returned from gulf countries in 2009. The survey revealed that only 33 per cent women workers return physically as well as mentally healthy. Of the 67 per cent workers with some health problems, 57 per cent were diagnosed with various types of psychiatric problems including schizophrenia.

Recently, a 27-year-old Nepali woman, sent back home from a gulf country, tried to commit suicide while undergoing treatment at Mental Hospital in Lagankhel. Suicidal tendencies and actual attempts are common in depressed migrant workers. According to a recent report published by the parliamentary committee on Women, Children and Social Welfare, nine Nepali housemaids committed suicide in Lebanon alone in the past three years.

According to Dr Shakya, most migrant workers reach gulf countries with some invisible seeds of mental illness. "The tense atmosphere in gulf countries coupled with the inescapable pressure to send home money serves as a fertile ground for symptoms of mental illness to explode," says Dr Shakya.

No check up before flying abroad

It is mandatory for migrant workers to obtain fitness certificates from licensed medical institutes before flying overseas. However, as far as foreign employment is concerned, fitness implies only physical health.

The government has not made mental health check-up mandatory so far. And, even if workers are already aware of their mental problems, they try to hide it for fear of being ineligible to go abroad. Such workers are more prone to develop mental problems while working abroad.

Psychiatrists say understanding the mother tongue and cultural values of mentally ill persons is important to be able to treat them properly. Unfortunately, Nepali migrant workers are unlikely to receive proper treatment if they develop mental illness while working abroad because of their inability to express what they think or feel to a foreign psychiatrist. So, the only option they have is returning home.

"There is a way to address this problem to some extent," says Dr Shakya. "The government can depute a couple of psychiatrists in some of our embassies in the gulf region. If not, we can also counsel mentally-ill migrant workers using telemedicine technology."

Published on: 26 March 2011 | Republica